Simplified lateral chest incision for most thoracotomies other than sternotomy.

Our experience using the lateral simplified thoracotomy incision for most chest work other than operations requiring median sternotomy is reported. The incision provides adequate exposure, yet preserves major muscle masses and decreases the postoperative morbidity. Return of normal ipsilateral arm function appears to be hastened in the postoperative period.

Myocardial damage in combined valvular and coronary bypass surgery.

The incidence of perioperative myocardial infarction (MI) and acute ischemic injury was determined in 44 patients having aortic valve replacement plus aortocoronary vein grafts (AVR + CABG) and in 22 patients having mitral valve repair or replacement plus aortocoronary vein grafts (MVR + CABG). These data were correlated with aortic cross-clamp time, fibrillation time, presence of left ventricular hypertrophy, and, in selected cases, left ventricular biopsy. Perioperative MI occurred in 21% (9/44) of the AVR + CABG patients and 5% (1/22) of MVR + CABG patients.