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February 27, 1967

Heart Substitutes: Mechanical and Transplant

Author Affiliations

Brighton, Mass

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