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Clin. Cardiol. 23, 138 (2000)
Edited by Mohammad Bashar Izzat, John E. Sanderson, and Martin G. St. John Sutton
Isis Medical Media Ltd, Oxford, United Kingdom (1999) 380 pages, illustrated, $245.00
ISBN: 1-899066-77-2
Echocardiography in Adult Cardiac Surgery is a textbook edited by three physicians--a cardiac surgeon and two cardiologists. It focuses on understanding the echocardiographic views and modalities and the common conditions seen by the cardiac surgeon and the anesthesiologist.
The book is divided into three sections: (1) "General Principles," which focuses on instrumentation and the standard examination; (2) "Clinical Applications," which includes assessment of ventricular function and evaluation of ischemic heart disease, the cardiomyopathies, valvular abnormalities, diseases of the aorta, pericardial disease, endocarditis, and cardiac masses; and (3) "Applications in Cardiac Surgery," which includes intraoperative transesophageal echocar- diography (TEE) and epiaortic ultrasound, perioperative echocardiography for mitral valve repair, and the use of echocardiography in the cardiac surgical intensive care unit. Other chapters assess prosthetic heart valves, the transplanted heart, left ventricular volume reduction, the MIDCAB procedure, and minimally invasive cardiac surgery.
The major strengths of this book are (1) the many excellent illustrations (black-white and color) demonstrating two-dimensional and Doppler images as well as extremely useful schematic diagrams; (2) that the essentials of two-dimensional transthoracic and transesophageal echocardiography and Doppler ultrasound are covered in one text; and (3) the two chapters analyzing mitral valve repair that, with perspectives from both the echocardiographer and the surgeon, provide an understanding of mitral valve anatomy, mechanisms of regurgitation, and the relationships of echocardiographic analysis to reconstructive techniques.
Echocardiography, especially the transesophageal and epicardial modalities, has become an integral part of routine cardiac surgical practice, not only in the operating room, but in the intensive care units and trauma centers. It is imperative that the cardiac surgeon become familiar with this technique and receive high quality information and morphologic detail. Preoperative assessment, intra-operative management, and postoperative surveillance of cardiac surgical patients are now critical for a wide variety of clinical situations. The cardiac surgeon must understand the pitfalls and limitations of the echocardiographic technique, particularly TEE.
If there is a deficiency, it is that of any book with multiple authors. Some of the material is redundant. In addition, it would have been informative to show the percentage of how often information obtained during peri-operative TEE changed or modified the surgical procedure.
This book will be extremely useful to cardiac surgeons because it gives a very good overview of the entire field of echocardiography. It is practical, informative, and a good beginning to an ever-burgeoning field. Anesthesiologists who have been using TEE for some time may find this volume useful but certainly not exhaustive.
Joel Felner, M.D.
Associate Dean, Clinical Education Professor of Medicine (Cardiology)
Emory University School of Medicine
Atlanta, Georgia