Tsung O. Cheng; ed. 556 pages. New York: Igaku-Shoin; 1992. $129.00.

Percutaneous balloon valvuloplasty, although a relatively new procedure, is now the subject of a second textbook. Does a technology that is so early in its development and that has relatively narrow applicability (particularly in the industrialized world) merit one text, let alone two?

The answer is yes. This procedure has revolutionized the treatment of pulmonary stenosis and offers distinct advantages over surgery for many patients with mitral valve stenosis. There are hazards of publishing textbooks too early, however, and they apply to Dr. Cheng's volume: Rapid evolution of techniques and the steady stream of publications describing individual cases and series mean that an early textbook inevitably becomes quickly outdated. Given the deadlines involved in textbook publishing and the book's focus on an immature technology, it is not surprising that more than 25% of the world's literature on this subject has been published since the book chapters were written. Nevertheless, the material and perspectives are largely up to date, in part, because the authors represent many of the major groups working in this field.

This fine textbook attempts, with some success, to provide a reference not only for valvuloplasty of mitral, aortic, and pulmonary stenosis, but also for the percutaneous approach to less common lesions such as tricuspid, bioprosthetic, conduit, and other obstructive stenoses. The illustrations are outstanding, with multiple color plates. Some chapters are particularly well written; a fine example is the chapter by Anderson and Becker on the anatomy and pathology of valvular stenosis. A few chapters, such as the extensive one dealing with mitral valvuloplasty in the setting of left atrial thrombi, although well written and interesting, do not merit an entire chapter. The text would have benefited from a firmer editorial hand: Individual authors sometimes champion their own procedures (a "how we do it" approach), rather than providing a balanced view. Considerable inconsistency in style and content and some redundancy, with the same tables and formulas appearing several times, occur.

The book ambitiously attempts to cover not only balloon valvuloplasty but also valvular heart disease, in general. Thus, chapters on electrocardiography and magnetic resonance imaging, although well written, may seem somewhat out of place. These chapters, however, serve to make the text valuable not only for interventional cardiologists but also for those seeking fresh insights into valvular heart disease. A second edition of this book, when percutaneous balloon valvuloplasty approaches a decade of widespread use, will also be welcome.