TY - CHAP M1 - Book, Section TI - Introduction A1 - Sugarbaker, David J. A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Colson, Yolonda L. A2 - Jaklitsch, Michael T. A2 - Krasna, Mark J. A2 - Mentzer, Steven J. A2 - Williams, Marcia A2 - Adams, Ann PY - 2015 T2 - Adult Chest Surgery, 2e AB - The emergence of general thoracic surgery in North America as a surgical subspecialty distinct from general surgery, congenital heart surgery, and adult cardiac surgery occurred through dramatic and tumultuous changes that once threatened but ultimately strengthened the integrity of the discipline. The discipline evolved from general surgery in the early 1900s in response to chest morbidities prevalent at that time, primarily tuberculosis and World War I-related trauma. Hence, the systems established to guide thoracic surgery were shaped by general surgeons. War continued to play a role in shaping surgery. In the 1940s, surgeons caring for soldiers in World War II struggled to manage the life-threatening chest injuries caused by modern weaponry. This spurred technological innovation during and after the war. By the 1950s, new knowledge and technology began to lift the physical and psychological barriers to surgery within the chest, including the heart. The technical achievement of extracorporeal circulation by John Gibbon, first used in humans successfully in 1953, allowed the extension of cardiac and congenital heart surgery into more complex problems, leading to new fields of specialization in myocardial revascularization, valve surgery, and heart transplantation in the late 1960s. These changes occurred as antibiotic use reduced the incidence of tuberculosis and the need for pulmonary surgery. Soon, combined cardiothoracic surgery programs began to form at leading academic centers. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1105837508 ER -