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About Cardiovascular treatment

The heart is a hollow, four-chambered muscular organ that lies beneath and to the left of the breastbone (sternum). Its primary function is to pump oxygen-rich blood to all parts of the body. The heart pumps approximately four quarts of blood per minute at rest and 10 to 15 quarts during exercise.

Types of Heart Surgery

Aortic surgery

If you or someone you love needs to have surgery for an aortic aneurysm, you’ll want to know what happens and what the recovery is like. An aortic aneurysm is a bulge in your aorta, the main blood vessel that carries blood from your heart to the rest of your body. Arteries usually have strong, thick walls. But sometimes, certain illnesses or problems with your genes make them weak. The force of your blood constantly pushing against those weakened walls can make them swell. The result is a balloon-like bulge, called an aneurysm. If it grows too large and bursts, it can become an emergency. So it needs treatment as soon as possible. Doctors can usually treat small aneurysms with medication. But larger ones may need surgery. There are two main types of surgery for aortic aneurysms: Open abdominal or open chest repair / Endovascular repair.

Aortic valve surgery

Aortic valve surgery, which includes an aortic valve replacement, or an aortic valve repair, fixes an aortic valve that isn’t working correctly. The aortic valve lets blood flow from the left lower chamber of the heart (left ventricle) to the aorta, which is the body’s main blood vessel. The aorta distributes blood throughout the body.

When do aortic valves need to be repaired or replaced?

Aortic valves help pump blood out of the heart to the rest of the body. In a person with aortic valve disease, the aortic valve has a malfunction:

Regurgitation: The aortic valve doesn’t close completely, causing blood to flow backward instead of forward through the valve.

Stenosis: The aortic valve opening doesn’t form properly or becomes narrow, inhibiting the flow of blood out of the chambers of the heart. When this happens, the heart is forced to pump blood with increased force in order to move blood through the stiff (stenotic) valve. Aortic valves can have regurgitation and stenosis at the same time.When heart valves fail to open and close properly, the heart can become damaged. Heart valve problems are one cause of heart failure.

Our goal is to comprehensively evaluate a patient’s suitability for all types of aortic valve interventions and to provide the most effective treatment option(s) for patients with symptomatic aortic stenosis. We aim to optimize clinical outcomes and seek to improve and prolong quality and duration of life. Individualized treatment plans are developed in conjunction with the referring physician to determine the optimal approach for each patient.


Arrhythmia surgery

Arrhythmia describes a group of conditions that affect the heart’s natural rhythm. Different types of arrhythmias cause the heart to beat too fast, too slowly, or in an irregular pattern. An arrhythmia is a disorder of the heart’s electrical system that affects heart rate and rhythm. Different arrhythmias can cause your heart to beat too fast, too slowly, or in a disorganized, irregular pattern.

The more serious arrhythmias affect your heart’s ability to pump enough blood to the body. Poor blood flow causes you to feel weak, tired, and short of breath. The lack of oxygen caused by poor circulation can damage the brain, heart, and other organs. Some of the most serious arrhythmias, such as ventricular tachycardia or ventricular fibrillation, may cause collapse or even be life-threatening.

The heart’s electrical system controls your heartbeat by sending electrical signals from the top to the bottom of the heart. The signals begin in the sinoatrial node, specialized tissue in the right atrium (upper heart chamber) that conducts electrical activity. The electrical signals travel through the right and left atria, causing them to contract and pump blood into the ventricles (lower heart chambers). The signals then continue to the ventricles, causing them to contract and pump blood to the lungs and the body.

An arrhythmia occurs when any part of this process is disrupted. Arrhythmias can range from mild and harmless to severe and life threatening. No matter what type of arrhythmia you have, we offer care to help you live a healthy life.

Congenital Surgery

congenital heart disease (CHD) is an abnormal development of the heart that occurs during pregnancy before a baby is born. Congenital heart defects occur during the first eight weeks of a baby’s development. Congenital heart problems range from routine to complex. Some heart problems require careful monitoring. Other congenital heart defects may require more intensive treatments, such as medication or surgery. Most congenital heart defects have no known cause. Hereditary and genetic factors may play a role in some cases. Learn more about causes of congenital heart disease.

