Cardiac Surgery

Cardiac surgery refers to an operation on the heart which most commonly utilizes cardiopulmonary bypass (i.e. the heart-lung machine).  The heart-lung machine consists of a specialized pump which temporarily substitutes for the pumping function of the heart and an oxygenator device which replaces the function of the lungs.  This machine allows our surgeons to temporarily empty and stop the heart from beating, so that meticulous operations can be performed.  Our surgeons utilize various techniques to optimally preserve heart function during the course of the operation.

Coronary Artery Bypass Grafting (CABG)

CABG, or bypass surgery, is the most common type of heart operation. This procedure is designed to treat atherosclerosis (blockages) of the coronary arteries, to eliminate symptoms (angina, chest pain, shortness of breath), prevent myocardial infarction (heart attack), and ultimately minimize the risk of dying from cardiac disease. The CABG operation is performed by dividing the sternum (breastbone). Then, a vein from the leg (saphenous vein), artery from the chest wall (internal mammary artery) and/or arm (radial artery) are sewn onto the coronary arteries downstream from the blockages. This effectively reroutes the flow of blood around the blockages to nourish the previously oxygen-deprived heart muscle. The terms single-, double-, triple-bypass, etc. refer to the total number of coronary arteries bypassed, and varies considerably from patient to patient.Our surgeons perform minimally invasive harvesting of the saphenous vein to facilitate leg healing. In addition, they utilize multiple arterial grafts as much as feasible to facilitate long-term patient outcomes.

 

What is off-pump CABG?

Off-pump CABG, or OPCAB, is a specific type of coronary bypass operation in which the heart-lung machine is not used and the heart continues to beat throughout the procedure. Specialized equipment is used to stabilize the heart motion during each bypass graft. There are select circumstances in which it is preferable to perform OPCAB surgery. Our surgeons are well trained in all OPCAB techniques and employ this approach whenever it will benefit our patients.

Valve Repair/Replacement

The function of the four heart valves (aortic, mitral, tricuspid, and pulmonic) is to maintain unrestricted blood flow in a forward direction. When a valve becomes diseased, two things may happen; the valve may become too tight and restrict the passage of blood through it (stenosis), or, the valve may not close properly so that blood leaks in a backward direction (regurgitation or insufficiency). If either of these situations is severe, surgical repair of the valve or replacement with a new valve is required.Sometimes more than one valve is diseased, such that multiple valves may need to be repaired or replaced during the same operation. Repair of a heart valve involves a variety of techniques designed to alleviate stenosis and/or correct regurgitation. When possible this is much preferred over replacement.Our surgeons are skilled in performing all of the state-of-the-art techniques for repair of any of the four heart valves. However, when the valve becomes so severely damaged that repair is impossible, outright replacement of the valve is necessary.

What are the different types of heart valves that can be used for replacement?

In general, there are 2 kinds of valves used for heart valve replacement. Each type has advantages and disadvantages.Biological valves, or tissue valves, are made from animal or human tissue. (Visit Edwards Life Sciences and/or Medtronic) In general, tissue valves do not require long-term anticoagulation (blood thinning medication). However, in young individuals these valves may have limited durability and thus may need to be re-replaced.Mechanical valves are made from metal compounds such as stainless steel or pyrolytic carbon. They have great durability and will not wear out in your lifetime. (Visit Visit St. Jude Medical) They do, however, require lifelong anticoagulation with blood thinning medication, and regular blood tests to monitor the medication. Without this medication, blood clots will form on these valves.

Our surgeons implant only those valves with the best track record in terms of safety, durability, and performance. Should you need a valve replacement, you and your surgeon will decide the best valve replacement option for you.