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Thoracic and Cardiovascular Surgery

2017-06-23 15:18:56



On behalf of the faculty of the Department of Thoracic and Cardiovascular Surgery of West China Hospital, welcome to our website. Our Department was founded by Zhenhua Yang and Jingguo Yang, two national famous specialists of cardiothoracic surgery in the 1950’s, who witnessed the unprecedented growth and development over the past decades. During the past three years, more than 1,000 open-heart surgeries and 1,000 general thoracic surgeries were performed in our Department each year, placing the Department among the top centers in volume of both open-heart surgeries and general thoracic surgeries. This large number of operations means that our patients are guaranteed the benefit of experience and safety. In 1980, our Department was authorized to confer master’s degree, in 1993 to confer doctoral degree and in 1996 as a clinical post-doctoral station. Today, the Department prides itself in a strong faculty with middle-aged and young researchers and doctors as the main force and a rational human resources echelon formation and discipline structure.

 

Our Department is dedicated to providing patients up-to-date, cost-effective, quality cardiothoracic surgical services, training postgraduates and residents in the art and science of thoracic and cardiovascular surgery, and participating in advanced clinical and laboratory research. Our service covers diseases within the chest and includes the treatment of heart disease, aneurysms of the great vessels, lung diseases, and disorders of the esophagus and the mediastinum. We have a large devoted faculty who are committed to excellence in three areas:

1. Medical Care: We provide clinical excellence in our practice, from coronary bypass grafting, heart valve replacement, to correction of heart abnormalities in newborns, and we offer a multidisciplinary approach to the treatment of lung and esophageal cancer. At our Department, every patient receives a seamless continuum of care. From exacting preoperative evaluation, intraoperative care by an outstanding team that utilizes the most sophisticated technology, to postoperative treatment that focuses on enhancing recovery, every resource is marshaled and deployed to help the patient heal faster. And the patient"s doctor, at the center of it all, remains completely connected.

Upon admission each patient"s preoperative evaluation set the tone for what will be an exceptionally effective hospitalization. Each member of the surgical team-the surgeon, anesthesiologist, nurse, operation room nurse and intensive care nurse-visits the patient. Together, they form a constant, reassuring presence from day one through discharge and after, when indicated. Intraoperative care focuses on proactive operating room procedures. Postoperatively, the surgeon contacts the ICU physicians immediately after surgery to detail and discuss post-surgical specifics. Patients and families are informed about realistic expectations for a speedy recovery and told how they can support and enhance the recuperative process. Every resource available to the surgical team is utilized to help the patient heal faster.

Congenital Cardiac Surgery

Congenital means inborn or existing at birth. A congenital heart defect is a malformation of the heart existing at birth. This defect results from the failure of the heart or major blood vessel to mature normally during gestation. These defects may be readily apparent at birth or may be discovered later in life. Often children may remain without symptoms for many years.

Congenital heart disease affects eight out of every 1000 birth each year. Medical and surgical treatment now offers these children an opportunity to grow and mature into adult life, children that previously could not be helped. Many of the defects can be completely repaired to return the heart to "normal" anatomy. Other defects require inventive ways of redirecting the blood flow in order to "physiologically" correct the defect.

Heart defects that are fixed during surgery are grouped into two categories: open and closed. Closed heart surgery implies that the "heart lung machine" or "bypass" machine is not used and the heart is visualized but not cut open. These procedures are done with the heart beating. Open-heart surgery implies that the heart needs to be opened in order to repair the defect and therefore the "bypass" machine is used to oxygenate and circulate the blood without using the heart or lungs.

All aspects of congenital cardiac care function as an interactive team at our Department. The interventional catheterization lab, the cardiologists, the surgeons, the intensive care units, and nursing staff, must function as a single unit to provide the best care available for these complex patients. It is this integrated management that leads to effective communication and excellent patient care and outcomes.

Main surgical interventions in conjunction with congenital heart defects:
·ventricular septum defects (VSD)
·atrial septum defects (ASD)
·complex operations on infants, e.g. arterial switch, AV canal correction, correction of Fallot tetralogy
·heart valve reconstruction
· underdeveloped aorta reconstruction (aortic arch hypoplasia)
· pulmonary vein defects
· underdeveloped pulmonary artery reconstruction
· biological heart valve implantation

Aortic Surgery

Aortic aneurysm repair is required when there is an aneurysm (a weakening of the aortic wall causing it to thin and dilate) and/or a dissection (a tear in one or more of the layers of the aortic walls). In addition to standard aneursym repair, we offers endovascular aortic aneurysm repair with a stent graft. We have one of the largest aortic surgery practices in China performing 150 surgeries during the last five years. Our surgeons have vast experience in performing complex staged repairs of the ascending, arch, descending, and thoracoabdominal aorta, including those in Marfan’s patients. Additionally, our anesthesiologists offer state-of-the-art brain and spinal cord protection and monitoring during these procedures.

