52-592: JHH may refer to: John Hunter Hospital , Newcastle, Australia Johns Hopkins Hospital , Baltimore, United States Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title JHH . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=JHH&oldid=1217875276 " Category : Disambiguation pages Hidden categories: Short description
104-458: A congenital heart defect using hypothermia was performed by C. Walton Lillehei and F. John Lewis at the University of Minnesota on September 2, 1952. The following year, Soviet surgeon Aleksandr Aleksandrovich Vishnevskiy conducted the first cardiac surgery under local anesthesia . Surgeons realized the limitations of hypothermia – complex intracardiac repairs take more time and
156-550: A mini-thoracotomy for patients in end stage COPD due to underlying emphysema, and can improve lung elastic recoil as well as diaphragmatic function . The National Emphysema Treatment Trial (NETT) was a large multicentre study (N = 1218) comparing LVRS with non-surgical treatment. Results suggested that there was no overall survival advantage in the LVRS group, except for mainly upper-lobe emphysema + poor exercise capacity, and significant improvements were seen in exercise capacity in
208-519: A 4-year-old child in 1954. He continued to use cross-circulation and performed the first corrections of tetralogy of Fallot and presented those results in 1955 at the American Surgical Association. In the long-run, pediatric cardiovascular surgery would rely on the cardiopulmonary bypass machine developed by Gibbon and Lillehei as noted above. The development of cardiac surgery and cardiopulmonary bypass techniques has reduced
260-613: A bi-national (Australia and New Zealand) training program. Multiple examinations take place throughout the course of training, culminating in a final fellowship exam in the final year of training. Upon completion of training, surgeons are awarded a Fellowship of the Royal Australasian College of Surgeons (FRACS), denoting that they are qualified specialists. Trainees having completed a training program in General Surgery and have obtained their FRACS will have
312-407: A bleeding coronary artery in a 24-year-old man who had been stabbed in the left axilla and was in deep shock upon arrival. Access was through a left thoracotomy . The patient awoke and seemed fine for 24 hours, but became ill with increasing temperature and he ultimately died from what the post mortem proved to be mediastinitis on the third postoperative day. The first successful surgery of
364-1017: A combined team of OMFS and ENT surgeons Cardiothoracic surgery – Elective and emergency cardiac, aortic and thoracic surgery. Renal transplant Urology surgery Vascular surgery – Open and percutaneous interventional techniques Ophthalmology Plastic and reconstructive surgery General medicine Neurology – General neurology, stroke, interventional neuroradiology (DSA and anaerysm treatment, clot retrieval), EEG, neuropsychology, multiple sclerosis clinics. Cardiology – Interventional, electrophysiology and echocardiography. JHH Interventional Cardiologists have experience in percutaneous techniques such as TAVI and balloon aortic valvulopasty Respiratory medicine – Including sub-specialties of general respiratory, cystic fibrosis & sleep medicine. Toxicology Endocrinology , Gastroenterology , Nephrology and dialysis Rheumatology Immunology Dermatology The John Hunter Hospital and John Hunter Children's Hospital consists of
416-595: A fellowship in CV / CT / CVT. During the 1990s, the Canadian cardiac surgery training programs changed to six-year "direct-entry" programs following medical school. The direct-entry format provides residents with experience related to cardiac surgery they would not receive in a general surgery program (e.g. echocardiography , coronary care unit , cardiac catheterization etc.). Residents in this program will also spend time training in thoracic and vascular surgery . Typically, this
468-496: A fellowship in a variety of topics including pediatric cardiac surgery, cardiac transplantation , adult-acquired heart disease, weak heart issues, and many more problems in the heart. The highly competitive Surgical Education and Training (SET) program in Cardiothoracic Surgery is six years in duration, usually commencing several years after completing medical school. Training is administered and supervised via
520-442: A fully qualified surgeon. Cardiac surgery training may be combined with thoracic surgery and/or vascular surgery and called cardiovascular (CV) / cardiothoracic (CT) / cardiovascular thoracic (CVT) surgery. Cardiac surgeons may enter a cardiac surgery residency directly from medical school , or first complete a general surgery residency followed by a fellowship . Cardiac surgeons may further sub-specialize cardiac surgery by doing
