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id="toc-Cardiac_surgery" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Cardiac_surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Cardiac surgery</span> </div> </a> <button aria-controls="toc-Cardiac_surgery-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Cardiac surgery subsection</span> </button> <ul id="toc-Cardiac_surgery-sublist" class="vector-toc-list"> <li id="toc-Early_approaches_to_heart_malformations" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Early_approaches_to_heart_malformations"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Early approaches to heart malformations</span> </div> </a> <ul id="toc-Early_approaches_to_heart_malformations-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Open_heart_surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Open_heart_surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Open heart surgery</span> </div> </a> <ul id="toc-Open_heart_surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Modern_beating-heart_surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Modern_beating-heart_surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Modern beating-heart surgery</span> </div> </a> <ul id="toc-Modern_beating-heart_surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Minimally_invasive_surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Minimally_invasive_surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Minimally invasive surgery</span> </div> </a> <ul id="toc-Minimally_invasive_surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pediatric_cardiovascular_surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pediatric_cardiovascular_surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.5</span> <span>Pediatric cardiovascular surgery</span> </div> </a> <ul id="toc-Pediatric_cardiovascular_surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Risks_of_cardiac_surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Risks_of_cardiac_surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.6</span> <span>Risks of cardiac surgery</span> </div> </a> <ul id="toc-Risks_of_cardiac_surgery-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Thoracic_surgery" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Thoracic_surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Thoracic surgery</span> </div> </a> <button aria-controls="toc-Thoracic_surgery-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Thoracic surgery subsection</span> </button> <ul id="toc-Thoracic_surgery-sublist" class="vector-toc-list"> <li id="toc-Lung_volume_reduction_surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lung_volume_reduction_surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Lung volume reduction surgery</span> </div> </a> <ul id="toc-Lung_volume_reduction_surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Lung_cancer_surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lung_cancer_surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Lung cancer surgery</span> </div> </a> <ul id="toc-Lung_cancer_surgery-sublist" class="vector-toc-list"> <li id="toc-Complications" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Complications"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2.1</span> <span>Complications</span> </div> </a> <ul id="toc-Complications-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Types" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Types"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2.2</span> <span>Types</span> </div> </a> <ul id="toc-Types-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Cardiothoracic surgery</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 34 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-34" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">34 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AC%D8%B1%D8%A7%D8%AD%D8%A9_%D8%A7%D9%84%D9%82%D9%84%D8%A8_%D9%88%D8%A7%D9%84%D8%B5%D8%AF%D8%B1" title="جراحة القلب والصدر – Arabic" lang="ar" hreflang="ar" data-title="جراحة القلب والصدر" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Torakal_c%C9%99rrahiyy%C9%99" title="Torakal cərrahiyyə – Azerbaijani" lang="az" hreflang="az" data-title="Torakal cərrahiyyə" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%9A%D0%B0%D1%80%D0%B4%D0%B8%D0%BE%D1%82%D0%BE%D1%80%D0%B0%D0%BA%D1%81%D0%B8%D0%B0%D0%BB%D0%BD%D0%B0_%D1%85%D0%B8%D1%80%D1%83%D1%80%D0%B3%D0%B8%D1%8F" title="Кардиотораксиална хирургия – Bulgarian" lang="bg" hreflang="bg" data-title="Кардиотораксиална хирургия" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Cirurgia_tor%C3%A0cica" title="Cirurgia toràcica – Catalan" lang="ca" hreflang="ca" data-title="Cirurgia toràcica" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Thoraxkirurgi" title="Thoraxkirurgi – Danish" lang="da" hreflang="da" data-title="Thoraxkirurgi" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Torakaalkirurgia" title="Torakaalkirurgia – Estonian" lang="et" hreflang="et" data-title="Torakaalkirurgia" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Cirug%C3%ADa_tor%C3%A1cica" title="Cirugía torácica – Spanish" lang="es" hreflang="es" data-title="Cirugía torácica" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Toraxeko_kirurgia" title="Toraxeko kirurgia – Basque" lang="eu" hreflang="eu" data-title="Toraxeko kirurgia" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%AC%D8%B1%D8%A7%D8%AD%DB%8C_%D9%82%D9%81%D8%B3%D9%87_%D8%B3%DB%8C%D9%86%D9%87" title="جراحی قفسه سینه – Persian" lang="fa" hreflang="fa" data-title="جراحی قفسه سینه" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Chirurgie_thoracique" title="Chirurgie thoracique – French" lang="fr" hreflang="fr" data-title="Chirurgie thoracique" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Cirurx%C3%ADa_tor%C3%A1cica" title="Cirurxía torácica – Galician" lang="gl" hreflang="gl" data-title="Cirurxía torácica" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%ED%9D%89%EB%B6%80%EC%99%B8%EA%B3%BC" title="흉부외과 – Korean" lang="ko" hreflang="ko" data-title="흉부외과" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Kordiotorakala_kirurgio" title="Kordiotorakala kirurgio – Ido" lang="io" hreflang="io" data-title="Kordiotorakala kirurgio" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target"><span>Ido</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Bedah_toraks_dan_kardiovaskular" title="Bedah toraks dan kardiovaskular – Indonesian" lang="id" hreflang="id" data-title="Bedah toraks dan kardiovaskular" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Chirurgia_toracica" title="Chirurgia toracica – Italian" lang="it" hreflang="it" data-title="Chirurgia toracica" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%A2%D0%BE%D1%80%D0%B0%D0%BA%D0%B0%D0%BB%D0%B4%D1%8B_%D1%85%D0%B8%D1%80%D1%83%D1%80%D0%B3%D0%B8%D1%8F" title="Торакалды хирургия – Kazakh" lang="kk" hreflang="kk" data-title="Торакалды хирургия" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%9A%D0%B0%D1%80%D0%B4%D0%B8%D0%BE%D1%82%D0%BE%D1%80%D0%B0%D0%BA%D0%B0%D0%BB%D0%BD%D0%B0_%D1%85%D0%B8%D1%80%D1%83%D1%80%D0%B3%D0%B8%D1%98%D0%B0" title="Кардиоторакална хирургија – Macedonian" lang="mk" hreflang="mk" data-title="Кардиоторакална хирургија" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Thoraxchirurgie" title="Thoraxchirurgie – Dutch" lang="nl" hreflang="nl" data-title="Thoraxchirurgie" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%83%B8%E9%83%A8%E5%A4%96%E7%A7%91%E5%AD%A6" title="胸部外科学 – Japanese" lang="ja" hreflang="ja" data-title="胸部外科学" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Thoraxkirurgi" title="Thoraxkirurgi – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Thoraxkirurgi" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Kardiyotorasik_jarrohlik" title="Kardiyotorasik jarrohlik – Uzbek" lang="uz" hreflang="uz" data-title="Kardiyotorasik jarrohlik" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Torakochirurgia" title="Torakochirurgia – Polish" lang="pl" hreflang="pl" data-title="Torakochirurgia" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Cirurgia_tor%C3%A1cica" title="Cirurgia torácica – Portuguese" lang="pt" hreflang="pt" data-title="Cirurgia torácica" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Chirurgie_toracic%C4%83" title="Chirurgie toracică – Romanian" lang="ro" hreflang="ro" data-title="Chirurgie toracică" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A2%D0%BE%D1%80%D0%B0%D0%BA%D0%B0%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D1%85%D0%B8%D1%80%D1%83%D1%80%D0%B3%D0%B8%D1%8F" title="Торакальная хирургия – Russian" lang="ru" hreflang="ru" data-title="Торакальная хирургия" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Kirurgjia_kardiotorakale" title="Kirurgjia kardiotorakale – Albanian" lang="sq" hreflang="sq" data-title="Kirurgjia kardiotorakale" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target"><span>Shqip</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%9F%D0%BB%D0%B5%D1%83%D1%80%D0%B5%D0%BA%D1%82%D0%BE%D0%BC%D0%B8%D1%98%D0%B0" title="Плеуректомија – Serbian" lang="sr" hreflang="sr" data-title="Плеуректомија" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Torakalna_kirurgija" title="Torakalna kirurgija – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Torakalna kirurgija" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Kardiyotorasik_cerrahi" title="Kardiyotorasik cerrahi – Turkish" lang="tr" hreflang="tr" data-title="Kardiyotorasik cerrahi" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%A2%D0%BE%D1%80%D0%B0%D0%BA%D0%B0%D0%BB%D1%8C%D0%BD%D0%B0_%D1%85%D1%96%D1%80%D1%83%D1%80%D0%B3%D1%96%D1%8F" title="Торакальна хірургія – Ukrainian" lang="uk" hreflang="uk" data-title="Торакальна хірургія" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%DA%A9%D8%A7%D8%B1%DA%88_%DB%8C%D9%88_%D8%AA%DA%BE%D9%88%D8%B1%D8%A7%D8%B3%DA%A9_%D8%B3%D8%B1%D8%AC%D8%B1%DB%8C" title="کارڈ یو تھوراسک سرجری – Urdu" lang="ur" hreflang="ur" data-title="کارڈ یو تھوراسک سرجری" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target"><span>اردو</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Ph%E1%BA%ABu_thu%E1%BA%ADt_tim_%E2%80%93_l%E1%BB%93ng_ng%E1%BB%B1c" title="Phẫu thuật tim – lồng ngực – Vietnamese" lang="vi" hreflang="vi" data-title="Phẫu thuật tim – lồng ngực" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-zh-yue mw-list-item"><a href="https://zh-yue.wikipedia.org/wiki/%E5%BF%83%E8%83%B8%E8%82%BA%E5%A4%96%E7%A7%91" title="心胸肺外科 – Cantonese" lang="yue" hreflang="yue" 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class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical specialty involved in surgical treatment of organs inside the thorax</div> <p class="mw-empty-elt"> </p> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><caption class="infobox-title">Cardiothoracic Surgeon</caption><tbody><tr><td colspan="2" class="infobox-image"><span typeof="mw:File"><a href="/wiki/File:Ijn_surgeon.