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Clinical transesophageal echocardiography
JOURNAL OF VASCULAR SURGERY Volume 18, Number 3
rion of outflow velocity in the superficial femoral vein seems to be a useful screening tool in all patients who undergo operation on superficial veins. A brief but critical review of current tests used for venous evaluation is presented, including photoplethysmography, light reflection rheography, and air plethysmography. Chapter 10, written by the first author, discusses quantitative measurement of venous incompetence, as promised in the rifle. This chapter reflects a rich experience, discussing data on 200 patients investigated with segmental venous duplex scanning. The degree of reflux was quantitated by the level of segments involved. A seemingly weak point in the proposed classification is that incompetence of a deep vein segment is considered equivalent to incompetence of a segment of a superficial vein. Although referenced, the author's important work on quantitative evaluation of venous reflux by measuring valve closure time or peak reflux velocity is, unfortunately, entirely omitted from this chapter. The most important critique on quantitative evaluation of venous reflux is given in the superbly written overview of Dr. Bergan: "There is a disappointing lack of correlation of quantitation of reflux with clinical grades of venous stasis severity." This 106-page hard-bound book is printed on highquality paper. Those who would spend $90 to purchase this expensive book with the intention of getting the final word on noninvasive venous evaluation will be disappointed. Those who would like to get the latest information on the use of duplex scanning in venous disease, however, will find the book useful. The section about segmental duplex reflux examination and color-flow imaging is well illustrated, enabling physicians and technicians to learn this technique with ease. This and the final chapter on evaluation and management of superficial venous disease alone make the book outstanding by themselves. I recommend it to those physicians and technicians who are involved in the diagnosis or treatment of venous disease. Peter Gloviczki, A4D Mayo Clinic Rochester, Minn.
Management and treatment o f benign cutaneous vascniar lesions
Oon Tian Tan, Philadelphia, 1992, Lea & Febiger, 192 pages, $95. The opening chapter on the dassification of vascular birthmarks is another excellent contribution by John B. Mulliken on the embryology and pathology of a variety of vascular abnormalities. The quality color photographs enhance the clear and compact text. A number of chapters describe the use of laser therapy for the treatment of various cutaneous lesions and will be of particular value to those involved in this type of therapy. The chapter on the treatment of hemangiomas of infancy covers a variety of therapies, including steroids, embolization treatment of giant cutaneous hemangiomas, and surgical excision. The chapter on lower extremity venous
Book reviews
549
lesions provides helpful information on the use of sclerotherapy and laser therapy for these conditions. Perhaps most refreshing and interesting is a contribution rifled "Living with a Port-Wine Birthmark." Written by Pine Clementina Masciarelli, a health care worker who has an extensive extremity and chest port-wine stain, this personal account enlightens what is otherwise a traditional academic text. Patients with benign vascular cutaneous lesions such as hemangiomas, port-wine stains, and telangiectasias are often referred to vascular surgeons, even though there is very little relationship between these conditions and the vascular operations we are trained to perform. For those interested in expanding their understanding of the embryology, the pathology, the natural history, and the current treatment of these lesions, this 200-page, well-illustrated, and well-written text will be an excellent addition to your reference library. Thomas S. Riles, M D New York University Hospital New York
Clinical transesophageal echocardiography Howard C. Dittrich, St. Louis, 1992, Mosby-Year Book, Inc., 178 pages, $95. As the applications of transesophageal echocardiography (TEE) have expanded, so has the range of physician interest. This multiauthor text uses the expertise of some of the most sophisticated practitioners of this art to elucidate the basics of this new and rapidly developing field. A score of cardiologists and two anesthesiologists define the techniques, instrumentation, indications, and clinical results of TEE in is the first comprehensive text in this field. Presented in four sections, this book is intended primarily for persons interested in the clinical applications of TEE. The first section deals with the technical aspects of TEE, including clinical indications, pertinent techniques, and basic anatomy and image orientation. The second chapter in particular is excellent, detailing specifics of probe positioning and image orientation that will serve as an invaluable reference for the many applications of TEE. The second section focuses on pathologic conditions and associated TEE findings. Repetition here makes these chapters somewhat tedious, although they do reflect the state of the art. Chapters on cardiac valvular abnormalities, cardiac masses, disorders of the aorta, and congenital heart disease will be of interest primarily to cardiologists. The third section on clinical applications in the operating room and intensive care units contains material of interest to both surgeons and anesthesiologists. The role of TEE in intraoperative monitoring has evolved quite rapidly and is now an accepted monitoring device for many cardiac and vascular procedures. The portions dealing specifically with qualitative estimates of left ventricular filling and global ejection are superb, detailing how TEE may accurately guide use of fluid and inotropes duringrapid
550 Books received
rapid changes of preload and afterload. This section also emphasizes the increased sensitivity of segmental wall motion abnormalities to myocardial ischemia, with a caveat that subtle changes may go undetected by the less-practiced eye. The very significant limitations of TEE in this area are appropriately emphasized, importantly tempering the enthusiasm in the current literature. The final chapter in this section, dealing with its use in the intensive care unit, contains a wealth of information for diagnostic methods for acutely ill patients with a variety of pathologic conditions. This and the preceding chapter will undoubtedly be of greatest interest to surgeons, anesthesiologists, and others involved in intensive care.