572-478: A licensing body. 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) Dominique Jean Larrey , Henry Dalton , and Daniel Hale Williams . The first surgery on the heart itself was performed by Norwegian surgeon Axel Cappelen on 4 September 1895 at Rikshospitalet in Kristiania, now Oslo . He ligated
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#1732790517347624-532: A nation that would one day stand as an example to the rest of the world. One such man was Governor John Hunter. Our Valley is named in his honour. So, too, is the State's newest and most modern hospital, the John Hunter Hospital at New Lambton Heights." The three John Hunters referenced in the advertisement are: In late 2021, a solar installation said to be the largest on any hospital in the world,
676-510: A percentage chance of survival to discharge. Within the UK this EuroSCORE was used to give a breakdown of all the centres for cardiothoracic surgery and to give some indication of whether the units and their individual surgeons performed within an acceptable range. The results are available on the CQC website. The precise methodology used has however not been published to date nor has the raw data on which
728-430: A poor performance status or who have inadequate pulmonary reserve would be unlikely to survive. Even with careful selection, the overall operative death rate is about 4.4%. In non-small cell lung cancer staging , stages IA, IB, IIA, and IIB are suitable for surgical resection. Pulmonary reserve is measured by spirometry . If there is no evidence of undue shortness of breath or diffuse parenchymal lung disease , and
780-672: A successful series of operations with the controlled cross-circulation technique in which the patient's mother or father was used as a ' heart-lung machine '. John W. Kirklin at the Mayo Clinic in Rochester, Minnesota started using a Gibbon type pump-oxygenator in a series of successful operations, and was soon followed by surgeons in various parts of the world. Nazih Zuhdi performed the first total intentional hemodilution open heart surgery on Terry Gene Nix, age 7, on February 25, 1960, at Mercy Hospital, Oklahoma City, OK. The operation
832-437: A technique known as endoscopic vessel harvesting (EVH). Some researchers believe that the off-pump approach results in fewer post-operative complications, such as postperfusion syndrome , and better overall results. Study results are controversial as of 2007, the surgeon's preference and hospital results still play a major role. A new form of heart surgery that has grown in popularity is robot-assisted heart surgery . This
884-590: A three-year cardiac surgery fellowship for qualified general surgeons that is offered at several training sites including the University of Alberta , the University of British Columbia and the University of Toronto . Thoracic surgery is its own separate 2–3 year fellowship of general or cardiac surgery in Canada. Cardiac surgery programs in Canada: Cardiac surgery training in the United States
936-412: Is a procedure in which the patient's heart is opened and surgery is performed on the internal structures of the heart. It was discovered by Wilfred G. Bigelow of the University of Toronto that the repair of intracardiac pathologies was better done with a bloodless and motionless environment, which means that the heart should be stopped and drained of blood. The first successful intracardiac correction of
988-437: Is a surgical procedure in which part of the pleura is removed. It is sometimes used in the treatment of pneumothorax and mesothelioma . In case of pneumothorax, only the apical and the diaphragmatic portions of the parietal pleura are removed. Lung volume reduction surgery, or LVRS, can improve the quality of life for certain patients with COPD of emphysematous type, when other treatment options are not enough. Parts of
1040-399: Is combined with general thoracic surgery and called cardiothoracic surgery or thoracic surgery. A cardiothoracic surgeon in the U.S. is a physician who first completes a general surgery residency (typically 5–7 years), followed by a cardiothoracic surgery fellowship (typically 2–3 years). The cardiothoracic surgery fellowship typically spans two or three years, but certification is based on
1092-590: Is different from Wikidata All article disambiguation pages All disambiguation pages John Hunter Hospital The John Hunter Hospital and John Hunter Children's Hospital (sometimes known as the JHH and JHCH respectively, or more colloquially the John Hunter ) is a teaching hospital and children's hospital in Newcastle , and northern New South Wales , Australia . The 820 bed hospital