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/52/Ijn_surgeon.JPG/200px-Ijn_surgeon.JPG" decoding="async" width="200" height="319" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/5/52/Ijn_surgeon.JPG 1.5x" data-file-width="268" data-file-height="427" /></a></span><div class="infobox-caption">Cardiothoracic surgeon performs an operation.</div></td></tr><tr><th colspan="2" class="infobox-header">Occupation</th></tr><tr><th scope="row" class="infobox-label">Names</th><td class="infobox-data"> <ul><li>Doctor</li> <li>Surgeon</li></ul> </td></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Occupation type</div></th><td class="infobox-data"><a href="/wiki/Specialty_(medicine)" class="mw-redirect" title="Specialty (medicine)">Specialty</a></td></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Activity sectors</div></th><td class="infobox-data"><a href="/wiki/Medicine" title="Medicine">Medicine</a>, <a href="/wiki/Surgery" title="Surgery">Surgery</a></td></tr><tr><th colspan="2" class="infobox-header">Description</th></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Education required</div></th><td class="infobox-data"> <ul><li><a href="/wiki/Doctor_of_Medicine" title="Doctor of Medicine">Doctor of Medicine</a> (M.D.)</li> <li><a href="/wiki/Doctor_of_Osteopathic_medicine" class="mw-redirect" title="Doctor of Osteopathic medicine">Doctor of Osteopathic medicine</a> (D.O.)</li> <li><a href="/wiki/Bachelor_of_Medicine,_Bachelor_of_Surgery" title="Bachelor of Medicine, Bachelor of Surgery">Bachelor of Medicine, Bachelor of Surgery</a> (M.B.B.S.)</li> <li><a href="/wiki/Bachelor_of_Medicine,_Bachelor_of_Surgery" title="Bachelor of Medicine, Bachelor of Surgery">Bachelor of Medicine, Bachelor of Surgery</a> (MBChB)</li></ul> </td></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Fields of<br />employment</div></th><td class="infobox-data"><a href="/wiki/Hospital" title="Hospital">Hospitals</a>, <a href="/wiki/Clinic" title="Clinic">Clinics</a></td></tr></tbody></table> <p><b>Cardiothoracic surgery</b> is the <a href="/wiki/Medical_speciality" class="mw-redirect" title="Medical speciality">field</a> of <a href="/wiki/Medicine" title="Medicine">medicine</a> involved in <a href="/wiki/Surgery" title="Surgery">surgical treatment</a> of organs inside the <a href="/wiki/Thoracic_cavity" title="Thoracic cavity">thoracic cavity</a> — generally treatment of conditions of the <a href="/wiki/Heart" title="Heart">heart</a> (<a href="/wiki/Heart_disease" class="mw-redirect" title="Heart disease">heart disease</a>), <a href="/wiki/Lung" title="Lung">lungs</a> (<a href="/wiki/Pulmonology" title="Pulmonology">lung disease</a>), and other <a href="/wiki/Pleural" class="mw-redirect" title="Pleural">pleural</a> or <a href="/wiki/Mediastinal" class="mw-redirect" title="Mediastinal">mediastinal</a> structures. </p><p>In most countries, cardiothoracic surgery is further <a href="/wiki/Subspecialty" title="Subspecialty">subspecialized</a> into <b>cardiac surgery</b> (involving the heart and the <a href="/wiki/Great_vessels" title="Great vessels">great vessels</a>) and <b>thoracic surgery</b> (involving the lungs, <a href="/wiki/Esophagus" title="Esophagus">esophagus</a>, <a href="/wiki/Thymus" title="Thymus">thymus</a>, etc.); the exceptions are the <a href="/wiki/United_States" title="United States">United States</a>, <a href="/wiki/Australia" title="Australia">Australia</a>, <a href="/wiki/New_Zealand" title="New Zealand">New Zealand</a>, the <a href="/wiki/United_Kingdom" title="United Kingdom">United Kingdom</a>, <a href="/wiki/India" title="India">India</a> and some <a href="/wiki/European_Union" title="European Union">European Union</a> countries such as <a href="/wiki/Portugal" title="Portugal">Portugal</a>.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Training">Training</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=1" title="Edit section: Training"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A cardiac surgery <a href="/wiki/Residency_(medicine)" title="Residency (medicine)">residency</a> typically comprises anywhere from four to six years (or longer) of training to become a fully qualified surgeon.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Cardiac surgery training may be combined with thoracic surgery and/or <a href="/wiki/Vascular_surgery" title="Vascular surgery">vascular surgery</a> and called cardiovascular (CV) / cardiothoracic (CT) / cardiovascular thoracic (CVT) surgery. Cardiac surgeons may enter a cardiac surgery residency directly from <a href="/wiki/Medical_school" title="Medical school">medical school</a>, or first complete a <a href="/wiki/General_surgery" title="General surgery">general surgery</a> residency followed by a <a href="/wiki/Fellowship_(medicine)" title="Fellowship (medicine)">fellowship</a>. Cardiac surgeons may further sub-specialize cardiac surgery by doing a fellowship in a variety of topics including <a href="/wiki/Pediatric" class="mw-redirect" title="Pediatric">pediatric</a> cardiac surgery, <a href="/wiki/Heart_transplantation" title="Heart transplantation">cardiac transplantation</a>, adult-acquired heart disease, weak heart issues, and many more problems in the heart.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Australia_and_New_Zealand">Australia and New Zealand</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=2" title="Edit section: Australia and New Zealand"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The highly competitive Surgical Education and Training (SET) program in Cardiothoracic Surgery is six years in duration, usually commencing several years after completing medical school. Training is administered and supervised via a bi-national (Australia and New Zealand) training program. Multiple examinations take place throughout the course of training, culminating in a final fellowship exam in the final year of training. Upon completion of training, surgeons are awarded a Fellowship of the <a href="/wiki/Royal_Australasian_College_of_Surgeons" title="Royal Australasian College of Surgeons">Royal Australasian College of Surgeons</a> (FRACS), denoting that they are qualified specialists. Trainees having completed a training program in General Surgery and have obtained their FRACS will have the option to complete fellowship training in Cardiothoracic Surgery of four years in duration, subject to college approval. It takes around eight to ten years minimum of post-graduate (post-medical school) training to qualify as a cardiothoracic surgeon. Competition for training places and for public (teaching) hospital places is very high currently, leading to concerns regarding <a href="/wiki/Workforce_planning" class="mw-redirect" title="Workforce planning">workforce planning</a> in Australia.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2022)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Canada">Canada</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=3" title="Edit section: Canada"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Historically, cardiac surgeons in <a href="/wiki/Canada" title="Canada">Canada</a> completed general surgery followed by a fellowship in CV / CT / CVT. During the 1990s, the Canadian cardiac surgery training programs changed to six-year "direct-entry" programs following medical school. The direct-entry format provides residents with experience related to cardiac surgery they would not receive in a general surgery program (e.g. <a href="/wiki/Echocardiography" title="Echocardiography">echocardiography</a>, <a href="/wiki/Coronary_care_unit" title="Coronary care unit">coronary care unit</a>, cardiac catheterization etc.). Residents in this program will also spend time training in thoracic and <a href="/wiki/Vascular_surgery" title="Vascular surgery">vascular surgery</a>. Typically, this is followed by a fellowship in either Adult Cardiac Surgery, Heart Failure/Transplant, Minimally Invasive Cardiac Surgery, Aortic Surgery, Thoracic Surgery, Pediatric Cardiac Surgery or Cardiac ICU. Contemporary Canadian candidates completing general surgery and wishing to pursue cardiac surgery often complete a cardiothoracic surgery fellowship in the United States. The Royal College of Physicians and Surgeons of Canada also provides a three-year cardiac surgery fellowship for qualified general surgeons that is offered at several training sites including the <a href="/wiki/University_of_Alberta" title="University of Alberta">University of Alberta</a>, the <a href="/wiki/University_of_British_Columbia" title="University of British Columbia">University of British Columbia</a> and the <a href="/wiki/University_of_Toronto" title="University of Toronto">University of Toronto</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p><p>Thoracic surgery is its own separate 2–3 year fellowship of general or cardiac surgery in Canada. </p><p>Cardiac surgery programs in Canada:<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p> <ul><li><a href="/wiki/University_of_Alberta" title="University of Alberta">University of Alberta</a> – 1 position</li> <li><a href="/wiki/University_of_British_Columbia" title="University of British Columbia">University of British Columbia</a> – 1 position</li> <li><a href="/wiki/University_of_Calgary" title="University of Calgary">University of Calgary</a> – 1 position</li> <li><a href="/wiki/Dalhousie_University" title="Dalhousie University">Dalhousie University</a> – 1 position every other year</li> <li><a href="/wiki/Universit%C3%A9_Laval" title="Université Laval">Université Laval</a> – 1 position every three years</li> <li><a href="/wiki/University_of_Manitoba" title="University of Manitoba">University of Manitoba</a> – 1 position</li> <li><a href="/wiki/McGill_University" title="McGill