Interventional and surgical cardiovascular pathology

Interventional and surgical cardiovascular pathology

Volume 21, No. 5 [MAY 1990) HUMAN PATHOLOGY chapter is also extensively illustrated with photographs that are virtually of no use to anyone: Fig 2.6...

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Volume 21, No. 5 [MAY 1990)

HUMAN PATHOLOGY

chapter is also extensively illustrated with photographs that are virtually of no use to anyone: Fig 2.6 shows the biopsy team chatting with the patient, Fig 2.9 documents the patient on a litter being pushed through the hospital corridors, Figs 2.10 and 2.11 depict the patient getting a CT scan, Fig 2.29 demonstrates the correct method for placing a bandage on the scalp of the patient post biopsy, and Fig 2.14 (the reviewers’ favorite) shows the surgeon reading a computer printout prior to biopsy. All of these are halfpage photographs! This feature, plus the fact that the authors and publishers have decided to include exactly the same photograph of the tips of the stereotaxic instruments in two chapters (Figs 1.15 and 2.16), give the impression that the publication may have been a “quick job.” The overall impression of this book is favorable, but this is based on its value to pathologists. Those required to interpret stereotaxic biopsies, and especially those who have not been introduced to the smear as a diagnostic tool, will find it very helpful. If this text does not find a permanent place on pathologists’ bookshelves, it certainly will on their coffee tables. WILLIAM F. HICKEY, MD, and MICHAEL C. MOLLESTON, MD, Departments of Pathology (Neuropathology) and Neurosurgery, Washington University School of Medicine, St Louis, MO. Interventional and Surgical Cardiovascular Pathology. Frederick J. Schoen, Philadelphia, PA, WB Saunders, 432 pages, $75. Interventional and Surgical Cardiovascular Pathology is a single-authored text (with the exception of one chapter) that addresses clinicopathologic and pathophysiologic aspects of cardiovascular pathology. While traditional topics are covered, such as ischemic, valvular, and congenital heart disease, more contemporary subjects, such as transplantation, mechanical devices, and prostheses, are emphasized as well as other newer therapies used in the management of heart disease (laser and balloon angioplasty, ablation therapy). The emphasis is predominantly on pathology and pathophysiologic correlations, and the book provides up to date information on topics in cardiovascular pathology that, until now, have been difficult to find in a single source. Other subjects specifically address complications of open heart surgery, hemostasis (emphasizing the relationship to acute coronary syndromes), pathology of ischemic heart disease treatment, endomyocardial biopsy and its role in diagnosis and management, pathology of prosthetic grafts, and there is an excellent chapter contributed by William D. Edwards, MD, concerning the pathology associated with treatment of congenital heart disease. Of particular impact is an appendix that describes techniques for the pathologic analysis of heart disease as well as techniques that are potentially useful in the research arena. The illustrations are excellent, and the book contains useful schematic drawings that amplify and clarify concepts. Each chapter is well referenced, and the author has managed to keep abreast of the exponential proliferation of papers and reviews that have characterized cardiovascular pathology in recent years. The last decade has seen astounding advances in the evolution of the diagnosis and treatment of cardiovascular diseases. Implicit in this evolution has been the role of cardiovascular pathology as an important contributor toward understanding the mechanisms and complications that underlie these newer therapies. For that reason, at least half a dozen books have been published in the last 5 years that deal exclusively with cardiovascular pathology, and pathologists and clinicians have organized a “society for cardio-

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vascular pathology” to exchange experience and ideas and stay informed of new developments. Why, then, do we need yet another book on cardiovascular pathology, and who would benefit from such a compilation? Interoentional and Surgical Cardiovascular Pathology not only fills a void that has been present with respect to contemporary cardiovascular pathology, but also approaches more conventional concepts in a manner usually not found in most pathology texts. The author makes clinicopathologic and pathophysiologic correlations that are often ignored by pathologists, but which are essential if one is to understand cardiovascular pathology from other than a “static” perspective. While this aspect makes it attractive to surgical pathologists and researchers, this book should also be useful to clinical practitioners. Dr Schoen is a well-recognized cardiovascular pathologist and investigator whose background makes him uniquely qualified to write and present his experience in interventional cardiac surgical pathology, particularly with respect to prostheses and devices. While one might expect some bias in a largely single-authored book, if there is such a bias in this case, it is toward areas that have traditionally not been addressed by others; this adds to the book’s value. While the author states that this book is largely oriented toward cardiovascular clinicians and clinical investigators, it seems to be invaluable to any practicing anatomic pathologist confronted with a problem in cardiovascular disease, particularly as it relates to the specific topics listed above (prostheses, newer modalities of treatment, devices). Additionally, for those who are interested in the latest concepts of traditional cardiovascular pathology, this book is likewise an asset. For example, I have used Interventional and Surgical Cardiovascular Pathology as a reference for preparing lectures in heart disease for medical students, as well as a source for conferences given to cardiologists on prosthetic heart valves. This book should be in any pathology laboratory that is called on to provide service to patients on cardiology or cardiac surgery services, particularly in centers in which contemporary therapies are being practiced. It should also be available to practicing pathologists or pathologists-in-training who want to go beyond a simple understanding of pathologic anatomy and gain insight into the mechanisms of cardiovascular disease. One hopes that, as cardiovascular medicine continues to advance, revisions will be forthcoming that will enable Znteroentional and Surgical Cardiovascular Pathology to remain a valuable asset. JAMES B. ATKINSON, MD, PhD, Assistant Professor, Pathology, Vanderbilt University, Nashville, TN. Pathology and Pathophysiology of AIDS and HIV Related Diseases. S. J. Harawi and C. J. O’Hara (eds), St Louis, MO, Mosby, 1989, 512 pages, $89. The AIDS epidemic has taken a grip on the publishing industry; in the last 2 to 3 years, there have been a number of books devoted to the biology of HIV and its many clinical manifestations. Some of these books have been general and textbook in form, whereas others have been devoted to specific aspects of HIV infection, often emanating from specific scientific meetings. Among this growing number of published books there have been a few directed specifically at pathologists, including an excellent atlas by Macher and the recent one by Ioachim. A number of publishers have already announced in-preparation books specifically for pathologists. The obvious problem for a textbook is that, by its nature, it cannot include the most recent literature. In the case of HIV infection and AIDS, that literature is growing