Cardiovascular (or cardiothoracic) surgeons specialize in these heart procedures. In some cases these may be “open-heart” procedures, requiring a significant incision and opening of the chest; other procedures are offered through much smaller (keyhole) openings in the chest. In some cases, the team stops the heart and maintains circulation during the procedure with cardiopulmonary bypass pump; in other procedures, the team can operate on the beating heart, without the need to use a pump to maintain blood flow (off-pump surgery).
Critical parts: fix them
Most patients who require such operations need surgery for:
- coronary arteries. Sometimes blockages in these arteries are so extensive that interventional cardiologists cannot fully treat them using angioplasty techniques alone. These patients undergo coronary-artery bypass (CABG) surgery, in which the surgeons remove small arteries from other areas of the body and attach them to the patient’s diseased coronary arteries. These bypass grafts shunt blood around blockages, so that the blood reaches heart muscle that has been deprived of blood flow.
- heart valves. The valves of the heart serve as closable intake structures to the chambers of the heart, routing blood in the correct direction during compression of the heart. Without this function, the circulatory system could not keep blood flow moving in the correct direction through its vessels and in a continuous loop. Valves that are malformed, stiffened, or otherwise abnormal may leak in one direction or the other, causing insufficient blood flow. These valves may require surgery to correct their shape or to replace them.
or the heart wall. Some patients have defects in their heart walls, which typically are present since birth. These are often abnormal openings in the heart-wall tissue that separates the chambers of the hearts. These septa may have defects in the form of openings between the atria or ventricles of the heart that cause leakage of blood from one chamber to another and insufficient pumping of the blood. If cardiac interventionalists cannot close these holes with catheter procedures, heart surgeons may open the heart to do so directly.
A state-of-the-science operating room at Aria's Heart Center
In addition, in patients who have experienced heart attacks (acute loss of blood flow through the coronary arteries to the heart muscle) a portion of the cells within the heart wall can die, causing permanent damage to the ability of the heart to beat properly (heart failure). Often these patients have enlarged heart ventricles that need to be restructured surgically, or they may need to have ventricular assist devices implanted to improve the blood flow coming from the heart.
Kinder, gentler surgery
Advances in tools, techniques, and skills have steadily improved success rates for heart surgery and decreased the rate of both temporary and long-term complications. New innovations have continued to decrease the invasiveness of heart surgery, permitting patients shorter stays in the hospital and faster recovery. Better knowledge and capabilities in presurgical care and in cardiac rehabilitation are also helping to return patients to activity faster, after operations.Surgeons at the Aria's Heart Center are placing increasing emphasis on minimally invasive surgery and off-pump procedures. Because our center performs hundreds of cardiovascular surgical procedures each year, we provide heart surgery from a highly experienced and accomplished team.