CARDIOVASCULAR ENGINEERING

CARDIOVASCULAR
ENGINEERING

Journal for Extracorporeal Circulation, Assist Devices, Transplantation and Artificial Organs

Editorials


Editorials

Cardiovascular engineering is a currently dynamic field of interesting recent research, rapidly moving. The medical profession can only come to terms with such change through systematic, self-critical learning of new techniques from scratch, avoiding any pre-conceptions in terms of instruments or medical equipment and dominating technological reasons.New cardiovascular procedures and techniques will have even greater significance in the future as these innovations not only considerably reduce the amount of time hospital beds are occupied, but also allow employees to return to work a great deal sooner. Resulting from the increasing rate of new knowledge and technical innovations, we decided ourselves to create a new journal with the focus on these recent developments.

Our new journal "Cardiovascular Engineering" (Journal for Extracorporeal Circulation, Assist Devices, Transplantation and Artificial Organs) is published to fit the need for a journal devoted exclusively to the newest and most important advances in basic science and clinical research in these special fields. The basic idea of the founder of this new journal was: to cross the frontiers from biomedical technology and pharmaceutical industry to clinical practice and research, by bringing together cardiovascular and thoracic surgeons, cardiologists and pediatric cardiologists, anesthetists, specialists for intensive care medicine, bioengineers, perfusionists, researchers from the biomedical technology and pharmaceutical industry and specialists from all medical, biological and technical disciplines who are interested in cardiovascular engineering problems.

The interdisciplinary members of the editorial board of Cardiovascular Engineering include eminent cardiovascular surgeons, and other related specialists from Europe, USA, Australia and Japan thus providing a geographical balance as well as even exposure to each area within cardiovascular engineering. Coverage includes: Extracorporeal Circulation, Assisted Circulation Techniques, Hemofiltration, Hemodialysis, Cell saving and Blood Transfusion, Cardiac Anesthesia and Intensive Care, Organ Transplantation, Special Techniques, Artificial Organs, Surgical Research, Patient Monitoring, Biomedical Engineering, Pathological Mechanisms of Extracorporeal Circulation.

The new, more comprehensive understanding of quality criteria will alter hospitals in many ways. The aim of these changes is to ensure the best possible medical care, better service, and more economy efficiency through rationalisation of resources. There must be no competition between ethics, technology and economic viability. This is an interesting main issue for discussions with the biomedical technology and pharmaceutical industry.

The concept of our journal provides a theatre for scientific discussion with colleagues, the active exchange of personal experiences, and the possibility to publish manuscripts about your actual clinical and research problems, pending peer-review by our editorial board. We ask you for your kind support and suggestions as to the appropriate steps to be taken to ensure that the journal Cardiovascular Engineering includes a maximum number of readers in the field of cardiovascular engineering in as many countries as possible. Our intention is to awaken the reader's curiosity and arouse expectations to lead him into the text and encourage him to reflect upon it.

REINER KÖRFER, M.D., Ph.D., Professor


The cradle of modern cardio-thoracic surgery stood in the field theatres of the battle fields of the Second World War. It was there where intubation anaesthesia, mass fluid and blood transfusions and antibiotics together with new pathophysiological findings fructified thoracic surgery. This time was also the start of the popularization of English as the major international language in medical societies. After five years of surgical training I obtained my Ph.D. degree in 1949 with a thesis on whole body immersion hypothermia. In the next year I went into the United States. There I found that lung resection, extracardiac and blind intracardiac operations had already become established procedures which made headlines in the Fiftieth of this century followed by open heart surgery in the Sixtieth. In the Seventieth, the acceptance of brain death as human death brought another breakthrough in the form of heart and lung transplantation, accomplished again with major contributions from biological research and mechanical engineering.

Cardiac surgery became safer and its indications widened to octogenarians, reflecting the increase of degenerative cardiovascular and pulmonary diseases. Already surgery for pulmonary emphysema (volume reduction), advanced coronary artery disease (laser revascularization) and nodular lung lesions (early resection) enjoy wide popularity.

All this progress in today's cardio-thoracic surgery has been accomplished through the co-operation of surgeons and innovative and creative bioengineers.

The current fluctuations of world economy and new trends toward cost-effective surgical care inevitably invited minimally invasive, transluminal and endoscopic surgery as well as day-surgery. These new entities necessitated again compact, miniaturized and refined equipment.

Due to the shortage of donor organs, potential application of cardiac xenografts, as well as foetal surgery appear on the horizon. "Virtual reality", imaging engineering and the Internet are changing training and practice in surgery.

The case load of cardio-thoracic surgeons has been increasing and will continue to do so due to the increase of degenerative disorders related to the growing number of senior citizens.

The biggest problem which we face now is, to find ways to overcome the serious shortage of donor organs by mechanical prostheses of satisfactory durability or the use of xenograft hearts. Nearly equal priority deserves the realization of minimally invasive and cost-effective surgery. To meet with these future developments, engineers and biologists co-operating with cardio-thoracic surgeons will be in high demand in the next century. Space medicine already teaches us this. These challenges will also require foresighted new concepts in individual as well as societal ethics.

Let us put all our medical and scientific knowledge together to realize a better human life for our children and grandchildren.

JURO WADA, M.D., Ph.D., F.A.C.S., F.I.C.S.(Hon.), F.C.C.P.(Hon.), F.C.T.S., Professor



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