Moss and Adams’ Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adult, 6th Ed
Hugh D. Allen, ed
1632 pp. Baltimore, Md: Lippincott Williams & Wilkins; 2000. $269.00. ISBN 0-683-30742-8
Moss and Adams’ Heart Disease in Infants, Children, and Adolescents Including the Fetus and Young Adult is a longstanding and venerable resource for pediatric cardiology and congenital heart disease information. The new sixth edition arrived attractively and efficiently packaged in 2 volumes, and I placed it alongside the fifth edition, which was published in 1995, to help highlight the differences and the improved, updated sections. It looks like Lippincott has acquired Williams & Wilkins as part of the consolidation of the publications business, but there has certainly been no consolidation in the list of contributors to this expanded work.
Dr Hugh Allen has now become the chief editor; the other editors are Dr Howard Gutgesell, who has previously been involved, Dr Edward Clark, and Dr David Driscoll. Dr George Emmanouilides remains an honorary editor, which I think is appropriate and important. My copy of the first edition of this text, which was published in 1968 and is now all underlined with dog-eared pages and illegible side notes, is now elevated to my unreachable top shelf. The first edition, which was a tremendous resource for trainees, could actually be read cover to cover and studied, and Hugh Allen and I studied with it together when we were preparing to take our Boards in Pediatric Cardiology. A much bigger endeavor now is the update of Moss and Adams as a multiauthored text, which represents a major undertaking in recruitment, author retention, inspiration, and motivation, and I’m sure this group of editors invested the tremendous efforts to get it done. Of course, the price of a book never goes down. The fundamental question is, does the quality and timeliness of the content go up? Has the new material and the updates provided kept pace with the expansion of critical areas relating to pediatric cardiology and the diagnosis and treatment of congenital heart disease?
The first noticeable expansion is a new chapter on Molecular Determinants of Development by Drs Deepak Srivastava and Scott Baldwin, which is clearly written and elegantly illustrated. The Echocardiography chapter in the Diagnosis section has been completely rewritten and updated by Drs Thomas Kimball and Richard Meyer, but a separate chapter on Doppler Echocardiography shows little update. The chapters on fetal diagnosis and MRI have been substantially improved, and the MRI chapter was incorporated in a general chapter of advanced imaging techniques by Drs Frederick Long, Mark Smith, and Brent Adler. I enjoyed that one and admired the fact that the authors tried to teach about the physics underlying cardiac MRI, as opposed to just doing a picture show.
As one goes through this book, it is clear that some sections have not only just been reproduced, but that the illustration quality in them is not as good as the last edition. In some of the early sections on the pathology of the cardiovascular system, the exact same illustrations are still present, and a number of the roentgenograms, both in that chapter and in the chapter on chest x-rays, are underexposed and not as well reproduced. It is my understanding that these figures were to be adjusted in the printing process to make them easier to see than they were in the last edition.
The surgical chapters are very well done and informative. For instance, the chapter by Drs Richard Ohye and Edward Bove called “Current Topics in Congenital Heart Surgery” has clear and detailed topics in which it is easy to find the important, new areas of activity and progress in congenital heart surgery, an area of awesome advances that would have been pipe dreams 30 years ago. Unfortunately, when one carefully reexamines the interventional catheterization section, which was “Therapeutic Catheterization,” one discovers that it has been integrated into a general Cardiac Catheterization chapter, which is now written by Drs Nancy Bridges, Martin O’Laughlin, Charles Mullins, and Michael Freed, but it contains virtually the same material that was in it 5 years ago, including the references—despite the tremendous progress in this important area.
A new chapter on Coronary Artery Malformations by Dr Paul Matherne comes across very nicely, and there is great new material on electrophysiological diagnosis and therapy, including a discussion on Sudden Death by Dr Michael Silka. New horizons are opened with a molecular emphasis in the chapter on Pulmonary Hypertension by Dr Marlene Rabinovitch, as well as in the discussion of Myocarditis by Dr Jeff Towbin. The quality of both of these chapters are what one should expect from these individuals; they are meticulous and comprehensive teachers. There is not very much new information in the Kawasaki Disease chapter, or on dilated “congestive” cardiomyopathy and, sadly, there is little in the way of discussion of the overall issue of heart failure and pharmacological management of the failing ventricle. Also, there is very little discussion about diastolic function, which is key in understanding the natural history of post-Fontan patients. The sixth edition also lacks specific discussion of the problems that cover the Fontan circulation.
All in all, I think the addition of the new material and new authors by this new editorial group headed by Hugh Allen has improved and strengthened the wealth of information that Moss and Adams has come to represent as a resource, but the lack of revision or updating of many of the chapters and the retention of images that theoretically could have been retired 2 editions ago is less than ideal for this sixth edition. The nicest, most colorful material seems to occupy the first couple of chapters in the 2 volumes; I guess that is so it will be noticed.
One wonders, in the electronic era, why a somewhat expensive textbook like this cannot be marketed in segments so that the buyer can subscribe to all those chapters that are new and have them added to a loose-leaf bound or even a custom-bound book, without having to pay for all those chapters that just reproduce old material, ie, that a version of the material that one wants can be custom-made for the buyer. I hope that the new editorial group will be able to update many of the additional chapters that haven’t changed very much over the last 2 editions or use new authors. The new material on the molecular mechanisms underlying the genetics of heart disease, heart development, and heart function and the well-detailed discussions of shock, low output, and pulmonary hypertension will set a standard for future chapter quality.
This is still the reference for Pediatric Cardiology, with its emphasis on prenatal diagnosis, physiology, and heart disease in infants and children. It is not a resource that extends very much into the issues related to congenital heart disease in the adult. The list of contributors is a “who’s who” of pediatric cardiology and congenital heart disease. It has 12 columns of prestigious names on 6 pages.
The Editors state that their goal was “to develop a fresh textbook compatible with the explosion of information, technology, and methods” related to pediatric cardiology, and they have partially succeeded. This book certainly stands as a tremendous resource, and it takes comparing the sixth with the fifth edition, which I think is important to decide the reason for a new edition, to see those areas that do not have seem to have been systematically revised and illustrations and material that probably should have been retired in the fourth edition of the textbook.
Nonetheless, the sixth edition will represent a resource for nurses, students, trainees in pediatric cardiology, and perfectionistic teachers like myself who understand the pain and anguish the Editorial group goes through in working with the various levels of investment and reinvestment that occur in a multiauthored textbook while trying to wring out of some of the authors whose chapters have been reinvited an enhanced content of new, truly updated information.