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ARTICLE |

Cardiothoracic Surgery FREE

George J. Magovern, Sr; James A. Magovern, MD
JAMA. 1994;271(21):1658-1660. doi:10.1001/jama.1994.03510450030016
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Cardiothoracic surgery continues to be a dynamic field with new developments arising from a variety of sources. In the last 2 years the necessity for making a major incision for a thoracic operation has been challenged, and in many instances it has been replaced by video-assisted thoracoscopic surgery. This technique uses several small incisions (1 to 2 cm) on the chest wall through which a thoracoscope and endoscopic instruments can be introduced and manipulated. An image is captured on a video monitor by a miniature camera attached to the thoracoscope. The advantages of video-assisted thoracoscopic surgery over thoracotomy are decreased postoperative pain, shorter hospitalization, and faster patient recovery.1 The technique does require single-lung ventilation with collapse of the ipsilateral lung, and therefore general anesthesia and a double-lumen endotracheal tube are needed.

Video-assisted techniques have replaced the standard open thoracotomy approaches for most simple thoracic operations. Procedures that are now

REFERENCES

Allen MS, Deschamps C, Lee RE, et al.  Video-assisted thoracoscopic stapled wedge excision for indeterminate pulmonary nodules. J Thorac Cardiovasc Surg . 1993;;106:1048-1052.
Grandjean P, Austin L, Chan S, et al.  Dynamic cardiomyoplasty: clinical followup results. J Cardiac Surg . 1991;;6:80-88.
Magovern JA, Magovern GJ, Maher TD, et al.  Operation for congestive heart failure: transplantation, coronary artery bypass, and cardiomyoplasty. Ann Thorac Surg . 1993;;56:418-425.
Blackstone EH, Kirklin JW.  Recommendations for prophylatic removal of heart valve prostheses. J Heart Valve Dis . 1992;;1:3-14.
Shiley Heart Valve Research Center. Updated Information for Physicians About Patients With Björk-Shiley 60° Convexo-Concave Heart Valves . Irvine, Calif: Shiley Heart Valve Research Center; March 1993;.
Birkmeyer JD, Marrin CAS, O'Connor GT.  Should patients with Björk-Shiley valves undergo prophylactic replacement? Lancet . 1992;;340:520-523.

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Allen MS, Deschamps C, Lee RE, et al.  Video-assisted thoracoscopic stapled wedge excision for indeterminate pulmonary nodules. J Thorac Cardiovasc Surg . 1993;;106:1048-1052.
Grandjean P, Austin L, Chan S, et al.  Dynamic cardiomyoplasty: clinical followup results. J Cardiac Surg . 1991;;6:80-88.
Magovern JA, Magovern GJ, Maher TD, et al.  Operation for congestive heart failure: transplantation, coronary artery bypass, and cardiomyoplasty. Ann Thorac Surg . 1993;;56:418-425.
Blackstone EH, Kirklin JW.  Recommendations for prophylatic removal of heart valve prostheses. J Heart Valve Dis . 1992;;1:3-14.
Shiley Heart Valve Research Center. Updated Information for Physicians About Patients With Björk-Shiley 60° Convexo-Concave Heart Valves . Irvine, Calif: Shiley Heart Valve Research Center; March 1993;.
Birkmeyer JD, Marrin CAS, O'Connor GT.  Should patients with Björk-Shiley valves undergo prophylactic replacement? Lancet . 1992;;340:520-523.
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To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
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