Open Access Medical Books



Edited by Stefano Nazari .

412 pages .
Open Access .

It has indeed been a great privilege to be the Editor of the new book Front Lines of Thoracic Surgery, with the efficient assistance of the InTech technical team.
In this original and promising editorial format, the book collects the up to-date contributions on some of the most debated topics in today’s clinical practice of cardiac, aortic and general thoracic surgery and anesthesia, as viewed by authors personally involved in their evolution.
The strong and genuine enthusiasm of the authors was clearly perceptible in all their contributions, and I’m sure that will further stimulate the reader to understand their messages. Moreover, the strict adhesion of the authors’ original observations and findings to the evidence base proved that facts are the best guarantee of their scientific value.
Unfortunately however, no matter how strong their rational theoretical basis and evidence may be, new ideas and hypothesis are not usually accepted as easily and as quickly as any author would expect. That is the case in science in general and in surgery in particular.
This is probably most related to “tradition”, which is obviously widely recognized as the most important founding value of any culture. However, tradition is apparently resistant to innovations in different science fields in inverse proportion to the complexity of their own theoretical content.
This places surgery in an unfavorable position since, even though extensive theoretical and technological research precedes and justifies any surgical treatment, performance of any surgical act relies on very few, elementary, “mechanical” principles.
In considering the evolution of the vascular anastomosis technique, it is interesting to note that the famous Carrel “triangulation” original sketch still reported straight, not an atraumatic needle, similar to that in use then for gastrointestinal suture. That was in fact the necessary scenario for “triangulation” to stand for a very significant technical advancement at that point in time. Nonetheless, in spite of its persisting fame, “triangulation” was made obsolete by the advent of curved and proportionally dimensioned needles as well as of many other technical refinements.
After a century-long path, apparently pulverizing the retaining force of “tradition”, the extreme evolution of surgical technique has today reached man-driven robotic surgery, suggesting that the theoretically insurmountable limits other science fields have (like absolute zero for lowest temperature, or light speed for highest velocity) do not seem to have been yet identified in surgery!
However the new “thing” brought to the final surgical act by the complex, highly technologic and expensive robot apparatus is, essentially, at this point in time, the significantly increased precision of the surgical act resulting from the amplification of the surgeon's hand movement in relation to that transferred to the activated instrument in the operative field. Mini-access and magnified operative field view in fact were options already brought to clinical practice by video assisted, mini-invasive surgery.
All together these new technical modifications of the final surgical act are advantageous enough to justify the sacrifice, at least for selected surgical conditions, of the still unparalleled versatility of the direct hand movements in the operative field.
Sometimes in my work on vascular anastomosis devices, I thought that proposing innovations in this basic surgical ambit could be quite similar to trying to popularize the use of the fork and knife in China. The thorough analysis and explanation of the many details that provide that a fork and knife are a better and easier method of controlling food than chopsticks for anyone, independently from his own local
tradition, is as ingenuous and almost stupid as it is ineffective.
In surgery however, it is just the full and clear understanding of the little technical “things”, that can reveal the expected and very relevant final effects to the patient and thus can eventually urge someone to accept the difficult, monopolizing and often bitter, but always exciting, challenge of bringing it into clinical practice.
I'm grateful to Dr Giuseppe Rescigno, Division of Cardiac Surgery, Lancisi Hospital, Ancona for the review of Dr H. Hiroshi's Chapter on Off Pump CABG.

Dr. Stefano Nazari
Fondazione Alexis Carrel
Milan, Italy


Part 1 of the Textbook : Adult Cardiac Surgery .

