Heart Surgery
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Heart Surgery
Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease (for example, with coronary artery bypass grafting); to correct congenital heart disease; or to treat valvular heart disease from various causes, including endocarditis, rheumatic heart disease, and atherosclerosis. It also includes heart transplantation. History 19th century The earliest operations on the pericardium (the sac that surrounds the heart) took place in the 19th century and were performed by Francisco Romero (1801) in the city of Almería (Spain), Dominique Jean Larrey (1810), Henry Dalton (1891), and Daniel Hale Williams (1893). The first surgery on the heart itself was performed by Axel Cappelen on 4 September 1895 at Rikshospitalet in Kristiania, now Oslo. Cappelen ligated a bleeding coronary artery in a 24-year-old man who had been stabbed in the left axilla and was in deep sho ...
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Coronary Artery Bypass Surgery
Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage") is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest pain caused by CAD, slow the progression of CAD, and increase life expectancy. It aims to bypass narrowings in heart arteries by using arteries or veins harvested from other parts of the body, thus restoring adequate blood supply to the previously ischemic (deprived of blood) heart. There are two main approaches. The first uses a cardiopulmonary bypass machine, a machine which takes over the functions of the heart and lungs during surgery by circulating blood and oxygen. With the heart in arrest, harvested arteries and veins are used to connect across problematic regions—a construction known as surgical anastomosis. In the second approach, called the off-pump coronary artery bypass graft (OPCABG), these anastomoses are constructed while t ...
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Almería
Almería (, , ) is a city and municipality of Spain, located in Andalusia. It is the capital of the province of the same name. It lies on southeastern Iberia on the Mediterranean Sea. Caliph Abd al-Rahman III founded the city in 955. The city grew wealthy during the Islamic era, becoming a world city throughout the 11th and 12th centuries. It enjoyed an active port that traded silk, oil and raisins. Etymology The name "Almería" comes from the city's former Arabic name, ''Madīnat al-Mariyya'', meaning "city of the watchtower". As the settlement was originally port or coastal suburb of Pechina, it was initially known as ''Mariyyat al-Bajjāna'' (''Bajjāna'' being the Arabic name for Pechina). History The origin of Almería is connected to the 9th-century establishment of the so-called Republic of Pechina (Bajjana) some kilometres to the north, which was for a time autonomous from the Cordobese central authority: the settlement of current-day Almería initially developed as ...
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Mediastinitis
Mediastinitis is inflammation of the tissues in the mid-chest, or mediastinum. It can be either Acute (medical), acute or Chronic (medical), chronic. It is thought to be due to four different etiologies: * direct contamination * hematogenous or Lymphatic system, lymphatic spread * extension of infection from the neck or Retroperitoneal space, retroperitoneum * extension from the lung or pleura Acute mediastinitis is usually caused by bacteria and is most often due to perforation of the esophagus. As the infection can progress rapidly, this is considered a serious condition. Chronic Sclerosis (medicine), sclerosing (or fibrosis, fibrosing) mediastinitis, while potentially serious, is caused by a long-standing inflammation of the mediastinum, leading to growth of acellular collagen and fibrous tissue within the chest and around the central vessels and airways. It has a different cause, treatment, and prognosis than acute infectious mediastinitis. Space infections: Pretracheal space ...
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Fever
Fever, also referred to as pyrexia, is defined as having a body temperature, temperature above the human body temperature, normal range due to an increase in the body's temperature Human body temperature#Fever, set point. There is not a single agreed-upon upper limit for normal temperature with sources using values between in humans. The increase in set point triggers increased muscle tone, muscle contractions and causes a feeling of cold or chills. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes Flushing (physiology), flushed, and may begin to Perspiration, sweat. Rarely a fever may trigger a febrile seizure, with this being more common in young children. Fevers do not typically go higher than . A fever can be caused by many medical conditions ranging from non-serious to life-threatening. This includes viral infection, viral, bacterial infection, bacterial, and parasitic infect ...
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Thoracotomy
A thoracotomy is a surgical procedure to gain access into the pleural space of the chest. It is performed by surgeons (emergency physicians or paramedics under certain circumstances) to gain access to the thoracic organs, most commonly the heart, the lungs, or the esophagus, or for access to the thoracic aorta or the anterior spine (the latter may be necessary to access tumors in the spine). A thoracotomy is the first step in thoracic surgeries including lobectomy or pneumonectomy for lung cancer or to gain thoracic access in major trauma. Approaches There are many different surgical approaches to performing a thoracotomy. Some common forms of thoracotomies include: * Median sternotomy provides wide access to the mediastinum and is the incision of choice for most open-heart surgery and access to the anterior mediastinum * Posterolateral thoracotomy is an incision through an intercostal space on the back, and is often widened with rib spreaders. It is a very common approach ...
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Shock (circulatory)
Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Initial symptoms of shock may include weakness, fast heart rate, fast breathing, sweating, anxiety, and increased thirst. This may be followed by confusion, unconsciousness, or cardiac arrest, as complications worsen. Shock is divided into four main types based on the underlying cause: low volume, cardiogenic, obstructive, and distributive shock. Low volume shock, also known as hypovolemic shock, may be from bleeding, diarrhea, or vomiting. Cardiogenic shock may be due to a heart attack or cardiac contusion. Obstructive shock may be due to cardiac tamponade or a tension pneumothorax. Distributive shock may be due to sepsis, anaphylaxis, injury to the upper spinal cord, or certain overdoses. The diagnosis is generally based on a combination of symptoms, physical examination, and laboratory tests. A decreased pulse pressure (systolic blood pressure m ...
