Clamshell Incision vs. Sternal-Sparing Incision in Lung Transplantation

Arndt, George A.; Granger, Emily; Glanville, A.R.; Ma, Malouf

doi:10.1016/j.healun.2013.01.691

Cited by 7 publications

(5 citation statements)

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“…Thus, starting in July 1996, the Washington University group began using bilateral anterolateral thoracotomies without sternal division. These sternalsparing incisions are still used today and are associated with lower rates of wound infection and with better healing, but are not feasible in many cases due to limited exposure of the chest, and insertion of cannulas for bypass is more complicated (29). Although central cannulation or extracorporeal membrane oxygenation (ECMO)/ CPB via the groin are possible solutions for patients with hemodynamic compromise, some surgeons today prefer a sternal-sparing approach when possible.…”

Section: Left Bronchial Anastomosismentioning

confidence: 99%

Historical perspectives of lung transplantation: connecting the dots

Panchabhai¹,

Chaddha²,

McCurry³

et al. 2018

J. Thorac. Dis.

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Lung transplantation is now a treatment option for many patients with end-stage lung disease. Now 55 years since the first human lung transplant, this is a good time to reflect upon the history of lung transplantation, to recognize major milestones in the field, and to learn from others' unsuccessful transplant experiences. James Hardy was instrumental in developing experimental thoracic transplantation, performing the first human lung transplant in 1963. George Magovern and Adolph Yates carried out the second human lung transplant a few days later. With a combined survival of only 26 days for these first 2 lung transplant recipients, the specialty of lung transplantation clearly had a long way to go. The first "successful" lung transplant, in which the recipient survived for 10.5 months, was reported by Fritz Derom in 1971. Ten years later, Bruce Reitz and colleagues performed the first successful transplantation of the heart and one lung with a single distal tracheal anastomosis. In 1988, Alexander Patterson performed the first successful double lung transplant. The modern technique of sequential double lung transplantation and anastomosis performed at the mainstem bronchus level was originally described by Henri Metras in 1950, but was not reintroduced into the field until Pasque reported it again in 1990. Since then, lung transplantation has seen landmark changes: evolving immunosuppression regimens, clarifying the definition of primary graft dysfunction (PGD), establishing the lung allocation score (LAS), introducing extracorporeal membrane oxygenation (ECMO) as a bridge to transplant, allowing donation after cardiac death, and implementing perfusion, to name a few. This article attempts to connect the historical dots in this ﬁeld of research, with the hope that our effort helps summarize what has been achieved, and identifies opportunities for future generations of transplant pulmonologists and surgeons alike.

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Section: Left Bronchial Anastomosismentioning

confidence: 99%

Historical perspectives of lung transplantation: connecting the dots

Panchabhai¹,

Chaddha²,

McCurry³

et al. 2018

J. Thorac. Dis.

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“…Interventions provided were consistent with local discipline specific guidelines, individualised according to medical stability (Data S1). As per local protocols, lung transplantation was performed via unilateral or bilateral anterior thoracotomy (Arndt, Glanville, & Malouf, ), and patients were managed with triple therapy immunosuppression commonly consisting of prednisolone, tacrolimus, and mycophenolate (Scheffert & Raza, ; Snell & Westall, ).…”

Section: Methodsmentioning

confidence: 99%

The timing and extent of acute physiotherapy involvement following lung transplantation: An observational study

Tarrant

Holland

Maitre

et al. 2018

Physiotherapy Res Intl

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Lung transplant recipients spent 21-34% of observed sessions performing physical exercise beginning 48 hr following surgery. Remaining physiotherapist time was spent on assessment, respiratory interventions, education, and patient-specific duties. The use of physiotherapy assistants, structured, progressive exercise programs, and continued workplace innovation may enable a higher percentage of physiotherapist supervised physical exercise in the future.

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“…36,37 However, this technique has been associated with sternal wound dehiscence, infections, and other complications, highlighting the need for close surveillance of these patients and continued investigation of surgical approaches that ameliorate the risk of such comorbidities. 38,39…”

Section: Risk Factorsmentioning

confidence: 99%

Current Management of Sternal Wounds

Hamaguchi

Shekar

Johnson

et al. 2021

Plastic &Amp; Reconstructive Surgery

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Learning Objectives: After studying this article, the participant should be able to: 1. Describe the pathogenesis, classification, and risk factors of sternal wound infection. 2. Discuss options for sternal stabilization for the prevention of sternal wound infection, including wiring and plating techniques. 3. Discuss primary surgical reconstructive options for deep sternal wound infection and the use of adjunctive methods, such as negative-pressure wound therapy. Summary: Poststernotomy sternal wound infection remains a life-threatening complication of open cardiac surgery. Successful treatment relies on timely diagnosis and initiation of multidisciplinary, multimodal therapy. (Plast.

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Clamshell Incision vs. Sternal-Sparing Incision in Lung Transplantation

Cited by 7 publications

References 0 publications

Historical perspectives of lung transplantation: connecting the dots

Historical perspectives of lung transplantation: connecting the dots

The timing and extent of acute physiotherapy involvement following lung transplantation: An observational study

Current Management of Sternal Wounds

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