JOURNALOF VASCULARSURGERY September 1993
The fourth section deals with future advances and includes some advances already achieved, including biplane and mukiplane imaging and biplanar color-flow duplex imaging. Further opportunities include increasing miniaturization, steerability, intravascular and intracardiac applications, and three-dimensional reconstruction. It is a fitting conclusion to a well-conceived book that is highly recommended for cardiologists, cardiac surgeons, and anesthesiologists. For vascular surgeons its value may be more modest. 1L ScottMitchell, MD Stanford University Center Stanford, Calif.
BOOKS RECEIVED The receipt of the books listed below is acknowledged. This listing is regarded as appropriate return for the courtesy of the sender. The books that are ofparticular interest will be reviewed and the review published as space permits.
Quantitative measurement of venous incompetence (medical intelligence unit series) Paul S. van Bemmelen, John J. Bergan, Austin, 1992, R.G. Landes Company (distributed by CRC Press, Inc., Boca Raton, Fla.), 106 pages, $89.98. Endovascniar surgery, 2nd edition Samuel S. Ahn, Wesley S. Moore, Philadelphia, 1992, W.B. Sannders Company, 592 pages, $135. Diagnostic vascular ultrasound K. H. Labs, K. A. J~iger, D. E. Fitzgerald, J. B. Woodcock, D. Neuerburg-Heusler, London, 1992, Edward Arnold, 335 pages, 120.00£. Bradford Hill's principles of medical statistics, 12th edition Austin Bradford Hill, I. D. Hill, London, 1991, Edward Arnold, 339 pages, 13.99£. Ci~lian vascular trauma D. Preston Flanigan, Philadelphia, 1992, Lea & Febiger, 490 pages, $98.50. The search for Christian doppler Alec Eden, Wien, 1992, Springer-Verlag, 136 pages, $43. Current therapy of trauma, 3rd edition Donald D. Trunkey, Frank R. Lewis, Jr., Philadelphia (St. Louis), 1991, B.C. Decker (distributed by Mosby-Year Book, Inc.), 352 pages, $67. Peripheral vascular sonography: A practical guide Joseph F. Polak, Baltimore, 1992, Williams & Wilkins, 384 pages, $75. Cellular calcium: A practical approach (the practical approach series) J. G. McCormack, P. H. Cobbold, Oxford, 1991, IRL Press (Oxford University Press), 418 pages, $50.
Prevention of coronary heart disease Ira S. Ockene, Judith K. Ockene, Boston, 1992, Little, Brown & Company, 605 pages, $69.50. Manual of clinical problems in cardiology, 4th edition L. David Hillis, Richard A. Lange, Peter J. Wells, Michael D. Winniford, Boston, 1992, Little, Brown & Company, 553 pages, $28. Complications in thoracic surgery: Recognition and management Walter G. Wolfe, MD, St. Louis, 1992, Mosby-Year Book, Inc., 319 pages, $89. Critical care, 2nd edition Joseph M. Civetta, Robert W. Taylor, Robert R. Kirby, Philadelphia, 1992, J.B. Lippincott, 2,048 pages, $165. Lasers in plastic surgery and dermatology Bruce M. Achaner, Victoria M. Vander Kam, Michael W. Berns, New York, 1992, Thieme Medical Publishers, Inc., 206 pages, $89. Academic environment: A handbook for evaluating faculty employment opportunities Karl W. Lanks, Brooklyn, 1990, Faculty Press, 127 pages, $12.95. Nutrition and cardiovascular risks J. C. Somogyi, Gy. Biro, D. Hotzel, Basel, 1992, Karger, 154 pages, $134.50. "Redo" vascular surgery: Renal, aorto-iliac and infrainguinal areas (Serono Symposia Publications from Raven Press, volume 87) Carlo Spartera, Robert Courbier, Paolo Fiorani, Anthony M. Imparato, New York, 1992, Raven Press, 352 pages, $90.
