[After-care following heart and thoracic surgery]

The paper is directed towards those practitioners charged with the responsibility of delivering care pertinent to patients after cardiac valve replacement, coronary artery bypass grafting and surgery for lung cancer. In addition to the postpericardiotomy-syndrome the following complications associated with valve replacement are discussed: thrombotic occlusion or systemic thromboembolism, prosthetic valve endocarditis, mechanical valve dysfunction, postoperative arrhythmias. The patency of aorto-coronary bypass grafts decreases progressively over time and relates directly to improvement in symptoms and in myocardial function. Antiplatelet therapy or anticoagulants are effective in preventing graft occlusion early after operation. The goal of follow-up of patients with curative lung resection for bronchial carcinoma are early detection and treatment of recurrent cancer, metastases or second primary (metachronous carcinoma) tumor, functional cardiorespiratory decompensation and late postoperative complications. It is emphasized that the physician should not consider the patient "cured" once he has undergone cardiac valve replacement, coronary artery bypass grafting or lung resection, but rather should consider him to be the subject of meticulous long-term medical care.