Seminars in thoracic and cardiovascular surgery
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Semin. Thorac. Cardiovasc. Surg. · Jan 2013
ReviewSurgical treatment of hypertrophic cardiomyopathy.
Hypertrophic cardiomyopathy (HCM) is a unique primary myocardial disease characterized by unexplained left ventricular hypertrophy in absence of another etiology. One of the key features is the presence of systolic anterior motion of the anterior leaflet of the mitral valve which causes left ventricular outflow tract obstruction with various degrees of mitral valve regurgitation. Surgical septal myectomy is the preferred treatment of choice if medical treatment is unsuccessful or intolerable. We summarize in this review the available treatment options for HCM.
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Semin. Thorac. Cardiovasc. Surg. · Jan 2013
ReviewSurgical management of tetralogy of fallot: in defense of the infundibulum.
Surgical treatment of the Tetralogy of Fallot (ToF) is one of the great successes of medicine and also a topic of controversy. Different strategies have been proposed, including age-based (neonatal) management strategies as well as anatomic-based management strategies. ⋯ The goals of current surgical therapy should be to mitigate the late right ventricular (RV) dysfunction that may occur by minimizing the extent of surgical injury during the intial repair. As the surgical techniques continue to advance, the outcomes will continue to improve.
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Semin. Thorac. Cardiovasc. Surg. · Jan 2013
ReviewInvasive mediastinal staging: endobronchial ultrasound, endoscopic ultrasound, and mediastinoscopy.
Accurate mediastinal staging is essential to determining the optimal therapeutic strategy for many patients with lung cancer. Computed tomography and positron emission tomography are first steps, but frequently tissue sampling is recommended to confirm the radiographic findings. ⋯ The keys to achieving accurate results are skillful execution combined with sound clinical judgment regarding when to use which techniques. Patients with lung cancer are best served by clinicians experienced with all three methods for invasive mediastinal staging.
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Semin. Thorac. Cardiovasc. Surg. · Jan 2013
Current status of left ventricular assist device technology.
The use of long-term left ventricular assist devices (LVADs) has revolutionized the treatment of end-stage heart failure. The most significant advance in this field has been the longer durability of devices secondary to a simpler pump design with fewer or no mechanical bearings and valves. ⋯ As LVAD technology moves forward and new miniaturized, more durable, and reliable pumps are being developed, the number of recipients who will benefit from this technology continues to grow. Elimination of the driveline with fully implantable pumps, implantation of miniature pumps with minimally invasive surgical techniques, wireless data transmission, and improved patient selection will further transform this field in the next few years.