rion of outflow velocity in the superficial femoral vein seems to be a useful screening tool in all patients who undergo operation on superficial veins. A brief but critical review of current tests used for venous evaluation is presented, including photoplethysmography, light reflection rheography, and air plethysmography. Chapter 10, written by the first author, discusses quantitative measurement of venous incompetence, as promised in the rifle. This chapter reflects a rich experience, discussing data on 200 patients investigated with segmental venous duplex scanning. The degree of reflux was quantitated by the level of segments involved. A seemingly weak point in the proposed classification is that incompetence of a deep vein segment is considered equivalent to incompetence of a segment of a superficial vein. Although referenced, the author's important work on quantitative evaluation of venous reflux by measuring valve closure time or peak reflux velocity is, unfortunately, entirely omitted from this chapter. The most important critique on quantitative evaluation of venous reflux is given in the superbly written overview of Dr. Bergan: "There is a disappointing lack of correlation of quantitation of reflux with clinical grades of venous stasis severity." This 106-page hard-bound book is printed on highquality paper. Those who would spend $90 to purchase this expensive book with the intention of getting the final word on noninvasive venous evaluation will be disappointed. Those who would like to get the latest information on the use of duplex scanning in venous disease, however, will find the book useful. The section about segmental duplex reflux examination and color-flow imaging is well illustrated, enabling physicians and technicians to learn this technique with ease. This and the final chapter on evaluation and management of superficial venous disease alone make the book outstanding by themselves. I recommend it to those physicians and technicians who are involved in the diagnosis or treatment of venous disease. Peter Gloviczki, A4D Mayo Clinic Rochester, Minn.
Management and treatment o f benign cutaneous vascniar lesions
Oon Tian Tan, Philadelphia, 1992, Lea & Febiger, 192 pages, $95. The opening chapter on the dassification of vascular birthmarks is another excellent contribution by John B. Mulliken on the embryology and pathology of a variety of vascular abnormalities. The quality color photographs enhance the clear and compact text. A number of chapters describe the use of laser therapy for the treatment of various cutaneous lesions and will be of particular value to those involved in this type of therapy. The chapter on the treatment of hemangiomas of infancy covers a variety of therapies, including steroids, embolization treatment of giant cutaneous hemangiomas, and surgical excision. The chapter on lower extremity venous
Book reviews
549
lesions provides helpful information on the use of sclerotherapy and laser therapy for these conditions. Perhaps most refreshing and interesting is a contribution rifled "Living with a Port-Wine Birthmark." Written by Pine Clementina Masciarelli, a health care worker who has an extensive extremity and chest port-wine stain, this personal account enlightens what is otherwise a traditional academic text. Patients with benign vascular cutaneous lesions such as hemangiomas, port-wine stains, and telangiectasias are often referred to vascular surgeons, even though there is very little relationship between these conditions and the vascular operations we are trained to perform. For those interested in expanding their understanding of the embryology, the pathology, the natural history, and the current treatment of these lesions, this 200-page, well-illustrated, and well-written text will be an excellent addition to your reference library. Thomas S. Riles, M D New York University Hospital New York
Clinical transesophageal echocardiography Howard C. Dittrich, St. Louis, 1992, Mosby-Year Book, Inc., 178 pages, $95. As the applications of transesophageal echocardiography (TEE) have expanded, so has the range of physician interest. This multiauthor text uses the expertise of some of the most sophisticated practitioners of this art to elucidate the basics of this new and rapidly developing field. A score of cardiologists and two anesthesiologists define the techniques, instrumentation, indications, and clinical results of TEE in is the first comprehensive text in this field. Presented in four sections, this book is intended primarily for persons interested in the clinical applications of TEE. The first section deals with the technical aspects of TEE, including clinical indications, pertinent techniques, and basic anatomy and image orientation. The second chapter in particular is excellent, detailing specifics of probe positioning and image orientation that will serve as an invaluable reference for the many applications of TEE. The second section focuses on pathologic conditions and associated TEE findings. Repetition here makes these chapters somewhat tedious, although they do reflect the state of the art. Chapters on cardiac valvular abnormalities, cardiac masses, disorders of the aorta, and congenital heart disease will be of interest primarily to cardiologists. The third section on clinical applications in the operating room and intensive care units contains material of interest to both surgeons and anesthesiologists. The role of TEE in intraoperative monitoring has evolved quite rapidly and is now an accepted monitoring device for many cardiac and vascular procedures. The portions dealing specifically with qualitative estimates of left ventricular filling and global ejection are superb, detailing how TEE may accurately guide use of fluid and inotropes duringrapid
550 Books received
rapid changes of preload and afterload. This section also emphasizes the increased sensitivity of segmental wall motion abnormalities to myocardial ischemia, with a caveat that subtle changes may go undetected by the less-practiced eye. The very significant limitations of TEE in this area are appropriately emphasized, importantly tempering the enthusiasm in the current literature. The final chapter in this section, dealing with its use in the intensive care unit, contains a wealth of information for diagnostic methods for acutely ill patients with a variety of pathologic conditions. This and the preceding chapter will undoubtedly be of greatest interest to surgeons, anesthesiologists, and others involved in intensive care.
