Synopsis
Interventional cardiovascular medicine has evolved from an extremely crude method of opening femoral arteries initiated by Dotter, to a field that has now been recognized as having a sufficient fund of knowledge to require boards sanctioned by the American Board of Internal Medicine. From Andreas Gruentzig's development of the noncompliant balloon method, we have seen an explosion of bioengineering technology. The discipline of interventional cardiovascular medicine has perhaps initiated more registries and clinical trials than any other discipline in medicine. Indeed, the whole emphasis on evidence-based medicine has evolved during the era of interventional cardiology. Many basic science breakthroughs have been stimulated by the advances produced in interventional cardiology, as well as the problems and complications created by the new technologies. However, no matter how advanced the science becomes, the success of solving a patient's problem with interventional techniques usually depends on the operator's technical ability. This ability springs from the wealth of experience the operator has acquired to deal with routine situations as well as complex and almost unique problems that may present themselves. Because of the large number of interventional cardiologists and the rapidly expanding number of procedures that can be performed, it is difficult for many cardiologists to experience all of the situations that can be helpful in building this database. Dr. Thach Nguyen has prepared a remarkable book, rich with tips and tricks for performing interventional cardiovascular medicine procedures. He has enlisted numerous experts on various aspects of interventional cardiovascular medicine to describe their areas of expertise. Rather than let them recite the evidence from registries and trials that are available elsewhere, he forces the contributors to provide the practical tips that they have learned. It is almost as though Dr. Nguyen is trying to simulate the type of scenarios that exist in the catheterization laboratories with new cardiology fellows or less experienced operators. It is the type of advice that he has often given to cardiologists in developing countries who are bringing interventional techniques to help cope with the rapidly expanding new threat in these countries, vascular disease. Since new techniques are constantly appearing, all operators, experienced or not, can benefit from these tips. Whereas every operator will not agree with every approach to a problem or a complication, it is always instructive to understand many potential approaches. In this regard, the book does a masterful job of collecting not only the authors' experiences, but those of many others collected from the published literature, from numerous postgraduate courses, and from one-on-one demonstrations throughout the world. The second edition contains five brand new chapters covering 'Percutaneous Aortic Valvuloplasty', 'Interventional Cardiology in Congestive Heart Failure', 'Advanced Techniques of Cardiovascular Interventions', 'Percutaneous Exclusion of Aortic Aneurysm' and 'Percutaneous Replacement of Aortic Valve'. This book should be a valuable resource to trainees in formal programs that have now evolved in the United States and other countries, as well as the many preceptorships that are the major means of training in other countries. In addition, operators of all levels of experience will find many useful pearls of wisdom. Dr. Nguyen and his colleagues are to be congratulated for compiling this most practical guide.
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