Video-Assisted Thoracic Surgery After Median Sternotomy for Cardiac Surgery

Derek Serna-Gallegos; Heather Merry; Robert J McKenna Jr

doi:10.1016/j.thorsurg.2015.04.004

Video-Assisted Thoracic Surgery After Median Sternotomy for Cardiac Surgery

Thorac Surg Clin. 2015 Aug;25(3):349-54. doi: 10.1016/j.thorsurg.2015.04.004.

Authors

Derek Serna-Gallegos¹, Heather Merry¹, Robert J McKenna Jr²

Affiliations

¹ Division of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8631 West Third, Suite 240E, Los Angeles, CA 90048, USA.
² Division of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8631 West Third, Suite 240E, Los Angeles, CA 90048, USA. Electronic address: mckennar@cshs.org.

PMID: 26210930
DOI: 10.1016/j.thorsurg.2015.04.004

Abstract

Video-assisted thoracic surgery (VATS) lobectomy has become a standard approach for early stage 1 lung cancer. However, concerns still remain regarding certain clinical situations, such as potential damage to the heart or bypass grafts when VATS is performed after median sternotomy for cardiac surgery. In this article, techniques are described to minimize risk to an internal mammary artery graft during a VATS anatomic pulmonary resection in this group of patients. The article reviews data on VATS after median sternotomy for cardiac surgery and describes techniques to prevent, treat, and mitigate problems in this group of patients. Management of intraoperative crises is also discussed.

Keywords: Intraoperative crisis; Mammary artery graft; VATS lobectomy complications.

Publication types

Review

MeSH terms

Cardiac Surgical Procedures / methods*
Humans
Lung Neoplasms / surgery
Pneumonectomy / adverse effects
Pneumonectomy / methods
Postoperative Care / methods
Sternotomy / adverse effects*
Thoracic Surgery, Video-Assisted / adverse effects
Thoracic Surgery, Video-Assisted / methods*
Treatment Outcome