The Treatment of Acute Myocardial Ischemia [antikvár]

Foreword Five years ago Dr. Lawrence H. Cohn of the Peter Bent Brigham Hospital and Harvard University Medical School developed a precise and yet reasonably inclusive monograph entitled The Surgical Treatment of Acute Myocardial Ischemia. The book was well received, but now with the growth of coronary artery surgery surpassing almost everyone's predictions, a combined or hospital-wide approach, if you will, has been deemed appropriate by the surgeon-author, and we are treated to it in the following pages. Most books written by several authors range all the way from poorly integrated to frankly contradictory. What distinguishes this material from many others is the fact that members of the same hospital staff herein describe their modus operandi in effecting a unified medical, surgical and pathophysiological evaluation of the symptomatic patient with coronary artery disease. Dr. Cohn, in his introduction, underlines the need for a concentration of medical resources on the problem of coronary artery disease. Unfortunately, preventive medicine has made few inroads on the incidence of this near epidemic. New methods of medical management and direct suture techniques for saphenous vein or internal mammary artery bypass grafts in the past decade clearly reduced the morbidity, and perhaps the mortality, secondary to atheromatous disease of the coronary arteries. Considerable excitement and controversy were generated last year by the V.A. cooperative study attempting to ascertain any therapeutic advantage of the surgical versus the medical approach to patients with one- to three-vessel coronary artery disease. Everyone applauded the effort, but then most authorities criticized the study to the point that no similar program is likely ever to be designed. Suffice it to say here that the most common operation in most medical centers today is the CABG for CAD. Perhaps only the Comstock Lode has contributed more riches to so few in so brief a period of time. At any rate.