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Axilla
The axilla (also, armpit, underarm or oxter) is the area on the human body directly under the shoulder joint. It includes the axillary space, an anatomical space within the shoulder girdle between the arm and the thoracic cage, bounded superiorly by the imaginary plane between the superior borders of the first rib, clavicle and scapula (above which are considered part of the neck), medially by the serratus anterior muscle and thoracolumbar fascia, anteriorly by the pectoral muscles and posteriorly by the subscapularis, teres major and latissimus dorsi muscle. The soft skin covering the lateral axilla contains many hair and sweat glands. In humans, the formation of body odor happens mostly in the axilla. These odorant substances have been suggested by some to serve as pheromones, which play a role related to mate selection, although this is a controversial topic within the scientific community. The underarms seem more important than the pubic area for emitting body odor, whi ...
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Coronary Circulation
Coronary circulation is the circulation of blood in the blood vessels that supply the heart muscle (myocardium). Coronary arteries supply oxygenated blood to the heart muscle. Cardiac veins then drain away the blood after it has been deoxygenated. Because the rest of the body, and most especially the brain, needs a steady supply of oxygenated blood that is free of all but the slightest interruptions, the heart is required to function continuously. Therefore its circulation is of major importance not only to its own tissues but to the entire body and even the level of consciousness of the brain from moment to moment. Interruptions of coronary circulation quickly cause heart attacks (myocardial infarctions), in which the heart muscle is damaged by oxygen starvation. Such interruptions are usually caused by coronary ischemia linked to coronary artery disease, and sometimes to embolism from other causes like obstruction in blood flow through vessels. Structure Coronary arteri ...
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Ligature (medicine)
In surgery or medical procedure, a ligature consists of a piece of thread ( suture) tied around an anatomical structure, usually a blood vessel or another hollow structure (e.g. urethra) to shut it off. History The principle of ligation is attributed to Hippocrates and Galen. In ancient Rome, ligatures were used to treat hemorrhoids. The concept of a ligature was reintroduced some 1,500 years later by Ambroise Paré, and finally it found its modern use in 1870–80, made popular by Jules-Émile Péan. Procedure With a blood vessel the surgeon will clamp the vessel perpendicular to the axis of the artery or vein with a hemostat, then secure it by ligating it; i.e. using a piece of suture around it before dividing the structure and releasing the hemostat. It is different from a tourniquet in that the tourniquet will not be secured by knots and it can therefore be released/tightened at will. Ligature is one of the remedies to treat skin tag, or acrochorda. It is done by tying str ...
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Oslo
Oslo ( , , or ; sma, Oslove) is the capital and most populous city of Norway. It constitutes both a county and a municipality. The municipality of Oslo had a population of in 2022, while the city's greater urban area had a population of in 2019, and the metropolitan area had an estimated population of in 2021. During the Viking Age the area was part of Viken. Oslo was founded as a city at the end of the Viking Age in 1040 under the name Ánslo, and established as a ''kaupstad'' or trading place in 1048 by Harald Hardrada. The city was elevated to a bishopric in 1070 and a capital under Haakon V of Norway around 1300. Personal unions with Denmark from 1397 to 1523 and again from 1536 to 1814 reduced its influence. After being destroyed by a fire in 1624, during the reign of King Christian IV, a new city was built closer to Akershus Fortress and named Christiania in honour of the king. It became a municipality ('' formannskapsdistrikt'') on 1 January 1838. The city fu ...
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Rikshospitalet
Oslo University Hospital, Rikshospitalet is one of the four main campuses of Oslo University Hospital in Oslo, Norway. It was an independent hospital, ''Rigshospitalet'', later spelled ''Rikshospitalet'' ("The National Hospital"), from 1826 to 2009, when it merged with other university hospitals in Oslo. It is a highly specialized university hospital with special assignments in research and the development of new methods of treatment. Rikshospitalet is a part of Southern and Eastern Norway Regional Health Authority, and is affiliated with the University of Oslo. About 60% of the patients admitted to Rikshospitalet are referred from other hospitals in Norway for more specialized investigations and treatment. In Norway, Rikshospitalet plays an important part with expert knowledge of the treatment of rare and complicated disorders. Rikshospitalet covers the whole country in various fields, including organ and bone marrow transplants, advanced neurosurgery, and treatment of children ...
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Axel Cappelen
Axel Hermansen Cappelen (20 July 1858 – 13 November 1919) was a Norwegian surgeon. He was born in Selje as a son of district physician Johan Nicolay Cappelen (1818–1890) and Elisabeth Brunchorst Ravn (1825–1906). His brother Christian was also a physician, and through him, Axel was an uncle of Minister of Justice Johan Cappelen.
(1912), p. 81
He attended Bergen Cathedral School and his secondary education in 1876. He graduated from the with the