What Procedures are Available?
The Heart’s Blood Vessels: Coronary Artery Bypass Grafting
This procedure, also known as coronary artery bypass graft (CABG) surgery, as well as heart bypass or bypass surgery, is performed to relieve angina and reduce the risk of death from coronary artery disease.
Surgeons graft arteries or veins from elsewhere in the patient's body to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the circulation supplying the myocardium, or heart muscle. This surgery typically is performed with the heart stopped, necessitating the use of cardiopulmonary bypass.
Techniques are available to perform CABG on a beating heart, the so-called "off-pump" surgery.
The “off pump” method allows the heart to continue beating during surgery; consequently, the patient continues to have normal perfusion throughout the procedure. Though there are advantages to both on-pump and off-pump surgeries, Scottsdale Healthcare believes off-pump surgery, when performed by technically skilled surgeons, is better for patients in the long run. When it comes to the heart, time is muscle. The less time it takes to “interrupt” the heart’s normal functioning, the better.
Valve Repair/Replacement Surgery
The heart has four valves: Aortic, Mitral, Tricuspid and Pulmonary. Valves control the direction of blood flow through the heart. Their opening and closing are what produces the sound of the heartbeat.
Heart valve surgery is open-heart surgery (see minimally invasive heart surgery) that is done while the patient is under general anesthesia. A cut is made between the ribs, blood is then routed away from the heart to a heart-lung bypass machine which keeps the blood circulating while surgeons operate on the heart.
Valves may be repaired or replaced. Replacement heart valves are either natural (biologic) or artificial (mechanical):
- Natural valves are from human donors (cadavers).
- Modified natural valves come from animal donors. (Porcine
valves are from pigs, bovine are from cows.)
These are placed in synthetic rings.
- Artificial valves are made of metal like substance.
Patients who receive an artificial valve may need to take lifelong medication to prevent blood clots. Natural valves rarely require lifelong medication.
Why the Procedure is Performed
Heart valve surgery may be recommended due to narrowing of the heart valve (stenosis) or leaking of the heart valve (regurgitation). Valve problems may be caused by birth defects, calcium deposits (calcification), infections such as rheumatic fever or medications.
Defective valves may cause congestive heart failure and infections (infective endocarditis).
After the Procedure
The success rate of heart valve surgery is high. The operation can relieve symptoms and prolong life.
The death rate averages between two percent to five percent, depending on the heart valve. About two of every three patients who received an artificial mitral valve are still alive nine years after the surgery.
The clicking of the mechanical heart valve may be heard in the chest. This is normal.
Patients typically stay in the intensive care unit (ICU) for the first two or three days following the operation. Heart functions are monitored constantly. The average hospital stay is one to two weeks. Complete recovery can take a few weeks to several months, depending on the patient’s health before surgery.
Cardiac Arrhythmia Service
- Maze procedure for atrial fibrillation or atrial flutter
- Cardiac resynchronization therapy (CRT)