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Coronary Angioplasty
Book Reviews Noninvasive Cardiac Imaging: Recent De velopments, edited by Richard S. Meltzer, Zvi Vered, and Henry N. Neufeld, 376 pp, with illus, $75, Mount Kisco, New York, Futura Pub lishing Company, 1988 This book is dedicated to the memory of one of its editors, Henry N. Neufeld, M.D. Professor Neufeld was a distinguished cardiologist and an inspiring teacher who died between the comple tion of the text and its publication. The goal of the book was to provide an overview of the new and diverse field of noninvasive car diac imaging. The word "noninvasive" has had to be redefined somewhat to accommodate the in jection of radioactive and contrast material and the swallowing of a probe (for transesophageal echocardiography). This change in definition does not affect the concept that separates these techniques from those of the invasive cardiac laboratory. The various techniques are reviewed separately in the book. The greatest space and most com plete treatment are granted to the oldest modal ity, echocardiography. This technique is covered in a fresh and exciting manner, with emphasis on new and important developments in echo cardiography rather than simply repeating the information available in standard textbooks. The clear presentation of quantification with use of standard echocardiographic and Doppler tech niques should stimulate laboratories to increase their quantitative reporting. The chapter on trans esophageal echocardiography seems to have been completed before some of the recent developments in equipment and technique, but these advances were, for the most part, anticipated in the text. Importantly, the authors recognized the role of transesophageal echocardiography in operating room monitoring. The chapter on radionuclide cardioangiography is clearly and positively written. This chapter satis fies the overview format by providing enough information to kindle the interest of an individual or a beginning group. Subsequent chapters provide specific informa tion on the imaging of thrombi with use of tagged platelets, positron emission tomography of the myocardium, digital subtraction angiography, Mayo Clin Proc 64:377-384,1989
and cardiac magnetic resonance imaging. An interesting chapter considers the interaction of echocardiography with the new imaging modal ities, a subject that is discussed in regard to many clinical settings. The final chapter addresses sys tolic time intervals and external pulse recordings. This is a delightful book about an engaging topic. It is well written and offers new informa tion on some well-known subjects. The amount of information in each chapter is sufficient to illuminate the topic but is not exhaustive. The reference lists at the end of each chapter are extensive and as up-to-date as possible in consid eration of the time restraints imposed by book publishing. This book will be of interest to many readers: those involved in one type of cardiac imaging who should know more about the other types, beginning cardiologists and trainees, and those who are establishing a cardiology department or are working in a small clinic or in facilities in which it is necessary to choose carefully among diagnostic modalities because of limited funds. John A. Callahan, M.D. Division of Cardiology and Internal Medicine
Coronary Angioplasty (Cardiovascular Clinics, Vol 19, No. 2), edited by Sheldon Goldberg, 285 pp, with illus, $66, Philadelphia, F. A. Davis Company, 1988 Publishing an ongoing series of books is a trying business. The tasks of finding willing authors, attractive topics, and sufficient paying readers are significant challenges. Such problems can be overcome, however, as evidenced by Albert Brest and the medical publisher F. A. Davis Company, now in their 19th year of publishing the Cardio vascular Clinics series. The latest volume, Coronary Angioplasty, meets the series' usual high standards. The volume editor, Dr. Sheldon Goldberg, has brought to gether a most capable team of North American authors from 12 different medical centers. These experienced practitioners of percutaneous trans377
378
BOOK REVIEWS
luminal coronary angioplasty share their per sonal experience with the readers and thoroughly discuss most of the important issues in angio plasty practice. In some aspects, the practice of coronary angio plasty has matured to the point that a fair con sensus has been reached and the approaches of various centers do not differ significantly. It is now reasonable to make broad statements on practice issues—such as the recommendations of the American Heart Association/American Col lege of Cardiology on the indications for angio plasty. In other aspects, however, a lack of de velopment within the specialty is evident—for example in understanding the biologic processes of restenosis and in devising effective alternative techniques, especially for the treatment of diffuse disease and occluded segments. Perhaps under standably, this book does justice to areas of agreement but does not critically