The Memorial Hermann Heart & Vascular program offers a complete range of thoracic services, from diagnostic procedures to innovative minimally invasive surgical options designed to improve outcomes for patients with diseases of the chest, airway and esophagus.
Our affiliated surgeons are a nationally recognized team that has produced successful clinical outcomes with thoracic treatments, including more than 3,000 pulmonary resections. We also have special expertise in esophageal resections for both benign and malignant disease, colon interposition for total esophageal replacement, bronchial sleeve resections and related bronchoplasty procedures, and tracheal sleeve resections.
Thoracic conditions are diseases of the chest. This can include disorders of the heart, lungs, chest wall, esophagus, trachea, diaphragm and great vessels.
Thoracic conditions may occur in different organs located in or surrounding the chest. Common problems include difficulty with swallowing, esophageal motility and cancers of the chest.
Also called “acid reflux,” GERD is a common condition that affects about 20% of people in the United States and accounts for 75% of esophageal diseases. This type of reflux occurs when the valve at the end of the esophagus does not close properly, allowing acidic juices to move upward through the esophagus to the throat and mouth.
This type of hernia occurs when the stomach protrudes through the diaphragm into the chest. The cause is often unknown, but hiatal hernia may develop from the weakening of diaphragm muscles around the esophagus. Common symptoms of hiatal hernias include heartburn, difficulty swallowing, chest pain, anemia or chronic cough.
Chronic GERD can damage the lower esophageal sphincter and lead to a condition called Barrett’s esophagus. This condition is characterized by thickened, red lining in the esophagus. Patients with Barrett’s esophagus have an increased risk of developing esophageal cancer.
Chronic GERD can cause asthma-like symptoms in adults who do not have a history of asthma or respiratory problems. Acid in the esophagus or trachea can cause coughing, wheezing and pneumonia, and may improve with antacid therapy. Chronic aspiration of gastric acid and bile (non-acidic fluid), which typically occurs at night when patients are lying down, can severely damage the lungs and vocal cords.
Esophageal stricture is a narrowing of the esophagus. This narrowing or tightening is caused by chronic GERD and occurs in 1% to 5% of patients with esophagitis (irritation and inflammation of the lining of the esophagus). Patients with peptic esophageal stricture may have difficulty swallowing and feel like food is stuck in their throat.
Patients who experience recurrent symptoms after antireflux surgery may need a corrective procedure. This “redo” procedure aims to prevent the reflux of acid and bile (non-acidic juice) from the stomach into the esophagus. A procedure called Laparoscopic Nissen Fundoplication is most frequently used.
This condition affects the function of the nerves around the esophagus. With achalasia, the esophagus does not function well enough to effectively push food through to the stomach. The lower esophageal sphincter (valve between the esophagus and the stomach) cannot relax or open to allow food to pass. The goal of treatment is to improve symptoms by widening the obstruction where the esophagus meets the stomach.
Scleroderma is a rare autoimmune disease affecting the connective tissues of the body. The body’s immune system is designed to defend against infection, but patients with scleroderma have a response that hardens and thickens tissue in skin or other organs. Scleroderma can affect the skin, muscles, blood vessels, heart, lungs and digestive tract.
Uncoordinated contractions of the muscles in the esophagus are known as esophageal spasms. This abnormal muscle movement prevents food from moving correctly through the esophagus and into the stomach. Diffuse esophageal spasms may be related to triggers like hot or cold foods, and can cause chest pain, heartburn or painful swallowing.
Abnormal, intense contractions during swallowing occur in patients with Nutcracker esophagus. The condition is usually caused by chronic GERD and causes chest pain, difficulty swallowing and heartburn. Treatment involves addressing the underlying GERD problem.
This condition occurs when the lower esophageal sphincter (LES) is in a state of increased contraction pressures. Hypertensive LES can be caused by chronic GERD, although the cause is often unknown. Treatment options include Botox® injections to relax the sphincter or surgery for severe cases of dysphagia.
This condition is believed by be a form of food allergy that causes difficulty swallowing. With eosinophilic esophagitis, the lining of the esophagus develops an accumulation of eosinophils (a type of white blood cell associated with allergic immune response). The accumulation causes narrowing of the esophagus and swallowing becomes difficult. In severe cases, food may become impacted and require surgical removal.
This life-threatening condition occurs when the esophagus tissue is torn, leading to infection. The majority of esophageal perforations are caused by instrumentation following an upper endoscopy and dilation of the esophagus for treatment of conditions such as esophageal peptic stricture, achalasia or esophageal cancer. The esophagus can also be perforated following severe vomiting. Without treatment, esophageal perforation can result in sepsis (severe infection) and death.
The esophagus and trachea (windpipe) are separate parts of the human anatomy. Tracheoesophageal fistulas can be caused when any disease or trauma in the trachea or esophagus causes erosion into the wall of the other organ. This abnormal connection allows food or liquids that are swallowed to be inhaled into the lungs, and can result in difficulty swallowing, coughing and, pneumonia.
A Zenker’s diverticulum is a pouch at the back of the throat that develops where the lower portion of the throat meets the top of the esophagus. This condition develops when the muscles that control swallowing do not properly relax. Over time, food can accumulate in the pouch causing it to increase in size.
Chronic GERD can cause inflammation and damage to the lower esophagus. When the damage heals, a scar called Schatzki’s ring can develop. This condition is usually asymptomatic until it advances to a point where food becomes impacted, causing severe chest pain and difficulty swallowing.