University">McGill University</a> – 1 position every three years</li> <li><a href="/wiki/McMaster_University" title="McMaster University">McMaster University</a> – 1 position every other year</li> <li><a href="/wiki/Universit%C3%A9_de_Montr%C3%A9al" title="Université de Montréal">Université de Montréal</a> – 1 position every three years</li> <li><a href="/wiki/University_of_Ottawa" title="University of Ottawa">University of Ottawa</a> – 1 position</li> <li><a href="/wiki/University_of_Toronto" title="University of Toronto">University of Toronto</a> – 1 position</li> <li><a href="/wiki/University_of_Western_Ontario" title="University of Western Ontario">Western University</a> – 1 position</li></ul> <div class="mw-heading mw-heading3"><h3 id="United_States">United States</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=4" title="Edit section: United States"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Surgeon_operating,_Fitzsimons_Army_Medical_Center,_circa_1990.JPEG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Surgeon_operating%2C_Fitzsimons_Army_Medical_Center%2C_circa_1990.JPEG/200px-Surgeon_operating%2C_Fitzsimons_Army_Medical_Center%2C_circa_1990.JPEG" decoding="async" width="200" height="298" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Surgeon_operating%2C_Fitzsimons_Army_Medical_Center%2C_circa_1990.JPEG/300px-Surgeon_operating%2C_Fitzsimons_Army_Medical_Center%2C_circa_1990.JPEG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/41/Surgeon_operating%2C_Fitzsimons_Army_Medical_Center%2C_circa_1990.JPEG/400px-Surgeon_operating%2C_Fitzsimons_Army_Medical_Center%2C_circa_1990.JPEG 2x" data-file-width="1920" data-file-height="2860" /></a><figcaption> Surgeon operating</figcaption></figure> <p>Cardiac surgery training in the <a href="/wiki/United_States" title="United States">United States</a> is combined with general <a href="/wiki/Thoracic_surgery" class="mw-redirect" title="Thoracic surgery">thoracic surgery</a> and called cardiothoracic surgery or thoracic surgery. A cardiothoracic surgeon in the U.S. is a physician who first completes a <a href="/wiki/General_surgery" title="General surgery">general surgery</a> residency (typically 5–7 years), followed by a cardiothoracic surgery fellowship (typically 2–3 years). The cardiothoracic surgery fellowship typically spans two or three years, but certification is based on the number of surgeries performed as the operating surgeon, not the time spent in the program, in addition to passing rigorous board certification tests. Two other pathways to shorten the duration of training have been developed: (1) a combined general-thoracic surgery residency consisting of four years of general surgery training and three years of cardiothoracic training at the same institution and (2) an integrated six-year cardiothoracic residency (in place of the general surgery residency plus cardiothoracic residency), which have each been established at many programs (over 20).<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Applicants match into the integrated six-year (I-6) programs directly out of medical school, and the application process has been extremely competitive for these positions as there were approximately 160 applicants for 10 spots in the U.S. in 2010. As of May 2013, there are 20 approved programs, which include the following: </p><p>Integrated six-year Cardiothoracic Surgery programs in the United States:<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p> <ul><li><a href="/wiki/Medical_College_of_Wisconsin" title="Medical College of Wisconsin">Medical College of Wisconsin</a></li> <li><a href="/wiki/Stanford_University" title="Stanford University">Stanford University</a> – two positions</li> <li><a href="/wiki/University_of_North_Carolina_at_Chapel_Hill" title="University of North Carolina at Chapel Hill">University of North Carolina at Chapel Hill</a></li> <li><a href="/wiki/University_of_Virginia" title="University of Virginia">University of Virginia</a></li> <li><a href="/wiki/Columbia_University" title="Columbia University">Columbia University</a> – two positions</li> <li><a href="/wiki/University_of_Pennsylvania" title="University of Pennsylvania">University of Pennsylvania</a></li> <li><a href="/wiki/University_of_Pittsburgh" title="University of Pittsburgh">University of Pittsburgh</a> – two positions</li> <li><a href="/wiki/University_of_Washington" title="University of Washington">University of Washington</a></li> <li><a href="/wiki/Northwestern_University" title="Northwestern University">Northwestern University</a></li> <li><a href="/wiki/Mount_Sinai_Hospital,_New_York" class="mw-redirect" title="Mount Sinai Hospital, New York">Mount Sinai Hospital, New York</a></li> <li><a href="/wiki/University_of_Maryland" class="mw-redirect" title="University of Maryland">University of Maryland</a></li> <li><a href="/wiki/University_of_California,_Los_Angeles" title="University of California, Los Angeles">University of California, Los Angeles</a> <a href="/wiki/UCLA" class="mw-redirect" title="UCLA">UCLA</a> – two resident positions, one Transplant Fellowship; one Congenital resident position</li> <li><a href="/wiki/University_of_Texas_Health_Science_Center_at_San_Antonio" title="University of Texas Health Science Center at San Antonio">University of Texas Health Science Center at San Antonio</a></li> <li><a href="/wiki/Medical_University_of_South_Carolina" title="Medical University of South Carolina">Medical University of South Carolina</a></li> <li><a href="/wiki/University_of_Southern_California" title="University of Southern California">University of Southern California</a> – two positions</li> <li><a href="/wiki/University_of_Rochester" title="University of Rochester">University of Rochester</a></li> <li><a href="/wiki/University_of_California,_Davis" title="University of California, Davis">University of California, Davis</a></li> <li><a href="/wiki/Indiana_University" title="Indiana University">Indiana University</a></li> <li><a href="/wiki/University_of_Kentucky" title="University of Kentucky">University of Kentucky</a></li> <li><a href="/wiki/Emory_University" title="Emory University">Emory University</a></li> <li><a href="/wiki/University_of_Michigan" title="University of Michigan">University of Michigan</a></li> <li><a href="/wiki/Yale_University" title="Yale University">Yale University</a></li></ul> <p>The <a href="/wiki/American_Board_of_Thoracic_Surgery" title="American Board of Thoracic Surgery">American Board of Thoracic Surgery</a> offers a special pathway certificate in congenital cardiac surgery which typically requires an additional year of fellowship. This formal certificate is unique because congenital cardiac surgeons in other countries do not have formal evaluation and recognition of pediatric training by a licensing body. </p> <div class="mw-heading mw-heading2"><h2 id="Cardiac_surgery">Cardiac surgery</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=5" title="Edit section: Cardiac surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Cardiac_surgery" title="Cardiac surgery">Cardiac surgery</a></div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical intervention</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1257001546"><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Cardiac surgery</th></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Coronary_artery_bypass_surgery_Image_657B-PH.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/05/Coronary_artery_bypass_surgery_Image_657B-PH.jpg/280px-Coronary_artery_bypass_surgery_Image_657B-PH.jpg" decoding="async" width="280" height="188" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/05/Coronary_artery_bypass_surgery_Image_657B-PH.jpg/420px-Coronary_artery_bypass_surgery_Image_657B-PH.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/05/Coronary_artery_bypass_surgery_Image_657B-PH.jpg/560px-Coronary_artery_bypass_surgery_Image_657B-PH.jpg 2x" data-file-width="2500" data-file-height="1681" /></a></span><div class="infobox-caption">Two cardiac surgeons performing a cardiac surgery known as <a href="/wiki/Coronary_artery_bypass_surgery" title="Coronary artery bypass surgery">coronary artery bypass surgery</a>. Note the use of a steel retractor to forcefully maintain the exposure of the patient's heart.</div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/ICD-9-CM_Volume_3" title="ICD-9-CM Volume 3">ICD-9-CM</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="http://icd9cm.chrisendres.com/index.php?srchtype=procs&srchtext=35&Submit=Search&action=search">35</a>–<a rel="nofollow" class="external text" href="http://icd9cm.chrisendres.com/index.php?srchtype=procs&srchtext=37&Submit=Search&action=search">37</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D006348">D006348</a></span></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/OPS-301" title="OPS-301">OPS-301 code</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="http://www.icd-code.de/ops/code/5-35...5-37.html">5-35...5-37</a></td></tr><tr class="noprint"><td colspan="2" class="infobox-full-data"><div style="text-align: right;">[<a href="https://www.wikidata.org/wiki/Q2964004" class="extiw" title="d:Q2964004">edit on Wikidata</a>]</div></td></tr></tbody></table> <p>The earliest operations on the <a href="/wiki/Pericardium" title="Pericardium">pericardium</a> (the sac that surrounds the heart) took place in the 19th century and were performed by <a href="/wiki/Francisco_Romero_(surgeon)" title="Francisco Romero (surgeon)">Francisco Romero</a> (1801)<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Dominique_Jean_Larrey" title="Dominique Jean Larrey">Dominique Jean Larrey</a>, <a href="/wiki/Henry_Dalton" title="Henry Dalton">Henry Dalton</a>, and <a href="/wiki/Daniel_Hale_Williams" title="Daniel Hale Williams">Daniel Hale Williams</a>.