Thoracic and cardiac surgery

• Indications for thoracic surgery

  • Pulmonary
  • Primary lung tumour
  • Idiopathic pneumothorax
  • Pulmoanry foreign body
  • Long lobe torsion
  • Cardiac
  • Vascular ring anomaly
  • Patent ductus arteriosus
  • Pericardiectomy for idiopathic pericardial effusion
  • Open heart surgery (mitral valve repair)
  • Miscellaneous
  • Thymectomy for thymoma
  • Thoracic duct ligation for idiopathic chylothorax
  • Oesophagotomy for FB
  • Tracheal alvulsion
  • Exploratory thoracotomy e.g. mediastinal abscess.
  • Thoracic wall abnormalities e.g. pectus examination
• Thoracoscopy

  There is a negative pressure in the thorax that keeps the lungs to the chest wall, so when you make a whole in the chest wall you can cause a pneumothorax, as the lungs fall away from the chest wall. Can place a port where you are putting your instruments through to prevent this.
• Indications for pace maker implantations

  Symptomatic bradycardia in both cats and dogs.

  Advances second degree atrioventricular block.

  Advanced third degree atrioventricular block.

  Sick sinus syndrome.

  Persistent atrial standstill.

  Vasovagal syncope
• First, second and third degree atrioventricular block

  First degree AV block - prolongation of the P interval, the sinus fires, goes down through the purkinje fibres the down the ventricles. If there is a delay in this, this is first degree and not an indication for pacemakers.

  Second degree AV block - unrelated P waves, intermittent indications for pacemakers.

  Third degree AV blocks - No P waves related to the QRS complexes at all, the natural rate is quite low. indication for pacemaker.

  Atrial standstill - No atrial contractions at all just get a ventricular rate.

  
• Pacemaker implantation

  Most pacemakers are implanted transvenously using Endocardial leads.

  Rarely, the pacemakers are placed in open surgery using epicardial leads. Done in cats as won’t fit anywhere else.

  Normally placed in the neck in the dog