BOOKREVIEWS

Book Reviews

Book Reviews Don’t Just Happen

Readers will be aware that every issue ofHeart Lung andCirculation contains at least three book reviews. The

books reviewed cover the same scope as the Journal itself,namely cardiology, cardiac surgeryandbasic science.Bookreviewshavebeenappearing in the Journal since 1995. Theprocess is that publishers send their latest volumes to theJournal for review, the book review editor Robert Den-niss, assisted by the specialist editors select appropriatereviewers who are then requested to carry out the reviewwithin 2 months. The carrot is that the reviewer is allowedto keep the book. This may be from something as humbleas a paper back, ranging through to a two volume, top ofthe range text book. The orchestrator of the whole processidtl

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siasts for a scientific and physiological approach to coro-nary artery disease and interventions. The title of the bookaptly captures the focus of the technique but undersellsits application to daily cardiology. Its conclusions applyto choosing vessels suitable for any invasive intervention,either coronary artery bypass grafting or percutaneouscoronary interventions. The basic tool advocated by theauthors is a coronary angioplasty guide wire capable ofmeasuring pressure near its tip. The wire is thin enoughnot to partially occlude the distal vessel or stenosis andflexible enough to be safe to pass through coronary ar-teries or stenoses. Proximal pressures are measured bythe guiding catheter. The key concept is that of myocar-dial fractional flow reserve. This is the maximummyocar-dial flow in the presence of a coronary artery stenosis asa fraction of the flow in the same vessel if there were no

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s the book reviews co-ordinator in the editorial office San-ra Hayes. She reminds and cajoles recalcitrant reviewerso return their reviews and then processes them for pub-ication.The editors would like to thank all those involved in theroductionofbookreviews, especiallyRobertDennissandandra Hayes, but also the reviewers themselves and theublishers who continue to send their valuable volumesor review.

Franklin Rosenfeldt, Founding EditorHead Cardiac Surgical Research Laboratory

stenosis. It is important that this parameter is measuredduringmaximal myocardial vasodilatation (maximumhy-peraemia) induced by intracoronary injection of papaver-ine or adenosine. All that is required is measurement ofsimultaneous coronary artery pressures in the proximalcoronary artery or aorta and the distal coronary artery.Measurement ofmyocardial fractional flow reserve allowsthe functional significance of any type of epicardial arte-rial obstruction to be assessed and the long-term clinicaloutcomeof removal or bypass of that obstruction tobepre-dicted. Additional measurement of distal coronary artery

The Alfred Hospital and Baker InstituteMelbourne, Australia

pressure during balloon occlusion of the artery provides

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E-mail address: f.rosenfeldt@alfred.org.au

oi:10.1016/j.hlc.2004.09.002

oronary Pressure, Second Ed.ico H.J. Pijls, Bernard De Bruyne, Kluwer Academicublishers

ngioplasty and stenting for coronary artery diseasehas became a relatively mechanical process with a

inimum of the scientific considerations which under-inned its introduction. Early proceduralists used over-he-wire balloon catheters which allowed them to mea-ure translesional pressure gradients plus assessment ofollateral flowbymeasurementofdistal coronarypressureuring balloon occlusion. Most modern interventionalistssemonorail balloon catheters anddonotperformroutineoronary artery pressure measurements before and afterntervention. A trial of therapy is often used in grey-zoneases. This well written book is authored by two enthu-

2004 Australasian Society of Cardiac and Thoracic Surgeustralia and New Zealand. Published by Elsevier Inc. Al

information on the proportional contribution of collateralanddirect coronary artery flows to perfusion of that vascu-lar bed. For instance, a myocardial fractional flow reserveof 0.50 indicates that the stenosis restricts maximum coro-nary flow in that bed to 50% of normal. Measurement ofdistal coronary pressure during balloon occlusion in thiscase might show 39% of maximal myocardial flow to bevia the direct coronary artery and 11% by collaterals. Afterrelief of the stenosis by stenting, the myocardial fractionalflow reserve in this vascular bedmight rise to 0.97 (i.e. 97%ofmaximum) and 96% ofmaximumflowmight be derivedfrom direct coronary flow and 1% by collaterals.The first few chapters are an excellent overview of

coronary artery physiology and the various methods forassessing the severity and functional significance of acoronary stenosis. These sometimes abstract concepts areexplained exceptionally well with simple clear diagramsand examples which reflect the authors’ long experiencewith teaching and research in this area. The equipment,techniques and pitfalls are outlined plus other chaptersbased on the authors’ published research that lead to thecut-off of 0.75 for a functionally significant myocardial

and the Cardiac Society ofhts reserved.

1443-9506/04/$30.00