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Heart Substitutes: Mechanical and Transplant

Robert L. Berger, MD
JAMA. 1967;199(9):678. doi:10.1001/jama.1967.03120090120045.
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Heart Substitutes surveys the impressive developments of the past decade in repairing or replacing the sick heart. It is divided into four parts, dealing with prosthetic heart valves, extracorporeal circulation, mechanical hearts, and cardiac transplantation.

The discussion on the physical characterization, hemodynamic performance and thrombogenic tendencies of prosthetic valves contains much information and it is well done. However, the chapters on clinical evaluation tend to be provincial and fail to present an inclusive broad view. The essentials of cardiopulmonary bypass are treated unevenly, eg, discussion of principles of cardiopulmonary bypass is superficial, enumeration of techniques employed in one institution is dogmatic, but the chapter on metabolic responses to prolonged cardiopulmonary bypass is superb, and that on assisted circulation in acute cardiac failure is good.

The section on mechanical hearts makes it painfully clear how helpful is a solid background in physics. Nevertheless, the writing is lucid and even the unsophisticated


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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