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(Chest. 1961;40:196-202.)
© 1961 American College of Chest Physicians

Pulmonary Function in the Selection of Patients for Open Heart Surgery

ROE E. WELLS JR. M.D., F.C.C.P.1; WARREN J. TAYLOR M.D., F.C.C.P.2; HARRISON BLACK M.D., F.C.C.P.3; and DWIGHT E. HARKEN M.D., F.C.C.P.4

1 Associate in Medicine, Harvard Medical School and the Peter Bent Brigham Hospital.
2 Assistant in Surgery, Harvard Medical School.
3 Instructor in Surgery, Harvard Medical School.
4 Associate Clinical Professor of Surgery, Harvard Medical School.

1. Thoracotomy incident to cardiac surgery causes a variable restriction on pulmonary function. Bronchospirometric studies have shown that the predominant loss is due to restrictive disease in the operated hemithorax. Routine ventilatory studies will not ascertain this unilateral difference in function.

2. Pulmonary function testing in patients under study for repeat cardiac surgery distinguished three groups of patients:

I. Those whose respiratory limitations contraindicated further surgery.

II. Those with marginal function acceptable for surgery if it did not compromise the lung performing major function.

III. Those whose respiratory status permitted open-heart surgery through either hemithorax.

3. The unoperated hemithorax has been established as essential to survival in some patients. A surgical approach to the mitral valve through the previously operated hemithorax (left side) has been developed and used.






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Copyright © 1961 by the American College of Chest Physicians.