 1 Mitral Valve Subvalvular Apparatus Repair with Artificial Neochords Application 3 Sergey Y. Boldyrev, Kirill O. Barbukhatty, Olga A. Rossokha and Vladimir A. Porhanov

 2 Post Myocardial Infarction Ventricular Septal Defect 29 Michael S. Firstenberg and Jason Rousseau

 3 Current Trend of Off-Pump Coronary Artery Bypass Grafting 47 Hitoshi Hirose

 4 Psychiatric Factors Which Impact Coronary Heart Disease and Influence Outcomes Post-Coronary Artery Bypass Grafting Surgery 61 James J. Mahoney, III, Emily A. Voelkel, Jenny A. Bannister, Raja R. Gopaldas and Tam K. Dao

 5 Surgical Ventricular Restoration for Ischemic Cardiomyopathy with Functional Mitral Regurgitation 83 Masanori Hirota, Shintaro Katahira, Joji Hoshino, Yasuhisa Fukada, Taichi Kondo, Takayuki Gyoten, Yuichi Notomi and Tadashi Isomura

 6 Morphological Predictors and Molecular Markers of Progressing Postoperative Remodeling of Left Ventricle in Patients with Ischemic Cardiomyopathy 107 Vladimir Shipulin, Vitaly Kazakov, Alexander Lezhnev, Boris Kozlov, Vadim Babokin, Sergey Gutor and Irina Suhodolo

 7 Miniaturized Extracorporeal Circulation 135 Francesco Formica and Giovanni Paolini

 8 Hypothermic Cardiac Arrest to Remove Right Atrial Thrombi Due to Abdominal Malignancies 147 Pier Luigi Stefano, Stefano Romagnoli, Donata Villari and Giacomo Batignani

Part 2 of the Textbook : Pediatric Cardiac Surgery .

 9 Restoration of Transposed Great Arteries With or Without Subpulmonary Obstruction to Nature 169 Ing-Sh Chiu and Chi-Ren Hung

 10 Gene Expression Profiling - A New Approach in the Study of Congenital Heart Disease 187 Mohamed T. Ghorbel, Gianni D. Angelini and Massimo Caputo

 11 B-Type Natriuretic Peptide (BNP) in Neonates, Infants and Children Undergoing Cardiac Surgery 199 Peter E. Oishi, Aida Field-Ridley, Sanjeev A. Datar and Jeffrey R. Fineman

Part 3 of the Textbook : Aortic Surgery .

 12 Cerbral Protection Strategies for Aortic Arch Surgery 215 Bradley G. Leshnower and Edward P. Chen

 13 Recent Advances in the Management of Acute Aortic Syndrome 229 Laszlo Göbölös, Maik Foltan, Peter Ugocsai, Andrea Thrum, Alois Philipp, Steven A. Livesey, Geoffrey M. Tsang and Sunil K. Ohri

 14 Neurologic Injury Following Hypothermic Circulatory Arrest 243 Elizabeth O. Johnson, Antonia Charchanti, Maria Piagkou, Theodore Xanthos and Theodore Troupis

 15 New Approaches for Treatment and Prevention of Aortic Aneurysms 263 Stefano Nazari

Part 4 of the Textbook : General Thoracic Surgery .

 16 Lung Transplantation 295 Wickii T. Vigneswaran

 17 Systematic Review of the Literature: Comparison of Open and Minimal Access Surgery (Thoracoscopic Repair) of Esophageal Atresia with Tracheo-Esophageal Fistula (EA-TEF) 309 M. W. N. Oomen

Part 5 of the Textbook : Cardiothoracic Anaesthesia .

 18 Ventilator-Induced Lung Injury: Mechanisms and Future Therapeutic Interventions 321 Maria A. Hegeman, Marcus J. Schultz, Adrianus J. van Vught and Cobi J. Heijnen

 19 Optimizing Perioperative Ventilation Support with Adequate Settings of Positive End-Expiratory Pressure 353 Zhanqi Zhao, Claudius Stahl, Ullrich Müller-Lisse, Inéz Frerichs and Knut Möller

 20 Perioperative Pulmonary Functional Assessment 371 Felipe Villar Álvarez, Germán Peces-Barba Romero and Miguel Ángel Palomero Rodríguez

 21 Post Thoracotomy Pain Syndrome 391 F. Della Corte, C. Mendola, A. Messina and G. Cammarota .

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Published by: Unknown - Monday, June 3, 2013