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The first surgery on the heart itself was performed by <a href="/wiki/Norway" title="Norway">Norwegian</a> surgeon <a href="/wiki/Axel_Cappelen" title="Axel Cappelen">Axel Cappelen</a> on 4 September 1895 at <a href="/wiki/Rikshospitalet" class="mw-redirect" title="Rikshospitalet">Rikshospitalet</a> in Kristiania, now <a href="/wiki/Oslo" title="Oslo">Oslo</a>. He <a href="/wiki/Ligature_(medicine)" title="Ligature (medicine)">ligated</a> a bleeding <a href="/wiki/Coronary_circulation" title="Coronary circulation">coronary artery</a> in a 24-year-old man who had been stabbed in the left <a href="/wiki/Axilla" title="Axilla">axilla</a> and was in deep <a href="/wiki/Shock_(circulatory)" title="Shock (circulatory)">shock</a> upon arrival. Access was through a left <a href="/wiki/Thoracotomy" title="Thoracotomy">thoracotomy</a>. The patient awoke and seemed fine for 24 hours, but became ill with increasing temperature and he ultimately died from what the <a href="/wiki/Post_mortem" class="mw-redirect" title="Post mortem">post mortem</a> proved to be <a href="/wiki/Mediastinitis" title="Mediastinitis">mediastinitis</a> on the third postoperative day.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The first successful surgery of the heart, performed without any complications, was by <a href="/wiki/Ludwig_Rehn" title="Ludwig Rehn">Ludwig Rehn</a> of <a href="/wiki/Frankfurt" title="Frankfurt">Frankfurt</a>, <a href="/wiki/Germany" title="Germany">Germany</a>, who repaired a stab wound to the right <a href="/wiki/Ventricle_(heart)" title="Ventricle (heart)">ventricle</a> on September 7, 1896.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>Surgery in <a href="/wiki/Great_vessels" title="Great vessels">great vessels</a> (<a href="/wiki/Aortic_coarctation" class="mw-redirect" title="Aortic coarctation">aortic coarctation</a> repair, <a href="/wiki/Blalock-Taussig_shunt" class="mw-redirect" title="Blalock-Taussig shunt">Blalock-Taussig shunt</a> creation, closure of <a href="/wiki/Patent_ductus_arteriosus" title="Patent ductus arteriosus">patent ductus arteriosus</a>) became common after the turn of the century and falls in the domain of cardiac surgery, but technically cannot be considered heart surgery. One of the more commonly known cardiac surgery procedures is the <a href="/wiki/Coronary_artery_bypass_surgery" title="Coronary artery bypass surgery">coronary artery bypass graft (CABG)</a>, also known as "bypass surgery." </p> <div class="mw-heading mw-heading3"><h3 id="Early_approaches_to_heart_malformations">Early approaches to heart malformations</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=6" title="Edit section: Early approaches to heart malformations"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 1925 operations on the <a href="/wiki/Heart_valve" title="Heart valve">heart valves</a> were unknown. <a href="/wiki/Henry_Souttar" title="Henry Souttar">Henry Souttar</a> operated successfully on a young woman with <a href="/wiki/Mitral_stenosis" title="Mitral stenosis">mitral stenosis</a>. He made an opening in the appendage of the left atrium and inserted a finger into this chamber in order to palpate and explore the damaged mitral valve. The patient survived for several years<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> but Souttar's physician colleagues at that time decided the procedure was not justified and he could not continue.<sup id="cite_ref-Ellis_11-0" class="reference"><a href="#cite_note-Ellis-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-cohn_12-0" class="reference"><a href="#cite_note-cohn-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p><p>Cardiac surgery changed significantly after <a href="/wiki/World_War_II" title="World War II">World War II</a>. In 1948 four surgeons carried out successful operations for <a href="/wiki/Mitral_stenosis" title="Mitral stenosis">mitral stenosis</a> resulting from <a href="/wiki/Rheumatic_fever" title="Rheumatic fever">rheumatic fever</a>. <a href="/wiki/Horace_Smithy" title="Horace Smithy">Horace Smithy</a> (1914–1948) revived an operation due to Dr <a href="/wiki/Dwight_Harken" title="Dwight Harken">Dwight Harken</a> of the <a href="/wiki/Brigham_and_Women%27s_Hospital" title="Brigham and Women's Hospital">Peter Bent Brigham Hospital</a> using a punch to remove a portion of the <a href="/wiki/Mitral_valve" title="Mitral valve">mitral valve</a>. <a href="/wiki/Charles_P._Bailey_(surgeon)" title="Charles P. Bailey (surgeon)">Charles Bailey</a> (1910–1993) at the <a href="/wiki/Drexel_University_College_of_Medicine#Center_City_Hahnemann_Campus" title="Drexel University College of Medicine">Hahnemann Hospital</a>, <a href="/wiki/Philadelphia" title="Philadelphia">Philadelphia</a>, <a href="/wiki/Dwight_Harken" title="Dwight Harken">Dwight Harken</a> in <a href="/wiki/Boston" title="Boston">Boston</a> and <a href="/wiki/Russell_Brock" class="mw-redirect" title="Russell Brock">Russell Brock</a> at <a href="/wiki/Guy%27s_Hospital" title="Guy's Hospital">Guy's Hospital</a> all adopted Souttar's method. All these men started work independently of each other, within a few months. This time Souttar's technique was widely adopted although there were modifications.<sup id="cite_ref-Ellis_11-1" class="reference"><a href="#cite_note-Ellis-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-cohn_12-1" class="reference"><a href="#cite_note-cohn-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p><p>In 1947 <a href="/wiki/Thomas_Holmes_Sellors" class="mw-redirect" title="Thomas Holmes Sellors">Thomas Holmes Sellors</a> (1902–1987) of the <a href="/wiki/Middlesex_Hospital" title="Middlesex Hospital">Middlesex Hospital</a> operated on a <a href="/wiki/Fallot_tetralogy" class="mw-redirect" title="Fallot tetralogy">Fallot's Tetralogy</a> patient with <a href="/wiki/Pulmonary_stenosis" class="mw-redirect" title="Pulmonary stenosis">pulmonary stenosis</a> and successfully divided the stenosed <a href="/wiki/Pulmonary_valve" title="Pulmonary valve">pulmonary valve</a>. In 1948, <a href="/wiki/Russell_Brock" class="mw-redirect" title="Russell Brock">Russell Brock</a>, probably unaware of Sellor's work, used a specially designed dilator in three cases of <a href="/wiki/Pulmonary_stenosis" class="mw-redirect" title="Pulmonary stenosis">pulmonary stenosis</a>. Later in 1948 he designed a punch to resect the <a href="/wiki/Conus_arteriosus" class="mw-redirect" title="Conus arteriosus">infundibular muscle</a> <a href="/wiki/Stenosis" title="Stenosis">stenosis</a> which is often associated with <a href="/wiki/Fallot_tetralogy" class="mw-redirect" title="Fallot tetralogy">Fallot's Tetralogy</a>. Many thousands of these "blind" operations were performed until the introduction of heart bypass made direct surgery on valves possible.<sup id="cite_ref-Ellis_11-2" class="reference"><a href="#cite_note-Ellis-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Open_heart_surgery">Open heart surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=7" title="Edit section: Open heart surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Open heart surgery is a procedure in which the patient's heart is opened and surgery is performed on the internal structures of the heart. It was discovered by <a href="/wiki/Wilfred_G._Bigelow" class="mw-redirect" title="Wilfred G. Bigelow">Wilfred G. Bigelow</a> of the <a href="/wiki/University_of_Toronto" title="University of Toronto">University of Toronto</a> that the repair of intracardiac pathologies was better done with a bloodless and motionless environment, which means that the heart should be stopped and drained of blood. The first successful intracardiac correction of a <a href="/wiki/Congenital_heart_defect" title="Congenital heart defect">congenital heart defect</a> using <a href="/wiki/Hypothermia" title="Hypothermia">hypothermia</a> was performed by <a href="/wiki/C._Walton_Lillehei" title="C. Walton Lillehei">C. Walton Lillehei</a> and <a href="/wiki/F._John_Lewis" title="F. John Lewis">F. John Lewis</a> at the <a href="/wiki/University_of_Minnesota" title="University of Minnesota">University of Minnesota</a> on September 2, 1952. The following year, <a href="/wiki/Soviet_Union" title="Soviet Union">Soviet</a> surgeon <a href="/wiki/Aleksandr_Aleksandrovich_Vishnevskiy" class="mw-redirect" title="Aleksandr Aleksandrovich Vishnevskiy">Aleksandr Aleksandrovich Vishnevskiy</a> conducted the first cardiac surgery under <a href="/wiki/Local_anesthesia" title="Local anesthesia">local anesthesia</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p><p>Surgeons realized the limitations of hypothermia – complex intracardiac repairs take more time and the patient needs blood flow to the body, particularly to the <a href="/wiki/Brain" title="Brain">brain</a>. The patient needs the function of the heart and <a href="/wiki/Lung" title="Lung">lungs</a> provided by an artificial method, hence the term <a href="/wiki/Cardiopulmonary_bypass" title="Cardiopulmonary bypass">cardiopulmonary bypass</a>. <a href="/wiki/John_Heysham_Gibbon" title="John Heysham Gibbon">John Heysham Gibbon</a> at Jefferson Medical School in Philadelphia reported in 1953 the first successful use of extracorporeal circulation by means of an <a href="/wiki/Oxygenator" title="Oxygenator">oxygenator</a>, but he abandoned the method, disappointed by subsequent failures. In 1954 Lillehei realized a successful series of operations with the controlled cross-circulation technique in which the patient's mother or father was used as a '<a href="/wiki/Heart-lung_machine" class="mw-redirect" title="Heart-lung machine">heart-lung machine</a>'. <a href="/wiki/John_W._Kirklin" title="John W. Kirklin">John W. Kirklin</a> at the <a href="/wiki/Mayo_Clinic" title="Mayo Clinic">Mayo Clinic</a> in Rochester, Minnesota started using a Gibbon type pump-oxygenator in a series of successful operations, and was soon followed by surgeons in various parts of the world.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p><p><a href="/w/index.php?title=Nazih_Zuhdi&action=edit&redlink=1" class="new" title="Nazih Zuhdi (page does not exist)">Nazih Zuhdi</a> performed the first total intentional hemodilution open heart surgery on Terry Gene Nix, age 7, on February 25, 1960, at Mercy Hospital, Oklahoma City, OK. The operation was a success; however, Nix died three years later in 1963.