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This book is based on the experience of the Paul Munk Cardiac Centre in Toronto Canada from where all the contributors come. It is divided into six sections progressing from pre-operative considerations to postoperative ward management. A third of the 40 chapters are surgically orientated but these are useful for anaesthetic trainees to read. Knowledge and understanding of each other's perspectives are essential for first class patient care and this book can provide both. Throughout the book useful research and audit data from the Toronto computerized database is given, sometimes compared with published figures where they are available. The book has several chapters on complications and the Toronto way of avoiding and managing them, with some notable successes. As a book this is based on one large and successful centre's way of doing things, it works. There is a selectied reading list for each chapter with mostly up-to-date articles. This handbook achieves its purpose of being a source of practical information for trainee doctors, nurses, perfusionists and other healthcare personnel involved with patients undergoing open-heart surgery. Anaesthetists on their cardiac module would find it helpful and the appendices at the back of the manual give the Toronto algorithms and protocols, from wich some departments may get useful ideas.
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