Book Review

Cardiac Surgery of the Neonate and Infant

N Engl J Med 1995; 333:742September 14, 1995

Article

Cardiac Surgery of the Neonate and Infant
Edited by Aldo R. Castañeda, Richard A. Jonas, John E. Mayer, Jr., and Frank L. Hanley. 506 pp., illustrated. Philadelphia, W.B. Saunders, 1994. $169. ISBN: 0-7216-4301-9

This treatise on pediatric heart surgery is an excellent discussion of the care of infants with congenital heart disease. The material is based on a quarter century of experience with prompt and definitive repair of congenital heart defects in neonates and infants.

The book has three parts. The first consists of seven chapters dealing with the fundamentals of the surgical treatment of congenital heart disease. The opening chapter emphasizes the developmental biology of the cardiac, central nervous, and respiratory systems. The following chapter deals with the science and application of cardiopulmonary bypass, hypothermia, and circulatory arrest in the neonate and infant, with primary reference to the clinical and experimental experience at Children's Hospital in Boston. The topics discussed include cerebral blood flow and metabolism, the physiology of acid–base balance, and the strategy of acid–base management (alpha stat or pH stat) during cardiopulmonary bypass and circulatory arrest.

The chapter on perioperative care is superb. It stresses the interaction among the members of a multidisciplinary team committed to patient care and summarizes the conceptual approach to the care of infants undergoing cardiac surgery. There is an excellent discussion of single-ventricle physiology and cardiac arrhythmias. Other chapters in this section review the development of synthetic and biologic vascular grafts and their role in cardiac repair and the role of interventional cardiology in the management of congenital heart disease.

The second section of the book consists of 23 chapters addressing various congenital heart anomalies and defects. Each chapter gives clear and crisp descriptions of the unique anatomical features, natural history, and pathophysiology of the disorder; perioperative management; surgical techniques, with an emphasis on the authors' preferences; the postoperative course; and the results and outcomes at Children's Hospital.

The book has many appropriate, high-quality illustrations. Easily interpretable charts and graphs complement the experimental and clinical data presented in the text.

The final three chapters — on myocardial preservation, cerebral protection, and fetal intervention for congenital heart disease — represent the emerging frontiers in pediatric cardiac surgery. These discussions are designed to whet the investigative appetite of future cardiac surgeons and scientists.

This state-of-the-art book is essential reading for all pediatric cardiac surgeons and cardiologists in training. It will also prove invaluable to anyone else involved in the care of infants and neonates with congenital heart disease.

Jonah Odim, M.D., Ph.D.
University of Manitoba School of Medicine, Winnipeg, MB R3E 0Z2, Canada