Coronary Artery Bypass Grafting (CABG)

This surgery is needed when one or more coronary arteries are blocked or narrowed. A CABG diverts or bypasses blood flow around the blocked artery to increase blood flow to heart muscle. This can be done by using vessels from the legs (saphenous vein), chest (mammary artery) and arm (radial artery).

Off Pump CABG (OPCAB)

This surgery, which has been performed at our Department for five years, is indicated for selected patients. During the surgery, stabilizing devices on the heart are used to allow bypassing of the coronary artery while the heart is beating. The use of the heart and lung machine is avoided.

Heart Valve Surgery

Depending on the disease process and condition of the valve, heart valves are either replaced or repaired. Heart valve surgery is performed when heart valve regurgitation or stenosis exists. When there is heart valve insufficiency (regurgitation or stenosis), a heart valve repair may be indicated. The valve is repaired by remodeling the valve tissue followed by the insertion of a prosthetic ring for reinforcement. The advantage of heart valve repair is preservation of the native valve tissue, ventricular function, and the avoidance of anticoagulation. When the valve is seriously deformed or degenerated it is often replaced. The valve can be replaced with either a mechanical or tissue valve. Our surgeons have access to state of the art mechanical and tissue valves. The decision of which valve to use is made by the patient and the surgeon. Our surgeons perform more than 400 valve procedures annually.

Esophageal Cancer - Treatment Overview
· If the tumor is very small and in its early stage, surgery alone may be recommended.
· If the cancer has spread to other areas of the body, such as the liver or brain, chemotherapy or radiation therapy alone will likely be recommended
· For all others, Multimodality Therapy may be recommended. Multimodality is the use of chemotherapy, radiation therapy and surgery in one of several different combinations. Preoperative chemotherapy and radiation therapy are used to shrink the tumor and decrease the chance of cancer cells surviving after surgery. Postoperative chemotherapy and radiation therapy are used to kill any cancer remaining after surgery in order to decrease the chance of tumor regrowth.

Lung Cancer - Treatment Overview
· If your tumor is very small and in its early stage, surgery alone may be recommended.
· If the cancer has spread to other areas of the body, such as your liver or brain, chemotherapy or radiation therapy alone will likely be recommended
· For all others, Multimodality Therapy may be recommended. Multimodality is the use of chemotherapy, radiation therapy and surgery in one of several different combinations. Preoperative chemotherapy and radiation therapy are used to shrink the tumor and decrease the chance of cancer cells surviving after surgery. Postoperative chemotherapy and radiation therapy are used to kill any cancer remaining after surgery in order to decrease the chance of tumor regrowth.

Cancer Diagnosis and Treatment:
Patients are evaluated by a multidisciplinary team that includes a surgeon, medical oncologist, radiation oncologist, and other specialists. We take pride in meeting our patients’ needs in a caring environment. Some of our services include:
·Surgical resection for lung, esophageal, and other chest malignancies.
·Minimally invasive surgical staging and treatment, using video-assisted thoracoscopic techniques (VATS) as well as mediastinoscopy.
· Specialized treatment for patients with advanced and high-risk lung cancer.
· Combined modality treatment for lung and esophageal carcinoma.
· Surgical and medical management of patients with cancer that has spread to the lung.
2. Education: We train the nation"s future Thoracic and Cardiac Surgeons by immersing them in a dynamic clinical, teaching, and research enterprise. Our training program is widely recognized and it attracts high quality postgraduates and residents in China. The postgraduates and residents are closely involved in the pre-operative assessment, operation, and post-operative care of all patients on their services. Their operative experience is commensurate with their increasing skills, judgment and surgical maturity. All areas of cardiothoracic experience are available at the our Department, including congenital and acquired cardiac problems, aortic pathologies, pulmonary malformations and neoplasms, esophageal procedures, chest wall abnormalities and post-operative critical care.
Currently four Medical Doctor tutors and six Medical Master tutors, with varied interests in individual areas of expertise, lead the postgraduates through their training. The high volumes and tertiary complexities of the cases lead to a very close and highly educational relationship between postgraduates and residents with faculty.
3. Research: Most members of our Department participate or lead national and provincial efforts to develop new treatments for heart disease, lung disease, cancer of the lung and esophagus, and the development of devices to replace heart function. Basic science research into the development, treatment and prevention of these diseases is conducted. Clinical studies in thoracic and cardiovascular surgery investigate techniques and clinical outcomes after various surgical interventions. These activities are the driving force that allows our Department to offer patients the most advanced forms of therapy available in China.
We are proud of who we are and what we do for our patients. We hope that you will find the information you need in order to make the best possible decisions for you or your loved ones.

 

 






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