There are several cardiac surgical procedures performed at Southlake, including:
- Coronary Artery Bypass Surgery (CABG)
- Heart Valve Surgery (Aorta, Mtiral, Tricuspid valves)
- Atrial or Ventricular Septal Defect Repair Surgery
- Aortic Aneurysm Repair
- Ventricular Aneurysm Repair
- Minimally Invasive Surgery for repair and replacement of mitral and tricuspid valves
- Transthoracic Aortic Valve Implantation
For information on how to prepare for a procedure, visit the Preparing for Cardiac Surgery
Individuals who are waiting at home for surgery may be referred to Cardiac Pre-hab by their cardiologist or by their cardiac surgeon. This program provides rehabilitation before surgery and is designed to help individuals maintain their current level of activity as they wait to have their operation.
Coronary Artery Bypass Surgery (CABG)
Coronary artery bypass grafting (CABG) surgery is the most common type of heart surgery. When medication and/or other procedures are not able to improve the blood flow to the heart, bypass surgery improves the blood flow to the heart muscle, which provides relief of angina symptoms and may increase life expectancy.
During surgery, the patient is connected to the heart-lung bypass machine, which takes over the function of the heart and lungs during surgery. A portion of a blood vessel from the patient’s leg, arm or inner chest wall is used to bridge the blocked or diseased area and to improve blood flow to the heart muscle.
The vein or artery is attached to the aorta (large blood vessel that supplies blood to the heart) at one end and the other end is attached to the coronary artery below the area of blockage or disease. The diseased area is essentially “bypassed” and the coronary artery beyond the blockage receives the oxygen and nutrient-rich blood that is delivered to the heart muscle.
Heart Valve Surgery
Heart valves can be abnormally formed as birth defects or damaged by rheumatic fever, bacterial infection, and calcific degeneration. Valves can also degenerate with the normal aging process. To compensate for these disorders, the heart is forced to pump harder. This excess work can weaken the heart, causing it to enlarge, and cause shortness of breath, chest pain, increased fatigue, swelling of the ankles and legs, dizziness or fainting.
If medications are no longer able to control the symptoms, heart valve surgery may be recommended. Some valves can be surgically repaired to help them open or close more efficiently.
Atrial or Ventricular Septal Defect Surgery
The ‘septum’ is the wall of the heart that divides the left and right chambers. Occasionally, areas in this wall fail to close during development before birth, leaving an opening called a septal defect. This opening may increase the workload on the heart; however, this can be surgically repaired. During surgery, the opening is sewn together or patched with synthetic material or tissue from around the heart.
Ventricular Aneurysm Repair
After a heart attack, part of the heart muscle may become weakened or scarred. When this happens, a part of the heart may bulge causing the heart to pump inefficiently. This may lead to such symptoms as shortness of breath, pain or irregular heartbeats, as well as possibly aggravating already existing angina symptoms. At the time of surgery, the aneurysm may be removed or patched in conjunction with coronary artery bypass surgery.
Aortic Aneurysm Repair
The aorta may enlarge (dilate). This can occur due to high blood pressure, abnormal aortic valves, or genetic factors. If it reaches a certain diameter, and depending on any associated heart problem, it may be recommended that the aorta be replaced with a polyester graft. This may be done as scheduled surgery, and in addition to other procedures on the heart. Occasionally this must be done as an emergency procedure.
Minimally Invasive Surgery
Depending on certain conditions, it can be possible to repair the mitral valve, tricuspid valve, and close an atrial septal defect through a small incision in the chest, rather than opening the full length of the breastbone.
Transcatheter Aortic Valve Implantation (TAVI)
For some patients who are considered to be too high risk for standard surgical aortic valve replacement, it is possible to insert a new aortic valve using a tube that is placed either through an artery in the groin (Trans-femoral) or through a small incision made under the left breast (Trans-apical). An interventional cardiologist and cardiac surgeon review these patients and arrange for several tests including an echocardiogram and CAT scan to determine if the procedure should be done. Additional consultations may also be obtained with a doctor specializing in the health of the elderly.
The next step in a patient’s recovery following their surgery is participation in the Cardiac Rehabilitation Program. The majority of patients are referred to this program when they are discharged from the hospital.