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Extracorporeal Circulation for Open-Heart Surgery
Review of Recent Books tion simply did not come to mind. This beautiful three-volume text was written to clarify the essential diagnostic features of surgical disorders. All but 3 of the 23 contributors are from the faculty of The Johns Hopkins University School of Medicine. Disorders usually treated by general surgeons are given detailed attention, whereas those usually managed by specialty surgeons are described more generally. Only 15% of this book covers thoracic diseases. These four chapters, all in Volume I, include lungs, pleura and chest wall; lung disease in children; and adult heart disease. Special mention must be given to the comprehensive chapter on lesions of the esophagus written by the editor. Despite a lack of depth and detail and a sketchy bibliography, this section represents a useful summation of surgical disorders of the esophagus. This text should find its greatest usefulness among general surgeons, residents, and medical students-the audience toward whom this extensive work was primarily directed.
West Covina, Calif.
EXTKACOKPOKEAL CIRCULATION FOR OPEN-HEART SURGERY. By E . Converse Peirce, II, M.D. Charles C Thomas, Springfield, Ill., 1969. 117 pp., 28 illus., $9.50.
Reviewed by Watts R. Webb, M.D. This book presents a short, concise, and readable survey of the present status of extracorporeal circulation for open-heart surgery. As indicated by the title, the scope of the book is strictly limited to short-term extracorporeal circulation and does not deal with assisted circulation or long-term cardiopulmonary bypass procedures. The book is organized into five chapters which discuss historical development, pathophysiology, equipment, adjunct techniques, and special techniques such as hypothermia and hyperbaria. The text is intended primarily as a practical guide to current practices; yet it also presents newer research findings with pertinent background material in basic pathophysiology. The chapter on pathophysiology considers not only the normal physiology that must be replaced by extracorporeal circulation, but also the alterations that occur in blood-flow distribution, metabolism, blood-cell damage, protein denaturation, and disturbances of coagulation. In addition, it presents a brief survey of the effects on specific organs, including the heart, lungs, brain, and kidneys. The section on pumps is perhaps undesirably brief, while the gas-exchange devices are discussed more completely. A disproportionate amount of space is devoted to membrane lungs; however, this is an area in which the author has had considerable experience. T h e bubble oxygenators are dismissed with greater abandon than their present widespread utilization deserves. T h e subsidiary equipment such as cannulas, tubing, heat exchangers, reservoirs, control devices, and circuits is well presented. T h e advantages and disadvantages of hemodilution and of ACD blood in contrast to heparinized blood are presented, as are the problems of coagulation
Reuiew of Recent Books
and acid-base management. The principles, advantages, and limitations of hypothermia with and without perfusion are perhaps given undue emphasis. I n general the book is very readable. The illustrations might have been better chosen; many are inadequately explained and unduly complicated for the scope of the book. Overall, this is an excellent book, particularly for trainees in cardiovascular surgery who have just begun to study the principles and practice of extracorporeal circulation. Dnllas
390
THE ANNALS OF THORACIC SURGERY
West Covina, Calif.
EXTKACOKPOKEAL CIRCULATION FOR OPEN-HEART SURGERY. By E . Converse Peirce, II, M.D. Charles C Thomas, Springfield, Ill., 1969. 117 pp., 28 illus., $9.50.
Reviewed by Watts R. Webb, M.D. This book presents a short, concise, and readable survey of the present status of extracorporeal circulation for open-heart surgery. As indicated by the title, the scope of the book is strictly limited to short-term extracorporeal circulation and does not deal with assisted circulation or long-term cardiopulmonary bypass procedures. The book is organized into five chapters which discuss historical development, pathophysiology, equipment, adjunct techniques, and special techniques such as hypothermia and hyperbaria. The text is intended primarily as a practical guide to current practices; yet it also presents newer research findings with pertinent background material in basic pathophysiology. The chapter on pathophysiology considers not only the normal physiology that must be replaced by extracorporeal circulation, but also the alterations that occur in blood-flow distribution, metabolism, blood-cell damage, protein denaturation, and disturbances of coagulation. In addition, it presents a brief survey of the effects on specific organs, including the heart, lungs, brain, and kidneys. The section on pumps is perhaps undesirably brief, while the gas-exchange devices are discussed more completely. A disproportionate amount of space is devoted to membrane lungs; however, this is an area in which the author has had considerable experience. T h e bubble oxygenators are dismissed with greater abandon than their present widespread utilization deserves. T h e subsidiary equipment such as cannulas, tubing, heat exchangers, reservoirs, control devices, and circuits is well presented. T h e advantages and disadvantages of hemodilution and of ACD blood in contrast to heparinized blood are presented, as are the problems of coagulation
Reuiew of Recent Books
and acid-base management. The principles, advantages, and limitations of hypothermia with and without perfusion are perhaps given undue emphasis. I n general the book is very readable. The illustrations might have been better chosen; many are inadequately explained and unduly complicated for the scope of the book. Overall, this is an excellent book, particularly for trainees in cardiovascular surgery who have just begun to study the principles and practice of extracorporeal circulation. Dnllas
390
THE ANNALS OF THORACIC SURGERY