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#17327905173471144-501: Is followed by a fellowship in either Adult Cardiac Surgery, Heart Failure/Transplant, Minimally Invasive Cardiac Surgery, Aortic Surgery, Thoracic Surgery, Pediatric Cardiac Surgery or Cardiac ICU. Contemporary Canadian candidates completing general surgery and wishing to pursue cardiac surgery often complete a cardiothoracic surgery fellowship in the United States. The Royal College of Physicians and Surgeons of Canada also provides
1196-507: Is further subspecialized into cardiac surgery (involving the heart and the great vessels ) and thoracic surgery (involving the lungs, esophagus , thymus , etc.); the exceptions are the United States , Australia , New Zealand , the United Kingdom , India and some European Union countries such as Portugal . A cardiac surgery residency typically comprises anywhere from four to six years (or longer) of training to become
1248-535: Is known as postperfusion syndrome , sometimes called "pumphead". The symptoms of postperfusion syndrome were initially felt to be permanent, but were shown to be transient with no permanent neurological impairment. To assess the performance of surgical units and individual surgeons, a popular risk model has been created called the EuroSCORE . This takes a number of health factors from a patient and using precalculated logistic regression coefficients attempts to give
1300-566: Is the main teaching hospital of the University of Newcastle . The hospital contains the only trauma centre in New South Wales outside the Sydney Metropolitan Area , and has the busiest emergency department in the state. John Hunter is the busiest trauma hospital in the country. The John Hunter health complex consists of 820 beds in total, and is co-located next to the 174 bed Newcastle Private Hospital, as well as
1352-408: Is where a machine is used to perform surgery while being controlled by the heart surgeon. The main advantage to this is the size of the incision made in the patient. Instead of an incision being at least big enough for the surgeon to put his hands inside, it does not have to be bigger than 3 small holes for the robot's much smaller "hands" to get through. Pediatric cardiovascular surgery is surgery of
1404-658: The Hahnemann Hospital , Philadelphia , Dwight Harken in Boston and Russell Brock at Guy's Hospital all adopted Souttar's method. All these men started work independently of each other, within a few months. This time Souttar's technique was widely adopted although there were modifications. In 1947 Thomas Holmes Sellors (1902–1987) of the Middlesex Hospital operated on a Fallot's Tetralogy patient with pulmonary stenosis and successfully divided
1456-640: The Hunter Region and beyond are referred to John Hunter for treatment in a range of specialities. The John Hunter Children's Hospital and Royal Newcastle Centre are located within the same building as the John Hunter Hospital. Also on the same grounds are Rankin Park Hospital (Rehab), Newcastle Private Hospital and the Hunter Medical Research Institute (HMRI). The JHH and JHCH are tertiary level hospitals, and provide
1508-406: The lung that are particularly damaged by emphysema are removed, allowing the remaining, relatively good lung to expand and work more efficiently. The beneficial effects are correlated with the achieved reduction in residual volume. Conventional LVRS involves resection of the most severely affected areas of emphysematous, non- bullous lung (aim is for 20–30%). This is a surgical option involving
1560-405: The 1990s, surgeons have begun to perform " off-pump bypass surgery " – coronary artery bypass surgery without the aforementioned cardiopulmonary bypass . In these operations, the heart is beating during surgery, but is stabilized to provide an almost still work area in which to connect the conduit vessel that bypasses the blockage; in the U.S., most conduit vessels are harvested endoscopically, using
1612-505: The FEV 1 exceeds 2 litres or 80% of predicted, the person is fit for pneumonectomy . If the FEV 1 exceeds 1.5 litres, the patient is fit for lobectomy. There is weak evidence to indicate that participation in exercise programs before lung cancer surgery may reduce the risk of complications after surgery. A prolonged air leak (PAL) can occur in 8–25% of people following lung cancer surgery. This complication delays chest tube removal and
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1664-402: The LVRS group. Later studies have shown a wider scope of treatment with better outcomes. Possible complications of LVRS include prolonged air leak (mean duration post surgery until all chest tubes removed is 10.9 ± 8.0 days. In people who have a predominantly upper lobe emphysema, lung volume reduction surgery could result in better health status and lung function, though it also increases
