Cardiothoracic surgery

Article Abstract:

Several important new developments in the field of cardiothoracic surgery are reviewed and evaluated. When damaged coronary arteries (which deliver blood to the heart itself) are replaced by grafts, the most commonly used vessel is the internal mammary artery (IMA). Technical aspects of the grafting procedure are discussed. In general, bilateral IMA grafting is the safest method for most patients undergoing coronary artery bypass surgery. Endocarditis (a life-threatening inflammation of the lining of the heart's chambers) is now treated by aortic allografts (grafts of tissue from other individuals); this method has led to decreased mortality. Sufferers from Marfan syndrome (a congenital condition involving abnormalities of the vascular system) benefit from surgical treatment, but may need second procedures, as well. Echocardiography (ultrasound) is being used more often during cardiothoracic surgical procedures; several recent reports on its usefulness are summarized. Innovative methods for treating congenital defects of the heart and great vessels are described. AIDS (acquired immunodeficiency syndrome) will influence cardiothoracic surgery in the future, as surgeons express both willingness to operate on AIDS patients, and a desire for all open-heart surgery candidates to undergo AIDS testing. The number of AIDS patients requiring heart surgery is expected to increase in the coming years. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Evaluation, Heart, Congenital heart disease, Congenital heart defects, Heart surgery, Cardiopulmonary bypass, Marfan syndrome, Endocarditis

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Cardiothoracic surgery

Article Abstract:

Organ and tissue transplants from one species to another(xenografts) are being actively researched. This would solve the problems of donor availability and compatibility. Using immunosuppressive drugs, physicians have successfully transplanted hearts from one primate species to another. Researchers are also looking for alternatives to balloon angioplasty to avoid damage to the endothelial cells lining the veins. Damage causes the recurrence of the disease within six months in 25% of cases. Future genetic solutions may involve the transfer of fat metabolizing genes into coronary artery endothelial cells to prevent or reverse atherosclerosis. The new maze procedure which interrupts potential electrical circuits within the atrium offers successful treatment for patients with chronic atrial flutter and/or fibrillation. Continuing education for physicians and the public is critical, particularly on the need for animal research.

Coronary heart disease, Cardiovascular system, Cardiovascular surgery

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Cardiothoracic surgery

Article Abstract:

Cardiothoracic surgery, like many other specialties, has been influenced by the move to diagnosis related groups, physician payment reform and the rise of managed care. Research shows that the porcine heart valve can last up to 15 years and a second-generation mechanical valve is being tested. Coronary artery bypass seems to produce better long-term outcomes compared to angioplasty. Innovative techniques to treat congestive heart failure include implantable defibrillators, mechanical assist devices and cardiomyoplasty. Gene therapy is also being tested for certain heart diseases.

Heart diseases

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