In medicine, the field of cardiothoracic surgery is involved in the surgical treatment of diseases that affect organs inside the thorax (the chest). In general it will mean conditions of the heart (cardiovascular disease) and lungs (lung disease). Cardiothoracic surgery is a recognised surgical specialty.

Thoracic surgery generally refers to surgery of the chest other than the heart. A general surgeon may have an interest in thoracic surgery.

A cardiothoracic surgeon will perform Coronary Artery Bypass Graft (CABG), Heart valve, lung volume reduction, heart and/or lung transplantation, as well as arrhythmia surgery and thoracic aorta repairs.

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Permanent Cardiothoracic Surgery Jobs

Cardiothoracic Surgeon Needed for Full Time Staff Position - North of New York City :: New York :: CompHealth Inc
Job 6512841 Board Certified Thoracic-CVT Surgeon Experienced Cardiothoracic Surgeon required Vascular skills desirable Competitive salary and benefits package Great location outside of Metro area -
Academic Transplant Surgery - Heart / Lung Opportunity in the Sunshine State :: Florida :: CompHealth Inc
Job 6512670 Transplant Surgery opportunity Academic employed position with the medical center Competitive salary and benefits package Growing academic program Excellent Metro Location Must be Fellowship
CardioThoracic Surgery with Big Volume of Open Hearts :: Tennessee :: CompHealth Inc
Job 6510246 SSG of CVT Surgeons Hospital based group Call of 1:3 Must have MIS Cardiac Surgery Skills Work out of one large hospital with 500+ beds Cardiac, thoracic and vascular available No State

The Journal of Thoracic and Cardiovascular Surgery current issue

Unifocalization of major aortopulmonary collateral arteries in pulmonary atresia with ventricular septal defect is essential to achieve excellent outcomes irrespective of native pulmonary artery morphology [Congenital Heart Disease]
Davies, B., Mussa, S., Davies, P., Stickley, J., Jones, T. J., Barron, D. J., Brawn, W. J. Objective Pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries is a complex lesion with a high rate of natural attrition. We evaluated the outcomes of our strategy of unifocalization in the management of these patients. Methods From 1989 to 2008, 216 patients entered a pathway aiming for complete repair by unifocalizing major aortopulmonary arteries to a right ventricle-pulmonary artery conduit with ventricular septal defect closure. Where ventricular septation was not possible, definitive repair was considered to include pulmonary artery reconstruction and a right ventricle-pulmonary artery conduit or systemic shunt. Native pulmonary artery morphology was classified into confluent intrapericardial (n = 139), confluent intrapulmonary (n = 51), and nonconfluent intrapulmonary (n = 26). Results A total of 203 patients (85%) had definitive repair at a median age of 2.0 years. There was no statistically significant difference in survival after complete repair among the 3 morphologic pulmonary artery groups (P = .18). A total of 132 patients (56%) had complete repair with ventricular septal defect closure, as a single procedure in 111 patients and a staged procedure in 21 patients. Focalization of major aortopulmonary collateral arteries with proven long-term patency with the right ventricle was associated with a survival benefit compared with 14 patients in whom unifocalization was not possible and who had only systemic shunts. Overall survival was 89% at 3 years after definitive repair. During follow-up, 190 patients required 196 catheter reinterventions and 60 surgical reinterventions. Conclusion By using a strategy of unifocalization, intrapericardial pulmonary artery reconstruction, and right ventricle-pulmonary artery conduit, excellent long-term survival can be achieved in this group of patients even in the absence of native intrapericardial pulmonary arteries.
Discussion [Congenital Heart Disease]

Primary left ventricular rehabilitation is effective in maintaining two-ventricle physiology in the borderline left heart [Congenital Heart Disease]
Emani, S. M., Bacha, E. A., McElhinney, D. B., Marx, G. R., Tworetzky, W., Pigula, F. A., del Nido, P. J. Objective Borderline left heart disease is characterized by left heart obstructive lesions (coarctation, aortic and mitral stenoses, left ventricular hypoplasia) and endocardial fibroelastosis. The multilevel obstruction and impaired left ventricular systolic and diastolic function contribute to failure of biventricular circulation. We studied the effects of left ventricular rehabilitation—endocardial fibroelastosis resection with mitral or aortic valvuloplasty—on left ventricular function and clinical outcomes. Methods All patients with borderline left heart structures and endocardial fibroelastosis who underwent a primary left ventricular rehabilitation procedure were retrospectively analyzed to determine operative mortality, reintervention rates, and hemodynamic status. Left heart dimensions and hemodynamics were recorded from preoperative and postoperative echocardiogram and cardiac catheterization. Postoperative left atrial pressure was obtained from the intracardiac line early after left ventricular rehabilitation. Preoperative and postoperative values were compared by paired t test. Results Between 1999 and 2008, 9 patients with endocardial fibroelastosis and borderline left heart disease underwent left ventricular rehabilitation at a median age of 5.6 months (range, 1–38 months). There was no operative mortality, and at a median follow-up of 25 months (6 months to 10 years) there was 1 death from noncardiac causes and 2 patients required reoperations. Significant increases in ejection fraction and left ventricular end-diastolic volume were observed, whereas left atrial pressure and right ventricular/left ventricular pressure ratios decreased postoperatively. Conclusion In patients with borderline left hearts, primary left ventricular rehabilitation with endocardial fibroelastosis resection and mitral and aortic valvuloplasty results in improved left ventricular systolic and diastolic performance and decreased right ventricular pressures. This approach may provide an alternative to single-ventricle management in this difficult patient group.
Discussion [Congenital Heart Disease]

