By Alex G. Little MD, Walter H. Merrill MD
Drs. Little and Merrill draw on their services generally thoracic and cardiac surgical procedure to study tracheobronchial operations, lung quantity aid operations, lung transplantation, minimally invasive esophagectomy, pleural operations, revascularizations, myocardial operations, and aortic and nice vessel operations. for every operation, best practitioners supply particular recommendation on what to pay attention to to avoid issues -- and the way to regulate them in the event that they do take place.
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Drs. Little and Merrill draw on their services regularly thoracic and cardiac surgical procedure to study tracheobronchial operations, lung quantity relief operations, lung transplantation, minimally invasive esophagectomy, pleural operations, revascularizations, myocardial operations, and aortic and nice vessel operations.
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Additional resources for Complications in Cardiothoracic Surgery: Avoidance and Treatment
It can be performed rapidly. The incision provides superior exposure to the heart, great vessels, and anterior mediastinum. As a midline access, it permits admission to both pleural cavities. Median sternotomy is safe and heals rapidly. And, since it is less painful than thoracotomy, it compromises pulmonary function less, especially in the early postoperative period, making it an ideal incision for patients with diminished pulmonary capacity . Median sternotomy carries certain disadvantages.
More recently, the incision has facilitated routine performance of off-pump beating heart coronary bypass operations. Median sternotomy also permits access to the bilateral pleural cavities, permitting pulmonary and hilar exposure without the complications associated with bilateral transverse thoracosternotomy. The utility of sternotomy applies to pulmonary resection [50, 51], lung volume reduction surgery , bilateral pulmonary metastasectomy , and trauma. When a patient has had prior pulmonary resection via a thoracotomy, reoperative pulmonary resection, particularly completion pneumonectomy, can be performed via median sternotomy, allowing hilar exposure in a field free of adhesions.
The sternal insertion of the sternocleidomastoid is sutured. Several authors have expressed concern about the functional effects of medial clavicular resection. An alternative approach is to perform an oblique osteotomy through the wide portion of the clavicular head. The clavicle is then retracted out of the operative field while performing the lobectomy and en bloc chest wall resection. The chest wall is then reconstructed, if needed, and the clavicle is rewired. An arm sling is used for 4–6 weeks postoperatively.
Complications in Cardiothoracic Surgery: Avoidance and Treatment by Alex G. Little MD, Walter H. Merrill MD