In today's healthcare environment, the real driver is value. Maximizing outcomes and minimizing costs or providing similar outcomes with lower cost in terms of actual numbers or recovery time will dominate our healthcare delivery system. An excellent example of this evolution is in the ?eld of cardiovascular intervention. Dr. Jacques Kpodonu's Manual of Thoracic Endo-Aortic Surgery is a most timely and descriptive work in this burgeoning ?eld. It provides an excellent overview of current technology and techniques, plus the endovascular expert can drill down into the details of the devices and technologies described and signi?cantly enhance their knowledge and perspective. Procedural detail, excellent graphics, pertinent imaging studies, and relevant instruction are the mainstays of this text. The ?rst chapter comprises the key overview and very comprehensively covers the platform - the hybrid OR, the tools, the accessories, and the medium - superb, state-of-the-art imaging modalities required to perform these advanced procedures. The text then moves into more technical details including options and instruction regarding access approaches and potential pitfalls of such. This is followed in en- ing chapters by dissemination of precise information, techniques, and indications for the most popular and utilized grafts including Boston Relay Stent Graft, Cook TX2 Zenith Stent Grafts, as well as the Gore and Medtronic Aortic Stent Grafts.
The development of less invasive technologies has resulted in a changing paradigm for the management of aortic diseases. Endovascular and hybrid surgical approaches have gradually been adopted by cardiovascular surgeons and have proven to shorten hospitalization, reduce morbidity and mortality, speed recovery and hasten return to normal life, and consequently have shown to be favorable to open surgical techniques in most situations. Nevertheless, the current training programs have not been designed to accommodate the rapid evolution in endovascular technology, 3D imaging modalities, intravascular ultrasound technology and advanced navigational tools. It is essential that cardiovascular surgeons have the fundamental knowledge and skill sets required to understand and incorporate all these latest technology into the practice of aortic surgery.
The Manual of Thoracic Endoaortic Surgery identifies both the limitations and the advantages of thoracic aortic endografting techniques. While there is no substitute for learning from experience, the book provides a useful tool for practitioners as they plan and execute treatment plans for patients with these various thoracic aortic pathologies as well as serving as a useful reference as this segment of the field expands.
