Michael Wait, M.D. Answers Questions On: Cardiovascular and Thoracic Surgery

The challenging cases include heart valve infections and lung transplants in young patients with cystic fibrosis.

The patients are young, small-framed, their lungs are very diseased, and there are often issues with their pancreas or liver. They are frequently very sick going into the transplant.

In a recent surgery, the patient had to be on an artificial lung machine in order to survive long enough for us to even find donor organs. It was the first one we’ve done here, and we will probably be doing more of those in the future.

We use ECMO, or extracorporeal membrane oxygenation, to support patients so that they can undergo lung transplants. It is not commonly used in America, but there are a few centers that use it to support patients while they’re looking for a lung.

Patients with really bad heart valve infections teeter on disaster. Heart valve infections are similar to what the general public would call flesh-eating bacteria.

If bacteria are destroying parts of the heart muscle that you depend on, that’s a real problem. Trying to prevent the infection is the biggest thing. So we try to be smart about catching it early and combine that with antibiotics and surgical techniques.

There will be advances in cardiopulmonary bypass that allow us to do safer heart surgery on all patients.

There will be improvements in anticoagulation for patients who need heart valves and improvements in organ preservation for patients who have to undergo heart and lung transplants.

And finally there will be a more tailored approach to chemotherapy for patients with lung cancer.