THE BOOKSHELF ARTIFICIAL HEART: Total Replacement and Partial Support. By TETSuzo Alrorsu. Amsterdam, Elsevier Excerpta Medica, and Tokyo, Igaku Shoin...

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THE BOOKSHELF ARTIFICIAL HEART: Total Replacement and Partial Support. By TETSuzo Alrorsu. Amsterdam, Elsevier Excerpta Medica, and Tokyo, Igaku Shoin Ltd ( copublishers), 1975, 364 pp, $39.95. This book is a thorough review of the history and current obstacles of the many phases in the development of the total artificial heart and circulatory assistance devices by one of the earliest pioneers in the field. The extensive review of the literature in each chapter makes the volume an indispensable reference for physicians and bioengineers interested in this field. The introductory chapter comments on the current status of the artificial heart and reviews various partial-support systems. Chapters 2 and 3 extensively review the design, energy sources, and the major problem of finding a suitable material for constructing the blood-handling parts of the artificial heart. Studies of Baier, Sawyer, and Leininger are presented; but details of the chemistry of plastics and the blood-plastic interface are not within the scope of this book. Chapters 4 and 5 discuss the series and parallel types of circulatory assistance devices. Work by various laboratories is reviewed before the author gives extensive experimental data from his own laboratory. The major problems encountered were infection, thrombosis, hemolysis, and mechanical failures. Chapter 6 tackles the historic development of the total artificial heart and reviews pertinent data of approximately 40 different designs. Dr. Akutsu has had extensive experience in the construction and implantation of total artificial hearts. His results of numerous studies range from systolic/ diastolic ratios to hemodynamic effects of cardiovascular drugs. The last chapter discusses clinical applications, transplantation, ·and expenses. This comprehensive book has been completed prior to the successful implantation of a total artificial heart. That goal, certainly within reach by the author, will need further governmental support to achieve success. W. ]. Kolff, M.D., Ph.D. Salt Lake City PULMONARY EMBOLI. Edited by Airrmm A. SASAHARA, EDMUND H. SoNNENBUCK, and MICHAEL LESCH. New York, Grune and Stratton, Inc., 1975, 175 pp, $16.50.

Pulmonary Emboli is a multi-authored report of the current status of the field of thromboembolism

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so skillfully edited by Sasahara and colleagues that overlapping material is minimal, yet each of the 17 chapters can be read separately. The chapters have all appeared originally in the 1975 issues of Progress in Cardiovascular Disease, a journal published by Grone and Stratton, Inc., and edited by Sonnenblick and Lesch. Sasahara was the guest editor for these chapters discussing a disease which affects half a million people yearly in the United States. Much of the material stems from the urokinasepulmonary embolism trial of the National Heart and Lung Institute, a massive source of fascinating data. It has become obvious that the occurrence of pulmonary embolism is much more frequent than suspected, and the majority of patients present a nonspecific clinical picture, so that a high degree of suspicion is needed to implement the final proofs of the diagnosis. Those of us who study this disease of pulmonary embolism have always realized its seriousness in cardiac patients. It was a pleasure to read the results of cardiodynamic studies obtained in the urokinase trial, particularly those relating the decline in cardiac index and stroke work index to preexisting congestive heart failure. The newer techniques for diagnosing deep venous thrombosis are well described and include occlusive impedance phlebography, radiographic fibrinogin, ultrasonic techniques, blood coagulation assays, and cineradiography. The final diagnostic studies include the nonspecific electrocardiogram, the sensitive lung scans, and the specific angiographic studies. All modes of therapy are clearly and separately discussed by known authorities on anticoagulation, thrombOlysis, venous interruption, the umbrella filter, and pulmonary embolectomy. There is an excellent resume of prevention by various means: physical measures, anticoagulation, alteration of platelet function, and patient selection. The volume is neatly bound and clearly printed on quality paper and contains numerous tables, photographs, x-ray films, and illustrations to document and clarify the text. The book will prove to be the current source of information on a serious life-threatening disease and should be read by all physicians who are called upon for its treatment. John]. Byrne, M.D. Boston



WIENER, EDWARD K. CHUNG, and HRATCH KAsPhiladelphia, F. A. Davis Co., 1975, 336 pp, 124 illus, $28.00. PARIAN.

Dr. Brest has done it again! In this comprehensive treatment of a "hot" subject, the series editor (this time with distinguished co-editors) has succeeded in maintruning the high standards of previous numbers of the series, Cardiovascular Clinics. Directly contributing to this result are Dr. Brest's own incisive discussions of infarction without coronary disease and heart failure in acute infarction. It is difficult to choose for special mention among 28 chapters whose contents transcend the book's title; while diagnostic and therapeutic innovations are indeed described, evaluated, and placed in context, established approaches are brought up-to-date. Corya's succinct, nicely illustrated echocardiographic chapter is a superb demonstration of the application of this noninvasive method to determiniiig ventricular dimensions, wall motion, and stroke volume. Hood's selfcontained monograph, "Modification of Infarct Size," a well-written discussion of the theory and state of the art, should be digested before turning to the valuable contributions of Lefer on glucocorticoids for stabilizing lysosomes, Austin and colleagues on intra-aortic balloon "assist," and Walinsky's outstanding presentations of the "nuts and bolts" of hemodynamic monitoring and of vasodilator therapy. Other "must" reading includes the pros and cons in evaluating and dealing with bradyarrhythmias, beautifully summarized by Meltzer, and Roberts' customary virtuoso performance, a think-piece on the puzzling correlations (and noncorrelations ) between coronary arterial disease and coronary heart disease. The contributors and editors of this book can be congratulated for a magnificent group effort which offers a great deal for everyone concerned with myocardial infarction and its consequences. David H. Spodick, M.D., D.Sc., F.C.C.P. Baston

BOOKS RECEIVED IMPORTANT TOPICS IN CONGENITAL, VALVULAR, AND CORONARY ARTERY DISEASE. Edited by DRYDEN P. MoRSE and HARRY GoLDBERG. Mt Kisco, NY, Futura Publishing Co., 1975, 191 pp, $18.95. PAEDIATRIC ANAESTHESIA (2nd ed) . By HAROLD T. DAVENPORT. Chicago, Year Book Medical Publishers, Inc., 1973, 258 pp, $16.95.