1716-622: The advertisement only explicitly references that the hospital was named after the former Governor, and although the advertisement states "Here's to the Governor who forged a nation, here's to the John Hunters who achieved so much in medical science, and here's to our John Hunter Hospital", the advertisement only explicitly references the former Governor of New South Wales as the namesake of the hospital, stating "...[S]everal dedicated and visionary people made enormous contributions toward building
1768-907: The following specialties and subspecialties: The ICU is able to provide advanced respiratory support for severe respiratory failure including invasive ventilation, non-invasive ventilation, high frequency oscillation ventilation, proning, and VV-ECMO. Haemodynamic support available includes vasopressor and inotropic support, advanced haemodynamic monitoring, echocardiography, continuous renal replacement therapy, intra-aortic balloon pump, VA-ECMO and Impella/percutaneous LVAD. Neurocritical care includes EVD pressure monitoring, continuous EEG monitoring, transcranial Doppler. General surgery Upper GI – hepatic, pancreatic and oesophageal surgery Colorectal surgery – Including laparoscopic and minimally invasive oncology surgery Endocrine surgery Orthopaedics (elective and trauma) Oral and maxillofacial surgery (OMFS) Ear nose and throat (ENT) Head and neck –
1820-490: The following ~30 bed wards. Wards are designated by their horizontal position along the hospitals long corridor (by letter) and the number indicates which level of the hospital the ward is on (Levels 1–3). Hence ward E3 is positioned above E2 and next door to ward F3. While a full page advertisement taken out by the John Hunter Hospital in the Newcastle Herald on 30 January 1991 references three notable John Hunters,
1872-509: The following: Integrated six-year Cardiothoracic Surgery programs in the United States: The American Board of Thoracic Surgery offers a special pathway certificate in congenital cardiac surgery which typically requires an additional year of fellowship. This formal certificate is unique because congenital cardiac surgeons in other countries do not have formal evaluation and recognition of pediatric training by
1924-436: The general surgery residency plus cardiothoracic residency), which have each been established at many programs (over 20). Applicants match into the integrated six-year (I-6) programs directly out of medical school, and the application process has been extremely competitive for these positions as there were approximately 160 applicants for 10 spots in the U.S. in 2010. As of May 2013, there are 20 approved programs, which include
1976-546: The heart of children. The first operations to repair cardio-vascular defects in children were performed by Clarence Crafoord in Sweden when he repaired coarctation of the aorta in a 12-year-old boy. The first attempts to palliate congenital heart disease were performed by Alfred Blalock with the assistance of William Longmire, Denton Cooley, and Blalock's experienced technician, Vivien Thomas in 1944 at Johns Hopkins Hospital. Techniques for repair of congenital heart defects without
2028-450: The heart, performed without any complications, was by Ludwig Rehn of Frankfurt , Germany , who repaired a stab wound to the right ventricle on September 7, 1896. Surgery in great vessels ( aortic coarctation repair, Blalock-Taussig shunt creation, closure of patent ductus arteriosus ) became common after the turn of the century and falls in the domain of cardiac surgery, but technically cannot be considered heart surgery. One of
2080-514: The more commonly known cardiac surgery procedures is the coronary artery bypass graft (CABG) , also known as "bypass surgery." In 1925 operations on the heart valves were unknown. Henry Souttar operated successfully on a young woman with mitral stenosis . He made an opening in the appendage of the left atrium and inserted a finger into this chamber in order to palpate and explore the damaged mitral valve. The patient survived for several years but Souttar's physician colleagues at that time decided
2132-455: The mortality rates of these surgeries to relatively low ranks. For instance, repairs of congenital heart defects are currently estimated to have 4–6% mortality rates. A major concern with cardiac surgery is the incidence of neurological damage. Stroke occurs in 5% of all people undergoing cardiac surgery, and is higher in patients at risk for stroke. A more subtle constellation of neurocognitive deficits attributed to cardiopulmonary bypass
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2184-469: The number of surgeries performed as the operating surgeon, not the time spent in the program, in addition to passing rigorous board certification tests. Two other pathways to shorten the duration of training have been developed: (1) a combined general-thoracic surgery residency consisting of four years of general surgery training and three years of cardiothoracic training at the same institution and (2) an integrated six-year cardiothoracic residency (in place of