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> In March, 1961, Zuhdi, Carey, and Greer, performed open heart surgery on a child, age <style data-mw-deduplicate="TemplateStyles:r1154941027">.mw-parser-output .frac{white-space:nowrap}.mw-parser-output .frac .num,.mw-parser-output .frac .den{font-size:80%;line-height:0;vertical-align:super}.mw-parser-output .frac .den{vertical-align:sub}.mw-parser-output .sr-only{border:0;clip:rect(0,0,0,0);clip-path:polygon(0px 0px,0px 0px,0px 0px);height:1px;margin:-1px;overflow:hidden;padding:0;position:absolute;width:1px}</style><span class="frac">3<span class="sr-only">+</span><span class="num">1</span>⁄<span class="den">2</span></span>, using the total intentional hemodilution machine. In 1985 Zuhdi performed Oklahoma's first successful heart transplant on Nancy Rogers at Baptist Hospital. The transplant was successful, but Rogers, who had <a href="/wiki/Cancer" title="Cancer">cancer</a>, died from an infection 54 days after surgery.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Modern_beating-heart_surgery">Modern beating-heart surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=8" title="Edit section: Modern beating-heart surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Since the 1990s, surgeons have begun to perform "<a href="/wiki/OPCAB" class="mw-redirect" title="OPCAB">off-pump bypass surgery</a>" – coronary artery bypass surgery without the aforementioned <a href="/wiki/Cardiopulmonary_bypass" title="Cardiopulmonary bypass">cardiopulmonary bypass</a>. In these operations, the heart is beating during surgery, but is stabilized to provide an almost still work area in which to connect the conduit vessel that bypasses the blockage; in the U.S., most conduit vessels are harvested endoscopically, using a technique known as <a href="/wiki/Endoscopic_vessel_harvesting" class="mw-redirect" title="Endoscopic vessel harvesting">endoscopic vessel harvesting</a> (EVH).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p><p>Some researchers believe that the off-pump approach results in fewer post-operative complications, such as <a href="/wiki/Postperfusion_syndrome" title="Postperfusion syndrome">postperfusion syndrome</a>, and better overall results. Study results are controversial as of 2007, the surgeon's preference and hospital results still play a major role.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Minimally_invasive_surgery">Minimally invasive surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=9" title="Edit section: Minimally invasive surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A new form of heart surgery that has grown in popularity is <a href="/wiki/Robot-assisted_heart_surgery" class="mw-redirect" title="Robot-assisted heart surgery">robot-assisted heart surgery</a>. This is where a machine is used to perform surgery while being controlled by the heart surgeon. The main advantage to this is the size of the incision made in the patient. Instead of an incision being at least big enough for the surgeon to put his hands inside, it does not have to be bigger than 3 small holes for the robot's much smaller "hands" to get through.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Pediatric_cardiovascular_surgery">Pediatric cardiovascular surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=10" title="Edit section: Pediatric cardiovascular surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Pediatric cardiovascular surgery is surgery of the heart of children. The first operations to repair cardio-vascular<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> defects in children were performed by Clarence Crafoord in Sweden when he repaired coarctation of the aorta in a 12-year-old boy.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> The first attempts to palliate congenital heart disease were performed by Alfred Blalock with the assistance of William Longmire, Denton Cooley, and Blalock's experienced technician, Vivien Thomas in 1944 at Johns Hopkins Hospital.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> Techniques for repair of congenital heart defects without the use of a bypass machine were developed in the late 1940s and early 1950s. Among them was an open repair of an atrial septal defect using hypothermia, inflow occlusion and direct vision in a 5-year-old child performed in 1952 by Lewis and Tauffe. C. Walter Lillihei used cross-circulation between a boy and his father to maintain perfusion while performing a direct repair of a ventricular septal defect in a 4-year-old child in 1954.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> He continued to use cross-circulation and performed the first corrections of tetralogy of Fallot and presented those results in 1955 at the American Surgical Association. In the long-run, pediatric cardiovascular surgery would rely on the cardiopulmonary bypass machine developed by Gibbon and Lillehei as noted above.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Risks_of_cardiac_surgery">Risks of cardiac surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=11" title="Edit section: Risks of cardiac surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The development of cardiac surgery and cardiopulmonary bypass techniques has reduced the mortality rates of these surgeries to relatively low ranks. For instance, repairs of congenital heart defects are currently estimated to have 4–6% mortality rates.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> A major concern with cardiac surgery is the incidence of <a href="/wiki/Neurological" class="mw-redirect" title="Neurological">neurological</a> damage. <a href="/wiki/Stroke" title="Stroke">Stroke</a> occurs in 5% of all people undergoing cardiac surgery, and is higher in patients at risk for stroke.<sup id="cite_ref-Bucerius_21-0" class="reference"><a href="#cite_note-Bucerius-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> A more subtle constellation of <a href="/wiki/Neurocognitive_deficit" class="mw-redirect" title="Neurocognitive deficit">neurocognitive deficits</a> attributed to <a href="/wiki/Cardiopulmonary_bypass" title="Cardiopulmonary bypass">cardiopulmonary bypass</a> is known as <a href="/wiki/Postperfusion_syndrome" title="Postperfusion syndrome">postperfusion syndrome</a>, sometimes called "pumphead". The symptoms of postperfusion syndrome were initially felt to be permanent,<sup id="cite_ref-Newman_22-0" class="reference"><a href="#cite_note-Newman-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> but were shown to be transient with no permanent neurological impairment.<sup id="cite_ref-VanDijk_23-0" class="reference"><a href="#cite_note-VanDijk-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p><p>To assess the performance of surgical units and individual surgeons, a popular risk model has been created called the <a href="/wiki/EuroSCORE" title="EuroSCORE">EuroSCORE</a>. This takes a number of health factors from a patient and using precalculated logistic regression coefficients attempts to give a percentage chance of survival to discharge. Within the UK this EuroSCORE was used to give a breakdown of all the centres for cardiothoracic surgery and to give some indication of whether the units and their individual surgeons performed within an acceptable range. The results are available on the CQC website.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> The precise methodology used has however not been published to date nor has the raw data on which the results are based.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p><p>Infection represents the primary non-cardiac complication from cardiothoracic surgery. Infections include mediastinitis, infectious myo- or pericarditis, endocarditis, cardiac device infection, pneumonia, empyema, and bloodstream infections. <i><a href="/wiki/Clostridioides_difficile" title="Clostridioides difficile">Clostridioides difficile</a></i> colitis can develop when prophylactic or post-operative antibiotics are used. </p><p>Post-operative patients of cardiothoracic surgery are at risk of nausea, vomiting, dysphagia, and aspiration pneumonia.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Thoracic_surgery"><span class="anchor" id="Lung_surgery"></span> Thoracic surgery</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=12" title="Edit section: Thoracic surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A pleurectomy is a surgical procedure in which part of the <a href="/wiki/Pleura" title="Pleura">pleura</a> is removed. It is sometimes used in the treatment of <a href="/wiki/Pneumothorax" title="Pneumothorax">pneumothorax</a> and <a href="/wiki/Mesothelioma" title="Mesothelioma">mesothelioma</a>.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> In case of pneumothorax, only the apical and the diaphragmatic portions of the parietal pleura are removed.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Lung_volume_reduction_surgery">Lung volume reduction surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=13" title="Edit section: Lung volume reduction surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Lung volume reduction surgery, or LVRS, can improve the quality of life for certain patients with <a href="/wiki/Chronic_obstructive_pulmonary_disease" title="Chronic obstructive pulmonary disease">COPD</a> of <a href="/wiki/Emphysema" title="Emphysema">emphysematous</a> type, when other treatment options are not enough. Parts of the <a href="/wiki/Lung" title="Lung">lung</a> that are particularly damaged by emphysema are removed, allowing the remaining, relatively good lung to expand and work more efficiently. The beneficial effects are correlated with the achieved reduction in residual volume.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> Conventional LVRS involves <a href="/wiki/Segmental_resection" title="Segmental resection">resection</a> of the most severely affected areas of emphysematous, non-<a href="/wiki/Chronic_obstructive_pulmonary_disease#Pathophysiology" title="Chronic obstructive pulmonary disease">bullous</a> lung (aim is for 20–30%). This is a surgical option involving a <a href="/wiki/Thoracotomy" title="Thoracotomy">mini-thoracotomy</a> for patients in end stage COPD due to underlying emphysema, and can improve lung <a href="/wiki/Elastic_recoil" title="Elastic recoil">elastic recoil</a> as well as <a href="/wiki/Thoracic_diaphragm" title="Thoracic diaphragm">diaphragmatic function</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p><p>The National Emphysema Treatment Trial (NETT) was a large multicentre study (N = 1218) comparing LVRS with non-surgical treatment. Results suggested that there was no overall survival advantage in the LVRS group, except for mainly upper-lobe emphysema + poor exercise capacity, and significant improvements were seen in exercise capacity in the LVRS group.