address areas of uncertainty. The 15 chapters are integrated into three parts. The first section, devoted to the performance of angioplasty, contains an excellent contribution on the adjunctive use of drug therapy with bal loon angioplasty. This subject has not been well addressed in other books. The chapter on tech niques includes a discussion of recommended technical approaches and a table of most of the currently used catheter models. Although some of the technical recommendations are open to debate (for example, the routine use of a right ventricular pacing catheter), the authors basi cally provide clear statements of current practice. The second section deals with angioplasty in specific patient populations. The discussions in clude its use in multivessel coronary disease, after bypass graft procedures, in coronary occlu sion, and in patients who are at high risk or have vasospastic angina. The section also contains an excellently thought-out chapter on the use of balloon angioplasty in patients with unstable angina and acute myocardial infarction. In view of the rapid advances in this field, it is not surprising that recent knowledge on thrombolytic regimens is not included. The section does con tain a chapter on laser thermal angioplasty (socalled hot tip laser). Currently, experience with this approach in patients with coronary artery disease is limited, and the authors missed a good opportunity to discuss other laser approaches and alternative interventional techniques such as
Mayo Clin Proc, March 1989, Vol 64
the clinical use of intracoronary stents, an area that has not been sufficiently addressed in the literature. The final section of the book addresses com plications and clinical results of the procedure. Although I agreed with the presentation in general, I found the approach on the relative considerations for bypass grafting and percu taneous transluminal coronary angioplasty to be unduly conservative and favoring surgical treat ment more than might be warranted. The sur geons who wrote this chapter did not accurately represent the uncertainty that currently exists in regard to the relative advantages of these two complementary revascularization techniques. The illustrations are of good quality, especially the reproductions of angiograms—an important feature in a book on interventional vascular tech niques. In addition, readers will find the layout of the book convenient. For those who want a summary of the current status of coronary angioplasty practice, this book is most recommendable. The hunger for knowl edge in this area is so great that this comprehen sive, yet compact, volume will be another "winner" for an already successful series. Ronald E. Vlietstra, M.B.,Ch.B. Division of Cardiovascular Diseases and Internal Medicine
Vulvovaginal Candidosis: Theory and Prac tice, by Werner Mendling, 171 pp, with illus, $21.90, New York, Springer-Verlag, 1988 This textbook was written and published in the Federal Republic of Germany. The format of the book is interesting in that it is divided into three distinct sections. The first section of the book consists of nine chapters. Indeed, the entire text of the book is incorporated into these nine chapters, which con stitute the first 52 pages of the textbook. The text is devoted to the incidence of yeast infections in humans. The chapter on genital colonization of the female reproductive tract is an excellent re view of the various yeast organisms found in this anatomic area. Another chapter describes yeast infections during pregnancy and includes an in teresting section on neonatal mycoses. Other chapters discuss the clinical signs and symptoms
and cardiac magnetic resonance imaging. An interesting chapter considers the interaction of echocardiography with the new imaging modal ities, a subject that is discussed in regard to many clinical settings. The final chapter addresses sys tolic time intervals and external pulse recordings. This is a delightful book about an engaging topic. It is well written and offers new informa tion on some well-known subjects. The amount of information in each chapter is sufficient to illuminate the topic but is not exhaustive. The reference lists at the end of each chapter are extensive and as up-to-date as possible in consid eration of the time restraints imposed by book publishing. This book will be of interest to many readers: those involved in one type of cardiac imaging who should know more about the other types, beginning cardiologists and trainees, and those who are establishing a cardiology department or are working in a small clinic or in facilities in which it is necessary to choose carefully among diagnostic modalities because of limited funds. John A. Callahan, M.D. Division of Cardiology and Internal Medicine
