Roland Hetzer Knihy

Surgical options for treating degenerative, ischemic, inflammatory, and functional mitral valve diseases have significantly expanded in recent decades. A key dilemma remains in using prosthetic mitral valves, as mechanical valves offer durability but necessitate anticoagulation, while biological valves have unpredictable longevity. Recent advancements indicate that reconstructing the mitral valve with autologous tissues can effectively resolve this issue, eliminating the need for anticoagulation and providing excellent durability. This method combines the best attributes of both prosthetic options without their drawbacks. Innovative repair strategies, including autologous pericardial leaflet augmentation and artificial chordal replacement, have broadened reparative techniques for nearly all pathologies, yielding outstanding long-term outcomes compared to prosthetic valve replacements. Currently, mitral repair is becoming the preferred procedure for most patients with mitral valve disease. This book showcases contemporary surgical techniques for various mitral valve repairs, featuring contributions from leading experts. It stems from the Berlin Heart Valve Symposium 2008, titled “The Biological Solution,” with the Mitral Valve Repair session held in June 2009. The publication serves as an authoritative reference for cardiac surgeons, family practitioners, and clinicians, compiling proceedings on current techniques and outcomes

Clinical lung transplantation has seen an early start within the history of solid organ trans plantation, marked by the 1963 first lung transplant by James D. Hardy. This was prompted by the seemingly easy way of joining the transplanted organ to the recipient by me ans of a few well-defined anastomoses, i. e. bronchus, pulmonary artery and pulmonary vein carry ing left atrial cuff. The following decade thus witnessed a number of such mostly unilateral lung transplants in several centres, in Germany represented by the two only lung transplants performed by E. S. Bücherl, then at the Neukölln City Hospital in Berlin in 1969. As with most other such attempts these two patients suffered early and lethai graft failure. There was only one single lung transplant patient who lived up to ten months after the transplant at Gent, Belgium, having been operated on by Derom in 1969. The alm ost universal failure during this initial phase was attributed to bronchial anasto motic insufficiency, pulmonary infection of either the transplanted lung or the left-in-place contralateral lung and a far-reaching lack of knowledge how to cope with transplant rejec tion. In the early 1970s it had become gene rally accepted that lung transplantation could not be performed successfully.

After decades of laboratory investigations mechanical circulatory support for the failing heart has entered the clinical arena. Today, a growing number of patients with progressive myocardial failure awaiting cardiac transplantation is successfully bridged to transplantation with ventricular assist devices. The proceedings of the „Mechanical Circulatory Support“-meeting, held in Berlin, October 21-22, 1995, present new aspects of mechanical circulatory support, recent experience with MCS in newborns and children using specially developed small devices, and the results of long-term mechanical assistance. The ability of the myocardium to recover under pressure de-loading and reduced workload is discussed. All these topics open up new perspectives for the use of mechanical circulatory support, not only as a bridge to transplantation, but also as a definitive approach for treating patients with end-stage heart failure. Some of these concepts may even provide real alternatives to heart transplantation, these being sorely needed in light of the severe donor organ shortage. Regulatory as well as ethical aspects of the extended use of mechanical circulatory support systems and new technical developments in the field are discussed by internationally distinguished experts.

Marfan Syndrome is a hereditary disorder of connective tissue which primarily affects the eyes, skeleton, blood vessels, and various structures of the heart. Since 1943, when the cardiovascular manifestations of Marfan Syndrome were first described, understanding of its nature, diagnostic tools, and surgical treatment have been remarkably improved. Although the specific surgical procedures have reached an advanced standard and general acceptance, many questions remain unanswered and have given rise to ongoing controversy. Cardiovascular Aspects of Marfan Syndrome presents the advances in understanding the cause and pathogenesis of Marfan Syndrome and its current specific surgical therapy.