Cardiac Assist Devices
Daniel J. Goldstein, ed.
444 pp. New York, NY: Futura Publishing Co; 2000. $115.00. ISBN 0-87993-449-2.
During the past 2 decades, ventricular assist devices (VADs) have evolved from rare, futuristic machines into relatively familiar systems that are increasingly encountered outside the hospital setting. So far, these pumps have been used primarily for treating postcardiotomy cardiogenic shock or for bridging to transplantation in patients with end-stage heart failure. As of July 2000, long-term VADs had been implanted in at least 4000 transplant candidates worldwide. Because of the shortage of donor hearts, VADs are now being evaluated as bridges to recovery or alternatives to transplantation in selected patients. Moreover, several total artificial hearts will soon undergo clinical trials aimed at permanent heart replacement. As the general population continues to age and assist devices continue to evolve, these pumps will become increasingly prevalent in our society.
Cardiac assist technology is advancing so rapidly that it is hard even for specialists to keep abreast of the latest developments. So far, the main sources of information about these devices have been journal articles and symposium proceedings. Although this information is abundant, it is not always easy to interpret or put into perspective. Also, most reports focus on a single type of VAD or total artificial heart, so readers may lack a sufficiently broad context to assess the wide array of available systems. Currently, the literature includes only a handful of books on cardiac assistance, including the volume reviewed here; most of these books were written in the 1980s or early 1990s and are no longer up-to-date. Cardiac Assist Devices not only fills a critical gap but fills it superbly and elegantly. Drs Goldstein and Oz, of New York’s Columbia Presbyterian Medical Center, have done an excellent job in organizing and editing this volume.
Written by the world’s foremost experts in cardiac substitution and replacement, Cardiac Assist Devices includes 30 chapters arranged into 3 sections: (1) General Aspects, which covers history, physiology, device selection, options for pediatric patients, anesthesia, perioperative bleeding, right-sided failure, arrhythmias, postoperative hypotension, recovery, exercise, outpatient therapy, rehabilitation, quality of life, economic considerations, and immunobiology; (2) Survey of Available Devices, which discusses device description, implantation, limitations, results and outcomes, and future directions; and (3) Future Devices, which describes the most promising pumps undergoing clinical evaluation.
Cardiac Assist Devices provides a wealth of practical, up-to-date information that is applicable to a wide range of clinical situations. Moreover, as Senator Bill Frist, MD, points out in the foreword, the book also chronicles the evolution of a thriving medical industry and presents insights into the innovative processes that characterize modern biomedicine. The book is nicely designed, highly readable, and stylistically consistent, with thorough, well-balanced presentations. The text is supplemented by adequate references, clear illustrations, and an excellent index.
I recommend Cardiac Assist Devices for cardiovascular surgeons, cardiologists, cardiac nurses, and all other clinicians who work with heart failure patients. It should also be valuable to cardiovascular researchers, biomedical engineers, and medical historians and policymakers. As the best current book on cardiac assistance, it is the benchmark against which future volumes in this field will be measured.
Denton A. Cooley, MD
Texas Heart Institute
- Copyright © 2001 by American Heart Association