Hensley’s Practical Approach to Cardiothoracic Anesthesia, 6th ed

The 6th edition of Hensley’s Practical Approach to Cardiothoracic Anesthesiology gives a comprehensive overview of cardiothoracic anesthesiology and is a good resource for trainees who need to prepare for new case types or for practitioners who would like a readily available review of important disease and management concepts. As with the previous edition, it is written in an outline and bullet point format that will appeal to some readers. The consistent approach taken throughout the book allows for quick access to key points for review, case-based learning, or test preparation. While the bulleted list approach has some advantages, not all learners will appreciate the associated abbreviated presentation of material and those readers may prefer a more in-depth text. The authors have divided the 27 chapters of the book into 5 sections to enhance targeted reading: cardiovascular physiology and pharmacology; general approach to cardiothoracic anesthesia; anesthetic management for specific disorders and procedures; circulatory support; and perioperative management. The first 2 sections cover the basics of cardiac anesthesia including the pharmacology, physiology, monitoring, and basic workflow aspects of cardiothoracic anesthesia care and provide good information for trainees within the constraints of the chosen presentation format. The remaining 3 sections are dedicated to more advanced topics, including perioperative management for specific procedures and heart failure devices, and are well suited for trainees to read before cases or for practicing cardiac anesthesiologists to use as a refresher. Overall, the chapters are well referenced and up to date with inclusion of landmark studies. However, several chapters would be improved by updated content and references. The 178 figures include black and white or grayscale line art and colorful diagrams and photographs in some chapters. These effectively illustrate important points in many chapters. There is variability in the way chapter authors use figures with the number of included figures varying between chapters from none to 18, and several longer chapters include only a few figures. Similarly, while tables are included that allow the reader to easily grasp some concepts, the number and use of these varies between chapters. One aspect that separates this book from other reviews of cardiothoracic anesthesia is the large amount of practical information included. Tips such as how to mix up various drug infusions or troubleshoot invasive monitoring catheter placement make this text particularly appealing to trainees. Clinical pearls have also been added to this edition, and these are highlighted throughout the text, making it easy for the reader to pull out key information. The authors’ use of key points, clinical pearls, tables, figures, and illustrations throughout the text can facilitate learners’ understanding of difficult material and speed review of key topics for practicing anesthesiologists. This 6th edition has also been updated to reflect the evolving practice of cardiothoracic anesthesiology by including new material from the prior editions. There is a robust amount of material dedicated to transcatheter procedures, and the section on transcatheter aortic valve replacements (TAVRs) is particularly useful. Transesophageal echocardiography has also been seamlessly incorporated into the material. One chapter is dedicated to the basics of transesophageal echocardiography (TEE) image acquisition and interpretation. In addition, key applications of TEE specific to individual procedures are woven throughout the text. While not as in depth as books dedicated solely to perioperative echocardiography, the authors do an excellent job highlighting high-yield basics. The included eBook requires sign up for the publisher’s “VitalSource Bookshelf.” Overall, the eBook is easy to navigate with multiple navigation tools that facilitate quick access to key information related to a specific disease or procedure. Navigation within chapters includes links to specific sections, illustrations, tables, and videos. The eBook includes supplemental echocardiography videos (mostly TEE with 1 transthoracic echocardiography [TTE]; although the links to Chapter 12 videos are missing in the review copy). These are useful because the moving images extend information conveyed by still images of echocardiographic findings. There is a robust search function, including hyperlinks to source material for some content such as references and the Society of Thoracic Surgeons (STS) risk calculator. Bookmarks, highlighting, and note entry are supported and provide powerful learning or test preparation tools. Navigation would be improved by adding a “back” function after clicking links and quick links to next chapters. These are minor issues that do not detract from the value of the text and are likely eBook software features that could be addressed in future updates. Overall, the text does a nice job covering the basics of cardiothoracic anesthesia and continues to be an excellent text for those learning cardiothoracic anesthesiology and as an easy-to-access reference for practicing cardiothoracic anesthesiologists. Nicole Weiss, MDRichard L. Applegate II, MD, FASADepartment of Anesthesiology and Pain MedicineUniversity of California DavisSacramento, California[email protected]