JOURNALOF VASCULARSURGERY September 1993
The fourth section deals with future advances and includes some advances already achieved, including biplane and mukiplane imaging and biplanar color-flow duplex imaging. Further opportunities include increasing miniaturization, steerability, intravascular and intracardiac applications, and three-dimensional reconstruction. It is a fitting conclusion to a well-conceived book that is highly recommended for cardiologists, cardiac surgeons, and anesthesiologists. For vascular surgeons its value may be more modest. 1L ScottMitchell, MD Stanford University Center Stanford, Calif.
BOOKS RECEIVED The receipt of the books listed below is acknowledged. This listing is regarded as appropriate return for the courtesy of the sender. The books that are ofparticular interest will be reviewed and the review published as space permits.
Quantitative measurement of venous incompetence (medical intelligence unit series) Paul S. van Bemmelen, John J. Bergan, Austin, 1992, R.G. Landes Company (distributed by CRC Press, Inc., Boca Raton, Fla.), 106 pages, $89.98. Endovascniar surgery, 2nd edition Samuel S. Ahn, Wesley S. Moore, Philadelphia, 1992, W.B. Sannders Company, 592 pages, $135. Diagnostic vascular ultrasound K. H. Labs, K. A. J~iger, D. E. Fitzgerald, J. B. Woodcock, D. Neuerburg-Heusler, London, 1992, Edward Arnold, 335 pages, 120.00£. Bradford Hill's principles of medical statistics, 12th edition Austin Bradford Hill, I. D. Hill, London, 1991, Edward Arnold, 339 pages, 13.99£. Ci~lian vascular trauma D. Preston Flanigan, Philadelphia, 1992, Lea & Febiger, 490 pages, $98.50. The search for Christian doppler Alec Eden, Wien, 1992, Springer-Verlag, 136 pages, $43. Current therapy of trauma, 3rd edition Donald D. Trunkey, Frank R. Lewis, Jr., Philadelphia (St. Louis), 1991, B.C. Decker (distributed by Mosby-Year Book, Inc.), 352 pages, $67. Peripheral vascular sonography: A practical guide Joseph F. Polak, Baltimore, 1992, Williams & Wilkins, 384 pages, $75. Cellular calcium: A practical approach (the practical approach series) J. G. McCormack, P. H. Cobbold, Oxford, 1991, IRL Press (Oxford University Press), 418 pages, $50.
Prevention of coronary heart disease Ira S. Ockene, Judith K. Ockene, Boston, 1992, Little, Brown & Company, 605 pages, $69.50. Manual of clinical problems in cardiology, 4th edition L. David Hillis, Richard A. Lange, Peter J. Wells, Michael D. Winniford, Boston, 1992, Little, Brown & Company, 553 pages, $28. Complications in thoracic surgery: Recognition and management Walter G. Wolfe, MD, St. Louis, 1992, Mosby-Year Book, Inc., 319 pages, $89. Critical care, 2nd edition Joseph M. Civetta, Robert W. Taylor, Robert R. Kirby, Philadelphia, 1992, J.B. Lippincott, 2,048 pages, $165. Lasers in plastic surgery and dermatology Bruce M. Achaner, Victoria M. Vander Kam, Michael W. Berns, New York, 1992, Thieme Medical Publishers, Inc., 206 pages, $89. Academic environment: A handbook for evaluating faculty employment opportunities Karl W. Lanks, Brooklyn, 1990, Faculty Press, 127 pages, $12.95. Nutrition and cardiovascular risks J. C. Somogyi, Gy. Biro, D. Hotzel, Basel, 1992, Karger, 154 pages, $134.50. "Redo" vascular surgery: Renal, aorto-iliac and infrainguinal areas (Serono Symposia Publications from Raven Press, volume 87) Carlo Spartera, Robert Courbier, Paolo Fiorani, Anthony M. Imparato, New York, 1992, Raven Press, 352 pages, $90.