Textbook of Cardiothoracic Anesthesiology. Edited by Daniel Thys, Zaharia Hillel, Alan Jay Schwartz. New York, McGraw Hill, 2001. Pages: 1180. Price: $195.00.

The Textbook of Cardiothoracic Anesthesiology  is a well-written volume that should be included as an authoritative text on the subject. With all of the changes in our field, the task of editing a comprehensive, up-to-date text on cardiothoracic anesthesia is a daunting one; however, Dr. Thys and his colleagues have done a good job. The book is logically organized into preoperative, intraoperative, and postoperative concerns. Within this framework, the authors are able to describe not only the things that are common in cardiac anesthesia, but also some of the more complicated aspects of patient care. The chapters are clearly written and are easily understood by everyone from the first-year resident in anesthesiology to the practicing physician looking for a review of a particular topic.

Although the book is too long to be read by a resident during a one-month cardiac rotation, it is the appropriate length to be used as a text for a cardiac anesthesia fellow, or a practicing physician. The chapter entitled “Learning Cardiothoracic Anesthesiology” is extremely useful and provides the beginner with a framework upon which to build further learning in this area. The appropriate amount of emphasis was given to relevant topics, including preoperative testing. Topics less commonly discussed in the anesthesia literature, such as myocardial perfusion imaging, stress testing, and pulmonary function testing, are also included.

The chapter on the conduct of cardiopulmonary bypass could have been extended to include more information “from the perfusionist's perspective.” Although the anesthesiologist is not the one operating the pump, a thorough knowledge of the perfusion apparatus is essential to the conduct of a successful cardiac anesthetic.

With more cases being done with “alternative techniques” (off pump, normothermia, transmyocardial revascularization, etc. ) it would have been helpful to have had these areas covered more thoroughly. With problems such as heparin-induced thrombocytopenia and heparin resistance becoming more prevalent, these topics, as well as heparin alternatives and treatment options, should have received more attention.

The text makes extensive use of transesophageal echocardiography (TEE) images and has an extensive chapter devoted to the subject. Nevertheless, a cardiac anesthesia fellow needing a reference text to prepare for the certification in intraoperative echocardiography will probably want to purchase an additional book devoted solely to TEE.

With those few exceptions, I found the volume to be very helpful. It compares well to other “standard” texts on the subject (i.e. , Cardiac Anesthesia , 4th edition. Edited by Joel Kaplan. Philadelphia, WB Saunders Company, 1999) and gives a different perspective in certain areas. It fills a niche for someone who needs a thorough review of cardiac anesthesiology and an overview of TEE, and should be helpful to everyone who reads it.