2236-611: The option to complete fellowship training in Cardiothoracic Surgery of four years in duration, subject to college approval. It takes around eight to ten years minimum of post-graduate (post-medical school) training to qualify as a cardiothoracic surgeon. Competition for training places and for public (teaching) hospital places is very high currently, leading to concerns regarding workforce planning in Australia. Historically, cardiac surgeons in Canada completed general surgery followed by
2288-521: The patient needs blood flow to the body, particularly to the brain . The patient needs the function of the heart and lungs provided by an artificial method, hence the term cardiopulmonary bypass . John Heysham Gibbon at Jefferson Medical School in Philadelphia reported in 1953 the first successful use of extracorporeal circulation by means of an oxygenator , but he abandoned the method, disappointed by subsequent failures. In 1954 Lillehei realized
2340-515: The procedure was not justified and he could not continue. Cardiac surgery changed significantly after World War II . In 1948 four surgeons carried out successful operations for mitral stenosis resulting from rheumatic fever . Horace Smithy (1914–1948) revived an operation due to Dr Dwight Harken of the Peter Bent Brigham Hospital using a punch to remove a portion of the mitral valve . Charles Bailey (1910–1993) at
2392-549: The regional Hunter Area Pathology Service which provides tertiary level pathology testing. The complex consists of a single building, which is divided into 694 adult beds and another 126 paediatric beds in the John Hunter Children's Hospital. The Royal Newcastle Centre (formerly Royal Newcastle Hospital ), opened as an extension wing to the John Hunter Hospital in April 2006, providing 144 of these beds. Patients from
2444-513: The results are based. Infection represents the primary non-cardiac complication from cardiothoracic surgery. Infections include mediastinitis, infectious myo- or pericarditis, endocarditis, cardiac device infection, pneumonia, empyema, and bloodstream infections. Clostridioides difficile colitis can develop when prophylactic or post-operative antibiotics are used. Post-operative patients of cardiothoracic surgery are at risk of nausea, vomiting, dysphagia, and aspiration pneumonia. A pleurectomy
2496-458: The risk of early mortality and adverse events. LVRS is used widely in Europe, though its application in the United States is mostly experimental. A less invasive treatment is available as a bronchoscopic lung volume reduction procedure. Not all lung cancers are suitable for surgery. The stage , location and cell type are important limiting factors. In addition, people who are very ill with
2548-459: The stenosed pulmonary valve . In 1948, Russell Brock , probably unaware of Sellor's work, used a specially designed dilator in three cases of pulmonary stenosis . Later in 1948 he designed a punch to resect the infundibular muscle stenosis which is often associated with Fallot's Tetralogy . Many thousands of these "blind" operations were performed until the introduction of heart bypass made direct surgery on valves possible. Open heart surgery
2600-410: The use of a bypass machine were developed in the late 1940s and early 1950s. Among them was an open repair of an atrial septal defect using hypothermia, inflow occlusion and direct vision in a 5-year-old child performed in 1952 by Lewis and Tauffe. C. Walter Lillihei used cross-circulation between a boy and his father to maintain perfusion while performing a direct repair of a ventricular septal defect in
2652-440: Was a success; however, Nix died three years later in 1963. In March, 1961, Zuhdi, Carey, and Greer, performed open heart surgery on a child, age 3 + 1 ⁄ 2 , using the total intentional hemodilution machine. In 1985 Zuhdi performed Oklahoma's first successful heart transplant on Nancy Rogers at Baptist Hospital. The transplant was successful, but Rogers, who had cancer , died from an infection 54 days after surgery. Since
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#17327905173472704-509: Was switched on at the John Hunter Hospital. It contains more than 5,000 solar panels, covers 12,000 square metres, and generates 3.24 gigawatt-hours per year. Cardiothoracic surgery Cardiothoracic surgery is the field of medicine involved in surgical treatment of organs inside the thoracic cavity — generally treatment of conditions of the heart ( heart disease ), lungs ( lung disease ), and other pleural or mediastinal structures. In most countries, cardiothoracic surgery
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