Thoracic and cardiac surgery

Question 1

In what ways can the thorax be accessed surgically?

Answer 1

• Lateral thoracotomy
• Sternal split
• Thoracoscopy probably more likely to become more available

Question 2

What are the indications for lung lobe removal?

Answer 2

• Tumour
• Pneumonia/abscess
• Large emphysematous bullae
• Bronchiectasis
• Bronchial foreign body causing lung consolidation
• Lobe torsion

Question 3

Why would thoracic duct ligation be carried out?

Answer 3

chylothorax

Question 4

Lateral thoracotomy access is usually used for which cardiac surgeries?

Answer 4

• Pericardectomy
• Congenital cardiac conditions
  
  • Patent ductus arteriosus
  • Persistent right aortic arch/other vascular ring anomaly
  • Pulmonic stenosis – patch grafting/inflow occlusion

Question 5

What are the indications for pericardectomy?

Answer 5

• Recurrent idiopathic pericardial haemorrhage
• Tumour removal?

Question 6

What interventional cardiology techniques may be used for conditions such as pulmonic stenosis?

Answer 6

• Balloon valvuloplasty
• Balloon pericardiotomy
• PDA occluder placement
• VSD/ASD occlusion

Question 7

When would pacemaker implantation be considered?

Answer 7

• Symptomatic bradydysrthymias that you cannot find a primary cause
• E.g. 2^nd/3^rd degree AV block, sick sinus syndrome