Morphologic spectrum of truncal valvar origin relative to the ventricular septum: Correlation with the size of ventricular septal defect [Congenital Heart Disease]
Adachi, I., Seale, A., Uemura, H., McCarthy, K. P., Kimberley, P., Ho, S. Y. Objective The common arterial trunk usually has a balanced origin from both right and left ventricles overriding a ventricular septal defect. The trunk occasionally originates predominantly, or even exclusively, from either ventricle, making the size of the ventricular septal defect an important factor in surgical repair. Methods We examined 56 autopsy specimens and reviewed another series of 12 consecutive patients with the malformation. Truncal origin was categorized as 1 of the following 5 types: exclusive origin from either the right or left ventricle, predominant origin from either ventricle, or balanced origin. We measured the size of ventricular septal defect ("width" and "depth") in specimens for any correlation with truncal origin. Results Balanced origin was seen in approximately one half of cases in both autopsy and clinical series. Predominantly or exclusively right ventricular origin was more prevalent than left ventricular origin in autopsy series (40% vs 9%, respectively), but such predilection was not observed in clinical series (both 25%). The more the truncal valve was committed to the right ventricle, the smaller was the "width" of the ventricular septal defect (predominant and exclusive vs balanced origin; both P < .0001), with similar tendency in the "depth." In 1 heart with extreme right ventricular origin, the defect was slit-like. Conclusion Origin of the truncal valve demonstrated a morphologic spectrum and correlated with the size of ventricular septal defect that was the main or even sole exit from the left ventricle in hearts with right ventricular origin. Truncal origin, therefore, requires recognition to optimize surgery.
Effects of moderate versus deep hypothermic circulatory arrest and selective cerebral perfusion on cerebrospinal fluid proteomic profiles in a piglet model of cardiopulmonary bypass [Congenital Heart Disease]
Allibhai, T., DiGeronimo, R., Whitin, J., Salazar, J., Yu, T. T.-S., Ling, X. B., Cohen, H., Dixon, P., Madan, A. Objective Our objective was to compare protein profiles of cerebrospinal fluid between control animals and those subjected to cardiopulmonary bypass after moderate versus deep hypothermic circulatory arrest with selective cerebral perfusion. Methods Immature Yorkshire piglets were assigned to one of four study groups: (1) deep hypothermic circulatory arrest at 18°C, (2) deep hypothermic circulatory arrest at 18°C with selective cerebral perfusion, (3) moderate hypothermic circulatory arrest at 25°C with selective cerebral perfusion, or (4) age-matched control animals without surgery. Animals undergoing cardiopulmonary bypass were cooled to their assigned group temperature and exposed to 1 hour of hypothermic circulatory arrest. After arrest, animals were rewarmed, weaned off bypass, and allowed to recover for 4 hours. Cerebrospinal fluid collected from surgical animals after the recovery period was compared with cerebrospinal fluid from controls by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. Protein spectra were analyzed for differences between groups by Mann–Whitney U test and false discovery rate analysis. Results Baseline and postbypass physiologic parameters were similar in all surgical groups. A total of 194 protein peaks were detected. Compared with controls, groups 1, 2, and 3 had 64, 100, and 13 peaks that were significantly different, respectively (P < .05). Three of these peaks were present in all three groups. Cerebrospinal fluid protein profiles in animals undergoing cardiopulmonary bypass with moderate hypothermic circulatory arrest (group 3) were more similar to controls than either of the groups subjected to deep hypothermia. Conclusions The mass spectra of cerebrospinal fluid proteins are altered in piglets exposed to cardiopulmonary bypass and hypothermic circulatory arrest. Moderate hypothermic circulatory arresst (25°C) with selective cerebral perfusion compared with deep hypothermic circulatory arrest (18°C) is associated with fewer changes in cerebrospinal fluid proteins, when compared with nonbypass controls.

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