Coronary Angioplasty (Cardiovascular Clinics, Vol 19, No. 2), edited by Sheldon Goldberg, 285 pp, with illus, $66, Philadelphia, F. A. Davis Company, 1988 Publishing an ongoing series of books is a trying business. The tasks of finding willing authors, attractive topics, and sufficient paying readers are significant challenges. Such problems can be overcome, however, as evidenced by Albert Brest and the medical publisher F. A. Davis Company, now in their 19th year of publishing the Cardio vascular Clinics series. The latest volume, Coronary Angioplasty, meets the series' usual high standards. The volume editor, Dr. Sheldon Goldberg, has brought to gether a most capable team of North American authors from 12 different medical centers. These experienced practitioners of percutaneous trans377
378
BOOK REVIEWS
luminal coronary angioplasty share their per sonal experience with the readers and thoroughly discuss most of the important issues in angio plasty practice. In some aspects, the practice of coronary angio plasty has matured to the point that a fair con sensus has been reached and the approaches of various centers do not differ significantly. It is now reasonable to make broad statements on practice issues—such as the recommendations of the American Heart Association/American Col lege of Cardiology on the indications for angio plasty. In other aspects, however, a lack of de velopment within the specialty is evident—for example in understanding the biologic processes of restenosis and in devising effective alternative techniques, especially for the treatment of diffuse disease and occluded segments. Perhaps under standably, this book does justice to areas of agreement but does not critically address areas of uncertainty. The 15 chapters are integrated into three parts. The first section, devoted to the performance of angioplasty, contains an excellent contribution on the adjunctive use of drug therapy with bal loon angioplasty. This subject has not been well addressed in other books. The chapter on tech niques includes a discussion of recommended technical approaches and a table of most of the currently used catheter models. Although some of the technical recommendations are open to debate (for example, the routine use of a right ventricular pacing catheter), the authors basi cally provide clear statements of current practice. The second section deals with angioplasty in specific patient populations. The discussions in clude its use in multivessel coronary disease, after bypass graft procedures, in coronary occlu sion, and in patients who are at high risk or have vasospastic angina. The section also contains an excellently thought-out chapter on the use of balloon angioplasty in patients with unstable angina and acute myocardial infarction. In view of the rapid advances in this field, it is not surprising that recent knowledge on thrombolytic regimens is not included. The section does con tain a chapter on laser thermal angioplasty (socalled hot tip laser). Currently, experience with this approach in patients with coronary artery disease is limited, and the authors missed a good opportunity to discuss other laser approaches and alternative interventional techniques such as
Mayo Clin Proc, March 1989, Vol 64
the clinical use of intracoronary stents, an area that has not been sufficiently addressed in the literature. The final section of the book addresses com plications and clinical results of the procedure. Although I agreed with the presentation in general, I found the approach on the relative considerations for bypass grafting and percu taneous transluminal coronary angioplasty to be unduly conservative and favoring surgical treat ment more than might be warranted. The sur geons who wrote this chapter did not accurately represent the uncertainty that currently exists in regard to the relative advantages of these two complementary revascularization techniques. The illustrations are of good quality, especially the reproductions of angiograms—an important feature in a book on interventional vascular tech niques. In addition, readers will find the layout of the book convenient. For those who want a summary of the current status of coronary angioplasty practice, this book is most recommendable. The hunger for knowl edge in this area is so great that this comprehen sive, yet compact, volume will be another "winner" for an already successful series. Ronald E. Vlietstra, M.B.,Ch.B. Division of Cardiovascular Diseases and Internal Medicine
Vulvovaginal Candidosis: Theory and Prac tice, by Werner Mendling, 171 pp, with illus, $21.90, New York, Springer-Verlag, 1988 This textbook was written and published in the Federal Republic of Germany. The format of the book is interesting in that it is divided into three distinct sections. The first section of the book consists of nine chapters. Indeed, the entire text of the book is incorporated into these nine chapters, which con stitute the first 52 pages of the textbook. The text is devoted to the incidence of yeast infections in humans. The chapter on genital colonization of the female reproductive tract is an excellent re view of the various yeast organisms found in this anatomic area. Another chapter describes yeast infections during pregnancy and includes an in teresting section on neonatal mycoses. Other chapters discuss the clinical signs and symptoms