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> Later studies have shown a wider scope of treatment with better outcomes.<sup id="cite_ref-JTD_29-0" class="reference"><a href="#cite_note-JTD-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p><p>Possible complications of LVRS include prolonged air leak (mean duration post surgery until all <a href="/wiki/Chest_tube" title="Chest tube">chest tubes</a> removed is 10.9 ± 8.0 days.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p><p>In people who have a predominantly upper lobe emphysema, lung volume reduction surgery could result in better health status and lung function, though it also increases the risk of early mortality and adverse events.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </p><p>LVRS is used widely in Europe, though its application in the United States is mostly experimental.<sup id="cite_ref-Kronemyer_DrugTopics_32-0" class="reference"><a href="#cite_note-Kronemyer_DrugTopics-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p><p>A less invasive treatment is available as a <a href="/wiki/Bronchoscopic_lung_volume_reduction" title="Bronchoscopic lung volume reduction">bronchoscopic lung volume reduction</a> procedure.<sup id="cite_ref-Hou_33-0" class="reference"><a href="#cite_note-Hou-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Lung_cancer_surgery">Lung cancer surgery<span class="anchor" id="Lung_cancer_surgery"></span></h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=14" title="Edit section: Lung cancer surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Not all lung cancers are suitable for surgery. The <a href="/wiki/Cancer_staging" title="Cancer staging">stage</a>, location and cell type are important limiting factors. In addition, people who are very ill with a poor <a href="/wiki/Performance_status" title="Performance status">performance status</a> or who have inadequate pulmonary reserve would be unlikely to survive. Even with careful selection, the overall operative death rate is about 4.4%.<sup id="cite_ref-Strand_34-0" class="reference"><a href="#cite_note-Strand-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p><p>In <a href="/wiki/Non-small-cell_lung_carcinoma#Staging" class="mw-redirect" title="Non-small-cell lung carcinoma">non-small cell lung cancer staging</a>, stages IA, IB, IIA, and IIB are suitable for surgical resection.<sup id="cite_ref-Mountain_35-0" class="reference"><a href="#cite_note-Mountain-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p>Pulmonary reserve is measured by <a href="/wiki/Spirometry" title="Spirometry">spirometry</a>. If there is no evidence of undue shortness of breath or <a href="/wiki/Diffuse_parenchymal_lung_disease" class="mw-redirect" title="Diffuse parenchymal lung disease">diffuse parenchymal lung disease</a>, and the FEV<sub>1</sub> exceeds 2 litres or 80% of predicted, the person is fit for <a href="/wiki/Pneumonectomy" title="Pneumonectomy">pneumonectomy</a>. If the FEV<sub>1</sub> exceeds 1.5 litres, the patient is fit for lobectomy.<sup id="cite_ref-Colice_36-0" class="reference"><a href="#cite_note-Colice-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p><p>There is weak evidence to indicate that participation in exercise programs before lung cancer surgery may reduce the risk of complications after surgery.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Complications">Complications</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=15" title="Edit section: Complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A prolonged air leak (PAL) can occur in 8–25% of people following lung cancer surgery.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> This complication delays chest tube removal and is associated with an increased length of hospital stay following a lung resection (lung cancer surgery).<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> The use of <a href="/wiki/Surgical_sealant_film" title="Surgical sealant film">surgical sealants</a> may reduce the incidence of prolonged air leaks, however, this intervention alone has not been shown to results in a decreased length of hospital stay following lung cancer surgery.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> </p><p>There is no strong evidence to support using <a href="/wiki/Non_invasive_positive_pressure_ventilation" class="mw-redirect" title="Non invasive positive pressure ventilation">non-invasive positive pressure ventilation</a> following lung cancer surgery to reduce pulmonary complications.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Types">Types</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=16" title="Edit section: Types"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Lobectomy_(lung)" class="mw-redirect" title="Lobectomy (lung)">Lobectomy</a> (removal of a lobe of the lung)<sup id="cite_ref-Fell_44-0" class="reference"><a href="#cite_note-Fell-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup></li> <li>Sublobar resection (removal of part of lobe of the lung)</li> <li>Segmentectomy (removal of an anatomic division of a particular lobe of the lung)</li> <li><a href="/wiki/Pneumonectomy" title="Pneumonectomy">Pneumonectomy</a> (removal of an entire lung)</li> <li><a href="/wiki/Wedge_resection_(lung)" title="Wedge resection (lung)">Wedge resection</a></li> <li><a href="/w/index.php?title=Sleeve/bronchoplastic_resection&action=edit&redlink=1" class="new" title="Sleeve/bronchoplastic resection (page does not exist)">Sleeve/bronchoplastic resection</a> (removal of an associated tubular section of the associated main bronchial passage during lobectomy with subsequent reconstruction of the bronchial passage)</li> <li><a href="/wiki/VATS_lobectomy" title="VATS lobectomy">VATS lobectomy</a> (minimally invasive approach to lobectomy that may allow for diminished pain, quicker return to full activity, and diminished hospital costs)<sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Esophagectomy" title="Esophagectomy">esophagectomy</a> (removal of the esophagus)</li></ul> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=17" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><i><a href="/wiki/Annals_of_Thoracic_Surgery" class="mw-redirect" title="Annals of Thoracic Surgery">Annals of Thoracic Surgery</a></i></li> <li><i><a href="/wiki/European_Journal_of_Cardio-Thoracic_Surgery" title="European Journal of Cardio-Thoracic Surgery">European Journal of Cardio-Thoracic Surgery</a></i></li> <li><i><a href="/wiki/Journal_of_Thoracic_and_Cardiovascular_Surgery" class="mw-redirect" title="Journal of Thoracic and Cardiovascular Surgery">Journal of Thoracic and Cardiovascular Surgery</a></i></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=18" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Eur+J+Cardiothorac+Surg&rft.atitle=Video-assisted+thoracic+surgery+lobectomy%3A+can+we+afford+it%3F&rft.volume=35&rft.issue=3&rft.pages=423-8&rft.date=2009-03&rft_id=info%3Adoi%2F10.1016%2Fj.ejcts.2008.11.008&rft_id=info%3Apmid%2F19136272&rft.aulast=Casali&rft.aufirst=G&rft.au=Walker%2C+WS&rft_id=https%3A%2F%2Fdoi.org%2F10.1016%252Fj.ejcts.2008.11.008&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACardiothoracic+surgery" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cardiothoracic_surgery&action=edit&section=19" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output 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specialty">Specialties</a><br />and<br /><a href="/wiki/Subspecialty" title="Subspecialty">subspecialties</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Surgery" title="Surgery">Surgery</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cardiac_surgery" title="Cardiac surgery">Cardiac surgery</a></li> <li><a class="mw-selflink selflink">Cardiothoracic surgery</a></li> <li><a href="/wiki/Endocrine_surgery" title="Endocrine surgery">Endocrine surgery</a></li> <li><a href="/wiki/Eye_surgery" title="Eye surgery">Eye surgery</a></li> <li><a href="/wiki/General_surgery" title="General surgery">General surgery</a> <ul><li><a href="/wiki/Colorectal_surgery" title="Colorectal surgery">Colorectal surgery</a></li> <li><a href="/wiki/Digestive_system_surgery" title="Digestive system surgery">Digestive system surgery</a></li></ul></li> <li><a href="/wiki/Neurosurgery" title="Neurosurgery">Neurosurgery</a></li> <li><a href="/wiki/Oral_and_maxillofacial_surgery" title="Oral and maxillofacial surgery">Oral and maxillofacial surgery</a></li> <li><a href="/wiki/Orthopedic_surgery" title="Orthopedic surgery">Orthopedic surgery</a></li> <li><a href="/wiki/Hand_surgery" title="Hand surgery">Hand surgery</a></li> <li><a href="/wiki/Otorhinolaryngology" title="Otorhinolaryngology">Otolaryngology</a> <ul><li><small>ENT</small></li></ul></li> <li><a href="/wiki/Pediatric_surgery" title="Pediatric surgery">Pediatric surgery</a></li> <li><a href="/wiki/Plastic_surgery" title="Plastic surgery">Plastic surgery</a></li> <li><a href="/wiki/Reproductive_surgery" title="Reproductive surgery">Reproductive surgery</a></li> <li><a href="/wiki/Surgical_oncology" 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microbiology">Medical microbiology</a></li> <li><a href="/wiki/Transfusion_medicine" title="Transfusion medicine">Transfusion medicine</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Addiction_medicine" title="Addiction medicine">Addiction medicine</a></li> <li><a href="/wiki/Adolescent_medicine" title="Adolescent medicine">Adolescent medicine</a></li> <li><a href="/wiki/Anesthesiology" title="Anesthesiology">Anesthesiology</a> <ul><li><a href="/wiki/Obstetric_anesthesiology" title="Obstetric anesthesiology">Obstetric anesthesiology</a></li> <li><a href="/wiki/Neurosurgical_anesthesia" title="Neurosurgical anesthesia">Neurosurgical anesthesiology</a></li></ul></li> <li><a href="/wiki/Aviation_medicine" title="Aviation medicine">Aviation medicine</a></li> <li><a href="/wiki/Dermatology" title="Dermatology">Dermatology</a></li> <li><a href="/wiki/Disaster_medicine" title="Disaster medicine">Disaster medicine</a></li> <li><a href="/wiki/Diving_medicine" title="Diving medicine">Diving medicine</a></li> <li><a href="/wiki/Emergency_medicine" title="Emergency medicine">Emergency medicine</a> <ul><li><a href="/wiki/Mass_gathering_medicine" title="Mass gathering medicine">Mass gathering