Esophageal cancer usually starts in the cells of the esophageal lining, occurring anywhere along the length of the esophagus. According to the American Cancer Society, this type of cancer is relatively rare but about 20,000 Americans are diagnosed each year.
Lung cancer is the second most common type of cancer in the United States, according to the American Cancer Society. Smoking is the most significant risk factor, but about one quarter of people diagnosed with lung cancer have never smoked. The two main types of lung cancer are small-cell lung cancer and non-small cell lung cancer. Non-small cell lung cancer is more common and develops slowly. Small-cell lung cancer grows faster and is often in an advanced stage by the time it is diagnosed.
Our comprehensive program offers a broad range of services and treatment options from cancer-screening techniques to the latest advances in minimally invasive surgical procedures.
Surgery is often recommended as the primary option for treating lung cancer in the early stages. When the disease is localized (has not spread), removing the malignant tumor can give patients the best chance for survival. However, surgery is not an option for all patients. Some tumors cannot be removed because of their location, and patients with underlying medical conditions may not be well suited for surgery.
Our multidisciplinary team of physicians evaluates each patient to determine whether or not lung-cancer surgery is a good option. Depending on the specifics of the tumor and the health condition of the patient, surgeons may recommend removing a small portion of the lung (limited resection), a larger section of the lung (lobectomy), or the entire lung (pneumonectomy).
Robotic surgery is a minimally invasive surgical technique used for lung-cancer patients. In a robotically assisted lung resection procedure, surgeons use computer consoles and 3-D technology to guide robotic instruments from a console in the operating room. The surgeon controls the robotic instruments and can remove the cancerous portions of the lung and the surrounding lymph nodes, if necessary. Because this is a minimally invasive surgery, the surgeon will make small incisions instead of opening the chest to reach the lungs.
When other treatments have not been successful, a lung transplant may be recommended. Some patients with conditions including cystic fibrosis, pulmonary hypertension, pulmonary fibrosis, and chronic obstructive pulmonary disease (COPD), may need to replace their lung with a donor lung in order to survive. Patients who meet the criteria for transplantation will wait until a donor lung is available. During surgery, a ventilator and/or heart-lung machine will be used to maintain breathing. Recovery may take up to 6 months.
This type of minimally invasive surgery can be used for a variety of thoracic procedures. VATS is also called thoracoscopy, thoracoscopic surgery or pleuroscopy. Surgeons make three small incisions in the chest and insert surgical instruments and the thoracoscope (small video device). The thoracoscope allows the surgeon to view the surgical area on a computer monitor. This is a less invasive alternative to traditional open-thoracic surgery, and generally has a faster recovery time and fewer complications.
When esophageal cancer is diagnosed in an early stage, surgery to remove part or all of the esophagus (esophagectomy) may be successful in eliminating the cancerous cells. However, most esophageal cancers are not discovered early enough for a surgical cure. If the cancerous area is located at the bottom of the esophagus, near the stomach, part of the stomach may also be removed. Esophagectomy can be performed as either a traditional open surgical procedure or a minimally invasive surgical procedure.
The Heller Myotomy procedure, also called laparoscopic esophagomyotomy, is a minimally invasive surgery for achalasia, a rare condition in which the esophagus cannot move food down into the stomach. During the procedure, an endoscope (thin instrument with a camera attached) is inserted through a small incision. The surgeon uses an endoscope to guide surgical devices and cut the muscle fibers of the lower esophageal sphincter to relieve the symptoms of achalasia.
Antireflux surgery, also called Nissen fundoplication, is a minimally invasive surgical procedure that tightens the connection between the esophagus and the stomach to prevent acid reflux and GERD symptoms. When medication and lifestyle changes have not been sufficient to relieve symptoms, your doctor may recommend antireflux surgery. Often, the symptom relief from surgery only lasts 2 or 3 years, and patients may need a repeat procedure.
This surgical procedure removes a portion of the lung or the entire lung. It is used to treat pulmonary diseases including lung cancer. Removal of a small portion of the lung is called a wedge resection. When a larger portion of the lung needs to be removed, the surgeon will perform a segmental resection. Removing one of the lobes of the lung is referred to as lobectomy, and removing the entire lung involves a pneumonectomy procedure.
Esophagectomy (also called esophageal resection) is a surgical procedure to replace damaged or diseased portions of the esophagus with healthy tissue from somewhere else in your body (usually stomach tissue). It is a treatment for esophageal cancer and Barrett’s esophagus.
This surgical procedure takes healthy tissue from the colon and uses it to replace diseased or damaged tissue in the esophagus. It is a treatment for esophageal cancer and Barrett’s esophagus.
Bronchial sleeve resection, also called sleeve lobectomy, is a surgical procedure to remove lung tumors from the lobes of the lung and the main bronchus (airway that draws air into the lungs). Part of the lung can usually be saved with this procedure.
Bronchoplasty is used to repair or reconstruct the bronchus (airway that draws air into the lungs). It is used to treat malignant (cancerous) and benign (not cancerous) lung tumors, and to expand a narrowed bronchus caused by inflammation or infection. Multiple types of bronchoplastic procedures are available: open bronchoplasty, balloon bronchoplasty and thermal bronchoplasty are common types.
This type of surgery is used to widen a narrowed portion of the trachea (airway that connects the throat to the lungs). The constricted area is removed, and the ends of the trachea are reconnected.
April 6, 2022
For as long as she can remember, Karen Wanjura suffered from a burning discomfort in her upper abdomen after she ate. A common symptom of gastroesophageal reflux disease, or GERD, the burning became a way of life that the 71-year-old resident of Cypress learned to accept. It was caused by a non-f...
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