Programs and Services

Treatment of Non-Cancerous Thoracic Disease

Emphysema

Emphysema, a chronic lung condition, is a major cause of death and disability in the United States. Two million Americans are affected, many of whom are over age 50. With emphysema, breathing becomes difficult as the fine architecture of the lung is destroyed, leading to large holes in the lung, obstruction of the airways, trapping of air, and difficulty exchanging oxygen because of reduced elasticity of the lungs.

For some emphysema patients, a surgical procedure called lung volume reduction can give relief.

Lung Volume Reduction Surgery

In addition to transplants, we perform the entire range of lung surgeries, including lung volume reduction. Originally developed as a bridge to lung transplantation, lung volume reduction has itself become a successful treatment for select patients with emphysema. This procedure removes certain damaged portions of the patient’s lung, helping the lung become more efficient. It can significantly improve the patient’s health and reduce feelings of breathlessness. For some patients, lung volume reduction surgery can be done instead of a lung transplant.

Froedtert & The Medical College of Wisconsin have also been selected to participate in a nationwide clinical trial of a new valve that is designed to mimic the effects of lung volume reduction surgery. Called the VITAL Valve Intervention Treatment Trial, it will study the effectiveness of a one-way valve, the IBV® Valve System, which would be inserted into the airway through a bronchoscope, without surgery. The umbrella shaped valves are designed to redistribute air flow to healthier portions of the lung, which may improve the overall health and quality of life for people with emphysema.

End-Stage Lung Disease

End-stage lung disease or lung failure occurs when the lung is weakened by disease and is unable to expand and contract with breathing. This prevents the lungs from oxygenating the blood properly, which can cause other organ systems to fail. There are several causes of end-stage lung disease including emphysema, cystic fibrosis; pulmonary fibrosis or scarring in the lungs; pulmonary hypertension or high blood pressure in the arteries that supply the lungs; and other conditions. Because there are so many possible causes, there is no one treatment option for end-stage lung disease.

For example, for patients with pulmonary hypertension, we work closely with Froedtert & The Medical College of Wisconsin’s Pulmonary Hypertension Program, which is the only one of its kind in the state.

We also have an outstanding program for adult patients with cystic fibrosis up to and including lung transplantation. Froedtert & The Medical College of Wisconsin is accredited by the Cystic Fibrosis Foundation as a care center that provides high-quality, specialized care and offers comprehensive diagnosis and treatment for people with CF and their families

Lung Transplant Program

The Lung Transplant Program at Froedtert & The Medical College of Wisconsin offers exceptional, high-quality care with an emphasis on personalized attention and long-term survival. Our highly experienced, multidisciplinary team designs comprehensive treatment plans to meet each patient’s needs. We care for the whole patient and understand that the treatment received before and after transplant plays a vital role in the patient’s long-term well being.

As an academic medical center, we know about the latest treatment options and can help you consider all of the possibilities open to you. We assess each patient individually to determine if a transplant might be necessary or if other courses of treatment are more suitable. Even if you’ve been told a lung transplant is your only option, we can offer an advanced opinion on whether you might benefit from other treatment approaches.

Thoracic Outlet Syndrome

The thoracic outlet, the area between the collarbone (clavicle) and the first rib, is crowded with blood vessels, muscles and nerves. Thoracic Outlet Syndrome refers to a group of diseases involving compression of these nerves, blood vessels and muscles. A variety of conditions can cause Thoracic Outlet Syndrome, and each may require a different treatment. For example, the shoulder muscles in the chest may not be strong enough to hold the collarbone in place, causing it to slip down and forward, putting pressure on the nerves and blood vessels that lie under it. The condition may also be caused by a congenital abnormality such as an extra rib; or work-related overuse.

One treatment option is a surgical procedure to relieve the compression, which can be done two ways. One is a standard transaxillary route, which begins underneath the armpit. Another surgical option is a supraclavicular route, which involves a low neck incision above the collar bone. The supraclavicular route may be more effective for patients with nerve-related problems or in the case of an extra rib. Each patient’s case is carefully evaluated on an individual basis to determine what treatment approach would be best

Chronic Pulmonary Embolism

A pulmonary embolism happens when a blood clot lodges in the lungs and blocks the arteries, reducing blood flow to the lungs and heart. There are non-surgical treatment options available, but in some cases, surgery may be required to remove the clot. This specialized procedure, called a pulmonary thromboendarterectomy or PTE, can avert the patient’s need for a lung transplant in some cases.

The general thoracic surgery program works closely with the team in pulmonary medicine to carefully evaluate each patient’s condition and develop the most effective treatment approach, whether it is surgical, non-surgical or a combination of both.

Author: Joan Cotter Pike

Date: Nov. 30, 2006