medicine</a></li></ul></li> <li><a href="/wiki/Evolutionary_medicine" title="Evolutionary medicine">Evolutionary medicine</a></li> <li><a href="/wiki/Family_medicine" title="Family medicine">Family medicine</a> / <a href="/wiki/General_practice" title="General practice">General practice</a></li> <li><a href="/wiki/Hospital_medicine" title="Hospital medicine">Hospital medicine</a></li> <li><a href="/wiki/Intensive_care_medicine" title="Intensive care medicine">Intensive care medicine</a></li> <li><a href="/wiki/Medical_genetics" title="Medical genetics">Medical genetics</a></li> <li><a href="/wiki/Narcology" title="Narcology">Narcology</a></li> <li><a href="/wiki/Neurology" title="Neurology">Neurology</a> <ul><li><a href="/wiki/Clinical_neurophysiology" title="Clinical neurophysiology">Clinical neurophysiology</a></li></ul></li> <li><a href="/wiki/Occupational_medicine" title="Occupational medicine">Occupational medicine</a></li> <li><a href="/wiki/Ophthalmology" title="Ophthalmology">Ophthalmology</a></li> <li><a href="/wiki/Oral_medicine" title="Oral medicine">Oral medicine</a></li> <li><a href="/wiki/Pain_management" title="Pain management">Pain management</a></li> <li><a href="/wiki/Palliative_care" title="Palliative care">Palliative care</a></li> <li><a href="/wiki/Pediatrics" title="Pediatrics">Pediatrics</a> <ul><li><a href="/wiki/Neonatology" title="Neonatology">Neonatology</a></li></ul></li> <li><a href="/wiki/Phlebologist" class="mw-redirect" title="Phlebologist">Phlebology</a></li> <li><a href="/wiki/Physical_medicine_and_rehabilitation" title="Physical medicine and rehabilitation">Physical medicine and rehabilitation</a> (PM&R)</li> <li><a href="/wiki/Preventive_healthcare" title="Preventive healthcare">Preventive medicine</a></li> <li><a href="/wiki/Prison_healthcare" title="Prison healthcare">Prison healthcare</a></li> <li><a href="/wiki/Psychiatry" title="Psychiatry">Psychiatry</a> <ul><li><a href="/wiki/Addiction_psychiatry" title="Addiction psychiatry">Addiction psychiatry</a></li></ul></li> <li><a href="/wiki/Radiation_therapy" title="Radiation therapy">Radiation oncology</a></li> <li><a href="/wiki/Reproductive_medicine" title="Reproductive medicine">Reproductive medicine</a></li> <li><a href="/wiki/Sexual_medicine" title="Sexual medicine">Sexual medicine</a> <ul><li><a href="/wiki/Venereology" title="Venereology">Venereology</a></li></ul></li> <li><a href="/wiki/Sleep_medicine" title="Sleep medicine">Sleep medicine</a></li> <li><a href="/wiki/Sports_medicine" title="Sports medicine">Sports medicine</a></li> <li><a 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href="/wiki/Master_of_Medicine" title="Master of Medicine">Master of Medicine</a></li> <li><a href="/wiki/Master_of_Surgery" title="Master of Surgery">Master of Surgery</a></li> <li><a href="/wiki/Doctor_of_Medicine" title="Doctor of Medicine">Doctor of Medicine</a></li> <li><a href="/wiki/Doctor_of_Osteopathic_Medicine" title="Doctor of Osteopathic Medicine">Doctor of Osteopathic Medicine</a></li> <li><a href="/wiki/MD%E2%80%93PhD" title="MD–PhD">MD–PhD</a> <ul><li><a href="/wiki/Medical_Scientist_Training_Program" title="Medical Scientist Training Program">Medical Scientist Training Program</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alternative_medicine" title="Alternative medicine">Alternative medicine</a></li> <li><a href="/wiki/Allied_health_professions" title="Allied health professions">Allied health</a></li> <li><a href="/wiki/Molecular_oncology" title="Molecular oncology">Molecular oncology</a></li> <li><a href="/wiki/Nanomedicine" title="Nanomedicine">Nanomedicine</a></li> <li><a href="/wiki/Personalized_medicine" title="Personalized medicine">Personalized medicine</a></li> <li><a href="/wiki/Public_health" title="Public health">Public health</a></li> <li><a href="/wiki/Rural_health" title="Rural health">Rural health</a></li> <li><a href="/wiki/Therapy" title="Therapy">Therapy</a></li> <li><a href="/wiki/Traditional_medicine" title="Traditional medicine">Traditional medicine</a></li> <li><a href="/wiki/Veterinary_medicine" title="Veterinary medicine">Veterinary medicine</a></li> <li><a href="/wiki/Physician" title="Physician">Physician</a> <ul><li><a href="/wiki/Chief_physician" title="Chief physician">Chief physician</a></li></ul></li> <li><a href="/wiki/History_of_medicine" title="History of medicine">History of medicine</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> <ul><li><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span> <a href="/wiki/Category:Medicine" title="Category:Medicine">Category</a></li> <li><span class="noviewer" typeof="mw:File"><span title="Commons page"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/12px-Commons-logo.svg.png" decoding="async" width="12" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/18px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/24px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></span></span> <a href="https://commons.wikimedia.org/wiki/Medicine" class="extiw" title="commons:Medicine">Commons</a></li> <li><span class="noviewer" typeof="mw:File"><span title="WikiProject"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/People_icon.svg/16px-People_icon.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/People_icon.svg/24px-People_icon.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/37/People_icon.svg/32px-People_icon.svg.png 2x" data-file-width="100" data-file-height="100" /></span></span> <a href="/wiki/Wikipedia:WikiProject_Medicine" title="Wikipedia:WikiProject Medicine">Wikiproject</a></li> <li><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Symbol_portal_class.svg" class="mw-file-description" title="Portal"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/e/e2/Symbol_portal_class.svg/16px-Symbol_portal_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/e/e2/Symbol_portal_class.svg/23px-Symbol_portal_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/e/e2/Symbol_portal_class.svg/31px-Symbol_portal_class.svg.png 2x" data-file-width="180" data-file-height="185" /></a></span> <a href="/wiki/Portal:Medicine" title="Portal:Medicine">Portal</a></li> <li><span class="noviewer" typeof="mw:File"><span title="Outline"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Global_thinking.svg/10px-Global_thinking.svg.png" decoding="async" width="10" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Global_thinking.svg/15px-Global_thinking.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/41/Global_thinking.svg/21px-Global_thinking.svg.png 2x" data-file-width="130" data-file-height="200" /></span></span> <a href="/wiki/Outline_of_medicine" title="Outline of medicine">Outline</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r886047488">.mw-parser-output .nobold{font-weight:normal}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r886047488"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r886047488"></div><div role="navigation" class="navbox" aria-labelledby="Tests_and_procedures_involving_the_heart" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Cardiac_procedures" title="Template:Cardiac procedures"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Cardiac_procedures" title="Template talk:Cardiac procedures"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Cardiac_procedures" title="Special:EditPage/Template:Cardiac procedures"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Tests_and_procedures_involving_the_heart" style="font-size:114%;margin:0 4em">Tests and <a href="/wiki/Medical_procedure" title="Medical procedure">procedures</a> involving the <a href="/wiki/Heart" title="Heart">heart</a></div></th></tr><tr><td class="navbox-abovebelow hlist" colspan="2"><div> <ul><li><a href="/wiki/Cardiac_surgery" title="Cardiac surgery">Cardiac surgery</a></li> <li><a href="/wiki/Interventional_cardiology" title="Interventional cardiology">Interventional cardiology</a></li> <li><a href="/wiki/Cardiology_diagnostic_tests_and_procedures" title="Cardiology diagnostic tests and procedures">Cardiology diagnostic tests and procedures</a></li> <li><a href="/wiki/Cardiac_imaging" title="Cardiac imaging">Cardiac imaging</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Surgery</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Heart_valve" title="Heart valve">Heart valves</a><br />and septa</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Heart_valve_repair" title="Heart valve repair">Valve repair</a></li> <li><a href="/wiki/Valvulotomy" title="Valvulotomy">Valvulotomy</a></li> <li><a href="/wiki/Mitral_valve_repair" title="Mitral valve repair">Mitral valve repair</a></li> <li><a href="/wiki/Valvuloplasty" class="mw-redirect" title="Valvuloplasty">Valvuloplasty</a> <ul><li><a href="/wiki/Aortic_valvuloplasty" title="Aortic valvuloplasty">aortic</a></li> <li><a href="/wiki/Mitral_valvuloplasty" class="mw-redirect" title="Mitral valvuloplasty">mitral</a></li></ul></li> <li><a href="/wiki/Valve_replacement" title="Valve replacement">Valve replacement</a></li> <li><a href="/wiki/Aortic_valve_repair" title="Aortic valve repair">Aortic valve repair</a></li> <li><a href="/wiki/Aortic_valve_replacement" title="Aortic valve replacement">Aortic valve replacement</a> <ul><li><a href="/wiki/Ross_procedure" title="Ross procedure">Ross procedure</a></li> <li><a href="/wiki/Transcatheter_aortic_valve_replacement" title="Transcatheter aortic valve replacement">Transcatheter</a></li></ul></li> <li><a href="/wiki/Mitral_valve_replacement" title="Mitral valve replacement">Mitral valve replacement</a></li> <li><a href="/wiki/Transcatheter_pulmonary_valve_replacement" title="Transcatheter pulmonary valve replacement">Transcatheter pulmonary valve replacement</a></li></ul> <dl><dt><span class="nobold">production of septal defect in heart</span></dt> <dd><i>enlargement of existing septal defect</i> <dl><dd><a href="/wiki/Atrial_septostomy" title="Atrial septostomy">Atrial septostomy</a></dd> <dd><a href="/wiki/Balloon_septostomy" title="Balloon septostomy">Balloon septostomy</a></dd></dl></dd> <dd><i>creation of septal defect in heart</i> <dl><dd><a href="/wiki/Blalock%E2%80%93Hanlon_procedure" title="Blalock–Hanlon procedure">Blalock–Hanlon procedure</a></dd></dl></dd></dl> <dl><dt><span class="nobold">shunt from heart chamber to blood vessel</span></dt> <dd><a href="/wiki/Atrium_(heart)" title="Atrium (heart)">atrium</a> to <a href="/wiki/Pulmonary_artery" title="Pulmonary artery">pulmonary artery</a> <dl><dd><a href="/wiki/Fontan_procedure" title="Fontan procedure">Fontan procedure</a></dd></dl></dd> <dd><a href="/wiki/Left_ventricle" class="mw-redirect" title="Left ventricle">left ventricle</a> to <a href="/wiki/Aorta" title="Aorta">aorta</a> <dl><dd><a href="/wiki/Rastelli_procedure" title="Rastelli procedure">Rastelli procedure</a></dd></dl></dd> <dd><a href="/wiki/Right_ventricle" class="mw-redirect" title="Right ventricle">right ventricle</a> to <a href="/wiki/Pulmonary_artery" title="Pulmonary artery">pulmonary artery</a> <dl><dd><a href="/wiki/Sano_shunt" title="Sano shunt">Sano shunt</a></dd></dl></dd></dl> <dl><dt><span class="nobold">compound procedures</span></dt> <dd>for <a href="/wiki/Transposition_of_the_great_vessels" title="Transposition of the great vessels">transposition of the great vessels</a> <dl><dd><a href="/wiki/Arterial_switch_operation" title="Arterial switch operation">Arterial switch operation</a></dd> <dd><a href="/wiki/Mustard_procedure" title="Mustard procedure">Mustard procedure</a></dd> <dd><a href="/wiki/Senning_procedure" title="Senning procedure">Senning procedure</a></dd></dl></dd> <dd>for univentricular defect <dl><dd><a href="/wiki/Norwood_procedure" title="Norwood procedure">Norwood procedure</a></dd> <dd><a href="/wiki/Kawashima_procedure" title="Kawashima procedure">Kawashima procedure</a></dd></dl></dd></dl> <dl><dt><span class="nobold">shunt from blood vessel to blood vessel</span></dt> <dd><a href="/wiki/Systemic_circulation" class="mw-redirect" title="Systemic circulation">systemic circulation</a> to <a href="/wiki/Pulmonary_artery" title="Pulmonary artery">pulmonary artery</a> shunt <dl><dd><a href="/wiki/Blalock%E2%80%93Taussig_shunt" class="mw-redirect" title="Blalock–Taussig shunt">Blalock–Taussig shunt</a></dd></dl></dd> <dd><a href="/wiki/Superior_vena_cava" title="Superior vena cava">SVC</a> to the right <a href="/wiki/Pulmonary_artery" title="Pulmonary artery">PA</a> <dl><dd><a href="/wiki/Glenn_procedure" title="Glenn procedure">Glenn procedure</a></dd></dl></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Cardiac vessels</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><span class="nobold"><a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">CHD</a></span></dt> <dd><a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">Angioplasty</a></dd> <dd><a href="/wiki/Vascular_bypass" title="Vascular bypass">Bypass</a>/<a href="/wiki/Coronary_artery_bypass_surgery" title="Coronary artery bypass surgery">Coronary artery bypass</a> <dl><dd><a href="/wiki/MIDCAB" class="mw-redirect" title="MIDCAB">MIDCAB</a></dd> <dd><a href="/wiki/Off-pump_coronary_artery_bypass" title="Off-pump coronary artery bypass">Off-pump CAB</a></dd> <dd><a href="/wiki/TECAB" class="mw-redirect" title="TECAB">TECAB</a></dd></dl></dd></dl> <dl><dt><span class="nobold"><a href="/wiki/Coronary_stent" title="Coronary stent">Coronary stent</a></span></dt> <dd><a href="/wiki/Bare-metal_stent" title="Bare-metal stent">Bare-metal stent</a></dd> <dd><a href="/wiki/Drug-eluting_stent" title="Drug-eluting stent">Drug-eluting stent</a></dd></dl> <dl><dt><span class="nobold">Obstacle removal</span></dt> <dd><a href="/wiki/Endarterectomy" title="Endarterectomy">Endarterectomy</a></dd> <dd><a href="/wiki/Atherectomy" title="Atherectomy">Atherectomy</a></dd></dl> <ul><li><a href="/wiki/Bentall_procedure" title="Bentall procedure">Bentall procedure</a></li> <li><a href="/wiki/Valve-sparing_aortic_root_replacement" title="Valve-sparing aortic root replacement">Valve-sparing aortic root replacement</a></li></ul> <ul><li><a href="/wiki/LeCompte_maneuver" title="LeCompte maneuver">LeCompte maneuver</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><span class="nobold"><a href="/wiki/Pericardium" title="Pericardium">Pericardium</a></span></dt> <dd><a href="/wiki/Pericardiocentesis" title="Pericardiocentesis">Pericardiocentesis</a></dd> <dd><a href="/wiki/Pericardial_window" title="Pericardial window">Pericardial window</a></dd> <dd><a href="/wiki/Pericardiectomy" title="Pericardiectomy">Pericardiectomy</a></dd></dl> <dl><dt><span class="nobold"><a href="/wiki/Myocardium" class="mw-redirect" title="Myocardium">Myocardium</a></span></dt> <dd><a href="/wiki/Cardiomyoplasty" title="Cardiomyoplasty">Cardiomyoplasty</a></dd> <dd><a href="/wiki/Dor_procedure" title="Dor procedure">Dor procedure</a></dd> <dd><a href="/wiki/Septal_myectomy" title="Septal myectomy">Septal myectomy</a></dd> <dd><a href="/wiki/Ventricular_reduction" class="mw-redirect" title="Ventricular reduction">Ventricular reduction</a></dd> <dd><a href="/wiki/Alcohol_septal_ablation" title="Alcohol septal ablation">Alcohol septal ablation</a></dd></dl> <dl><dt><span class="nobold"><a href="/wiki/Cardiac_conduction_system" title="Cardiac conduction system">Conduction system</a></span></dt> <dd>Maze procedure (<a href="/wiki/Cox_maze_procedure" title="Cox maze procedure">Cox maze</a> and <a href="/wiki/Minimaze_procedure" title="Minimaze procedure">minimaze</a>)</dd> <dd><a href="/wiki/Catheter_ablation" title="Catheter ablation">Catheter ablation</a></dd> <dd><a href="/wiki/Cryoablation" title="Cryoablation">Cryoablation</a></dd> <dd><a href="/wiki/Radiofrequency_ablation" title="Radiofrequency ablation">Radiofrequency ablation</a></dd> <dd><a href="/wiki/Artificial_cardiac_pacemaker" title="Artificial cardiac pacemaker">Pacemaker insertion</a></dd> <dd><a href="/wiki/S-ICD" class="mw-redirect" title="S-ICD">S-ICD</a> implantation</dd> <dd><a href="/wiki/Implantable_cardioverter-defibrillator" title="Implantable cardioverter-defibrillator">ICD</a> implantation</dd> <dd><a href="/wiki/Cardiac_resynchronization_therapy" title="Cardiac resynchronization therapy">Cardiac resynchronization therapy</a></dd></dl> <ul><li><a href="/wiki/Left_atrial_appendage_occlusion" title="Left atrial appendage occlusion">Left atrial appendage occlusion</a></li> <li><a href="/wiki/Cardiotomy" title="Cardiotomy">Cardiotomy</a></li> <li><a href="/wiki/Heart_transplantation" title="Heart transplantation">Heart transplantation</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Tests</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><span class="nobold"><a href="/wiki/Electrophysiology" title="Electrophysiology">Electrophysiology</a></span></dt> <dd><a href="/wiki/Electrocardiography" title="Electrocardiography">Electrocardiography</a> <dl><dd><a href="/wiki/Vectorcardiography" title="Vectorcardiography">Vectorcardiography</a></dd></dl></dd> <dd><a href="/wiki/Holter_monitor" title="Holter monitor">Holter monitor</a></dd> <dd><a href="/wiki/Implantable_loop_recorder" title="Implantable loop recorder">Implantable loop recorder</a></dd> <dd><a href="/wiki/Cardiac_stress_test" title="Cardiac stress test">Cardiac stress test</a> <dl><dd><a href="/wiki/Bruce_protocol" title="Bruce protocol">Bruce protocol</a></dd></dl></dd> <dd><a href="/wiki/Electrophysiology_study" title="Electrophysiology study">Electrophysiology study</a></dd></dl> <dl><dt><span class="nobold"><a href="/wiki/Cardiac_imaging" title="Cardiac imaging">Cardiac imaging</a></span></dt> <dd><a href="/wiki/Angiocardiography" class="mw-redirect" title="Angiocardiography">Angiocardiography</a></dd> <dd><a href="/wiki/Echocardiography" title="Echocardiography">Echocardiography</a> <dl><dd><a href="/wiki/Transthoracic_echocardiogram" title="Transthoracic echocardiogram">TTE</a></dd> <dd><a href="/wiki/Transesophageal_echocardiogram" title="Transesophageal echocardiogram">TEE</a></dd></dl></dd> <dd><a href="/wiki/Myocardial_perfusion_imaging" title="Myocardial perfusion imaging">Myocardial perfusion imaging</a></dd> <dd><a href="/wiki/Cardiac_magnetic_resonance_imaging" title="Cardiac magnetic resonance imaging">Cardiovascular MRI</a></dd> <dd><a href="/wiki/Cardiac_ventriculography" title="Cardiac ventriculography">Ventriculography</a> <dl><dd><a href="/wiki/Radionuclide_ventriculography" class="mw-redirect" title="Radionuclide ventriculography">Radionuclide ventriculography</a></dd></dl></dd> <dd><a href="/wiki/Cardiac_catheterization" title="Cardiac catheterization">Cardiac catheterization</a>/<a href="/wiki/Coronary_catheterization" title="Coronary catheterization">Coronary catheterization</a></dd> <dd><a href="/wiki/Cardiac_CT" class="mw-redirect" title="Cardiac CT">Cardiac CT</a></dd> <dd><a href="/wiki/Cardiac_PET" title="Cardiac PET">Cardiac PET</a></dd></dl> <dl><dt><span class="nobold"><a href="/wiki/Sound" title="Sound">sound</a></span></dt> <dd><a href="/wiki/Phonocardiogram" title="Phonocardiogram">Phonocardiogram</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiology_diagnostic_tests_and_procedures" title="Cardiology diagnostic tests and procedures">Function tests</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Impedance_cardiography" title="Impedance cardiography">Impedance cardiography</a></li> <li><a href="/wiki/Ballistocardiography" title="Ballistocardiography">Ballistocardiography</a></li> <li><a href="/wiki/Cardiotocography" title="Cardiotocography">Cardiotocography</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pacing</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cardioversion" title="Cardioversion">Cardioversion</a></li> <li><a href="/wiki/Transcutaneous_pacing" title="Transcutaneous pacing">Transcutaneous pacing</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span> <a href="/wiki/Category:Cardiac_procedures" title="Category:Cardiac procedures">Category</a></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Surgery_involving_the_chest_and_lungs" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Thoracic_surgery" title="Template:Thoracic surgery"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Thoracic_surgery" title="Template talk:Thoracic surgery"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Thoracic_surgery" title="Special:EditPage/Template:Thoracic surgery"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Surgery_involving_the_chest_and_lungs" style="font-size:114%;margin:0 4em"><a href="/wiki/Surgery" title="Surgery">Surgery</a> involving the <a href="/wiki/Thorax" title="Thorax">chest</a> and <a href="/wiki/Lung" title="Lung">lungs</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" 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