This edition of Critical Care Nursing Quarterly is dedicated to clinical nurses caring for the more than 71 million Americans with one or more forms of cardiovascular disease ranging from coronary artery disease to end-stage heart failure and pulmonary hypertension requiring advanced and sometimes heroic measures.1 The aim of the manuscript selections was to highlight the innovations in medical, surgical, and pharmacological management of cardiac diseases. Furthermore, the articles have been developed to take the reader on a journey from research efforts to the bedside with an emphasis on nursing implications and the impact on end point care delivery.

Since childhood serves as the beginning point for each of us, our first stop on our journey along the cardiovascular innovations tour is Thompson's article, "Care of the Adult Congenital Heart Disease Patient." With advances in care, many of the congenital patients who formerly would not have reached adulthood and would have been cared for primarily by pediatric nurses are now living into adulthood and requiring nursing care delivery beyond the pediatric ward or hospital walls.

With an estimated 700,000 Americans experiencing a new myocardial infraction and 500,000 having a recurrent infarct, and cardiac catheterization and interventional procedure rates increasing annually, it is important for nurses to have a current appreciation for the interventional approaches and subsequent postprocedure needs of these patients.1 Tarolli's article, "Percutaneous Interventions," provides a contemporary view of these topics.

Traiger provides the reader with a timely and comprehensive feature article on the treatment options, nursing care demands, and future research needs in pulmonary hypertension management. Her extensive clinical expertise and experience with this patient population are evident in the detailed case studies included in this article.

As our journey continues, we transition to a pharmacological view of cardiovascular disease with an emphasis on the heart failure epidemic that is facing our healthcare system. Heart failure is currently the most frequent cause for admissions in persons older than 65 years of age and the estimated cost burden for 2006 for this disease on the American healthcare system is $29.6 billion.1 With a dedicated heart failure section, "Cardiovascular Pharmacology Update for the Intensive Care Unit" will inform the reader of current medical treatment strategies for critically ill cardiac patients.

Saul's article, "Cardiac Resynchronization Therapy," provides a contemporary view of heart failure management from a device perspective and the benefits from resynchronization therapy.

The edition tour progresses into the operating room with a number of articles aimed at assisting the clinical nurse in being current with best practice and outcomes in surgical therapies. Surgical advances in off-pump coronary artery bypass techniques and nursing implications will be presented in "To Pump or Not To Pump?" Shepler and Patel will take the reader on a tour to newer frontiers with "Cardiac Cell Therapy: A Treatment Option for Cardiomyopathy," an article examining the role of cardiac cell therapy and its potential use in advanced heart failure management.

As we are always searching for opportunities to improve practice and outcomes, we end the edition with an analysis of current practice. Schmid's article, "Frequency and Pattern of Medical Emergency Team Activation Among Medical Cardiology Patient Care Units," describes the importance of early recognition of patient crisis in cardiac patients. The implications of early crisis recognition and nursing intervention are far reaching.

We extend a sincere thanks to all of the contributing authors for their time and efforts devoted to this edition. Each of them offers unique perspectives in the care of cardiovascular patients. A special thank you to Carmen Warner for providing us with this opportunity as issue editors. We thank Daniel Shearn, MSN, RN, Clinical Director of Critical Care Services at UPMC Presbyterian-Shadyside, and Susan Frank, MSN, RN, Clinical Director of Cardiovascular Services at UPMC Presbyterian-Shadyside, for support and encouragement throughout this endeavor.

Melanie B. Shatzer, MSN, RN, CCRN

Elisabeth L. George, PhD, RN, CCRN

Issue Editors, Divisions of Cardiothoracic and Critical Care Nursing, UPMC Presbyterian-Shadyside, Pittsburgh, Pa.

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