Cardiothoracic surgery

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Coronary artery bypass surgery
Surgeon operating, Fitzsimons Army Medical Center circa 1990
Surgery of suprasternal epidermoid cyst

In the realm of medicine, cardiothoracic surgery delves into the realm of surgical interventions targeting diseases that afflict organs nestled within the thorax or chest. This broadly encompasses conditions plaguing the heart (known as cardiovascular disease) and the lungs (often referred to as lung disease). Cardiothoracic surgery is acknowledged as a distinct surgical specialty with a rich history of groundbreaking achievements and critical procedures.

Thoracic Surgery[edit | edit source]

Thoracic surgery is a branch of cardiothoracic surgery that primarily focuses on surgical treatments of chest ailments, excluding heart-related issues. While general surgeons may possess expertise or show a keen interest in thoracic surgery, cardiothoracic surgeons specialize in procedures involving both the heart and lungs.

Role of a Cardiothoracic Surgeon[edit | edit source]

Cardiothoracic surgeons wield the expertise to execute a plethora of complex surgical procedures, including but not limited to:

  • Coronary Artery Bypass Graft (CABG): This procedure involves rerouting blood flow around blocked coronary arteries to improve blood supply to the heart muscle.
  • Heart valve surgeries: Repair or replacement of heart valves affected by conditions like valvular stenosis or regurgitation.
  • Lung volume reduction surgeries: Surgical reduction of damaged lung tissue to improve lung function in conditions such as emphysema.
  • Heart and/or lung transplantation procedures: Transplantation of hearts, lungs, or both, often the last resort for patients with end-stage heart or lung diseases.
  • Arrhythmia surgeries: Procedures like atrial fibrillation ablation to correct abnormal heart rhythms.
  • Thoracic aorta repairs: Repairing aortic dissections, a life-threatening condition involving the aorta's tearing.

History[edit | edit source]

The history of cardiothoracic surgery is decorated with momentous events and breakthroughs that have revolutionized medical practice. Pioneering animal experiments conducted by stalwarts like Vladimir Demikhov and Dominique Metras during the 1940s and 1950s bore evidence to the technical feasibility of such procedures.

In 1963, Hardy etched history by accomplishing the first human lung transplantation. The patient, after receiving a left lung transplant, managed to survive for 18 days. The period between 1963 and 1978 witnessed numerous endeavors to perfect lung transplantation, with challenges such as rejection and issues with bronchial healing impeding consistent success.

The epoch-making event of the first human-to-human heart transplantation was spearheaded by Dr. Barnard in South Africa on December 3, 1967. This monumental achievement had its seeds sown in 1905 when a puppy's heart was transplanted into a dog's neck. In the contemporary medical landscape, this surgery is predominantly reserved for individuals grappling with terminal congestive heart failure (CHF) and those beyond the aid of conventional medical interventions.

Procedures[edit | edit source]

Cardiothoracic surgery covers a wide spectrum of procedures, divided into the following categories:

Glossary of Cardiothoracic Surgery Terms[edit | edit source]

This glossary provides an overview of key terms and concepts related to cardiothoracic surgery, a specialized field of surgery focusing on the heart, lungs, and chest.

A[edit | edit source]

  • Aneurysm: A localized, abnormal dilation of a blood vessel, often involving the aorta.
  • Aortic dissection: A life-threatening condition where there is a tear in the inner layer of the aorta's wall, causing blood to flow between the layers.
  • Arrhythmia: An irregular heart rhythm that can be corrected through surgical procedures.
  • Atrial fibrillation ablation: A procedure to treat irregular heartbeats by targeting and isolating abnormal electrical pathways in the heart's atria.
  • Atrial septal defect (ASD): A congenital heart defect involving an abnormal opening in the atrial septum (the wall between the heart's upper chambers).

C[edit | edit source]

  • Cardiopulmonary bypass: A technique that temporarily takes over the function of the heart and lungs during surgery, allowing the surgeon to operate on a still and bloodless heart.
  • Congenital heart disease: Structural heart defects present at birth, often requiring surgical correction.
  • Coronary artery bypass graft (CABG): A surgical procedure to reroute blood flow around blocked coronary arteries to improve blood supply to the heart muscle.
  • Cardiotomy: A surgical procedure involving an incision into the heart.
  • Cardioplegia: The temporary cessation of the heart's activity during surgery.

D[edit | edit source]

E[edit | edit source]

  • Endoscopic vessel harvesting: A minimally invasive technique for harvesting blood vessels for coronary artery bypass surgery.
  • External support: Surgical techniques involving external support structures for the heart or blood vessels.

F[edit | edit source]

  • Fontan procedure: A surgical procedure used to redirect blood flow in individuals with certain congenital heart defects.
  • Balloon septostomy: A procedure involving the use of a balloon to enlarge an atrial septal defect.
  • Heart valve repair: Surgical procedures aimed at repairing heart valves.
  • Heart valve replacement: Surgical procedures involving the replacement of damaged or malfunctioning heart valves.

H[edit | edit source]

  • Henry Opitek: A pioneering figure in cardiothoracic surgery.
  • Hyperhidrosis: Excessive sweating, sometimes treated with surgical procedures.

K[edit | edit source]

  • Kawashima procedure: A surgical procedure used to reroute blood flow in certain congenital heart conditions.

L[edit | edit source]

  • LeCompte maneuver: A surgical technique used in certain congenital heart surgeries.
  • Lung surgery: Surgical procedures involving the lungs, often used to treat lung cancer or other conditions.

M[edit | edit source]

P[edit | edit source]

  • Pericardiectomy: Surgical removal of the pericardium (the sac around the heart).
  • Perfusionist: A healthcare professional who operates the heart-lung machine during cardiac surgery.
  • Postperfusion syndrome: A condition characterized by cognitive changes after cardiopulmonary bypass surgery.

R[edit | edit source]

  • Rib removal: Surgical removal of ribs, sometimes performed in thoracic surgery.
  • Ross procedure: A surgical procedure used to treat aortic valve disease.

S[edit | edit source]

T[edit | edit source]

V[edit | edit source]

List of Cardithoraci Surgeons (USA)[edit | edit source]

See Also[edit | edit source]

References[edit | edit source]

External Links[edit | edit source]

Cardiothoracic surgery Resources

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