Types of congenital heart disease:

  • Too much blood circulated in the lungs.
  • Too little blood circulated in the lungs.
  • Too little blood circulated throughout the body.

Coronary Artery Bypass Graft Surgery

Coronary artery bypass graft surgery (CABG) is a procedure used to treat coronary artery disease in certain circumstances. Coronary artery disease (CAD) is the narrowing of the coronary arteries (the blood vessels that supply oxygen and nutrients to the heart muscle), caused by a buildup of fatty material within the walls of the arteries. This buildup causes the inside of the arteries to become rough and narrowed, limiting the supply of oxygen-rich blood to the heart muscle.

One way to treat the blocked or narrowed arteries is to bypass the blocked portion of the coronary artery with another piece of blood vessel. Blood vessels, or grafts, may be pieces of a vein that are then grafted above and below the blocked area of a coronary artery, allowing blood to flow around the obstruction. Veins are usually taken from the leg, but arteries from the chest may also be used to create a bypass graft.

One end of the graft is attached above the blockage and the other end is attached below the blockage. Thus, the blood is rerouted around, or bypasses, the blockage through the new graft to reach the heart muscle.

This bypass of the blocked coronary artery can be done by performing coronary artery bypass surgery.

Traditionally, in order to bypass the blocked coronary artery in this manner, the chest is opened in the operating room and the heart is stopped for a time so that the surgeon can perform the bypass. In order to open the chest, the breastbone (sternum) is cut in half and spread apart.

Once the heart is exposed, tubes are inserted into the heart so that the blood can be pumped through the body during the surgery by a cardiopulmonary bypass machine (heart-lung machine). The bypass machine is necessary to pump blood while the heart is stopped and kept still in order for the surgeon to perform the bypass operation.

While the traditional “open heart” procedure is still performed and often preferred in many situations, newer, less invasive techniques have been developed to bypass blocked coronary arteries.

“Off-pump” procedures, in which the heart does not have to be stopped, were developed in the 1990’s. Other minimally-invasive procedures, such as key-hole surgery (performed through very small incisions) and robotic procedures (performed with the aid of a moving mechanical device), are also in development.


Left Ventricular Assist Device (LVAD)

 left ventricular assist device (LVAD) is a pump that we use for patients who have reached end-stage heart failure. We surgically implant the LVAD, a battery-operated, mechanical pump, which then helps the left ventricle (main pumping chamber of the heart) pump blood to the rest of the body. LVADs can be used as:

Bridge-to-transplant therapy: This is a life-saving therapy for patients awaiting a heart transplant. Patients use the LVAD until a heart becomes available. In some cases, the LVAD is able to restore the failing heart, eliminating the need for a transplant. Learn more about heart transplant.

Destination therapy: Some patients are not candidates for heart transplants. In this case, patients can receive long-term treatment using an LVAD, which can prolong and improve patients’ lives.


Left Ventricular Remodeling

Left ventricular remodeling, also known as surgical ventricular restoration, is a surgery to restore the natural shape of the heart in those who have had a heart attack. This allows the heart to pump blood more efficiently.

Why is left ventricular remodeling performed?

When a heart is healthy, oxygen-rich blood is pumped through the heart to the rest of the body. A heart attack damages heart tissue, usually in the left ventricle (main pumping chamber of the heart) causing a scar. The scar becomes enlarged over time, changing the size and shape of the heart.

The enlarged, deformed heart does not contract correctly and blood pools in the lungs; the weakened heart tissue may even burst. Left ventricular remodeling restores the heart to its normal shape, which allows it to pump blood more efficiently and prevents rupture of the heart.

Heart Valve Surgery

here are four heart valves that open and close to regulate blood flow through the heart. Heart valve surgery treats diseases and defects of these valves of the heart.There are two main types of heart valve surgery:

Surgery to replace faulty heart valves

Surgery to repair faulty heart valves

How is surgery accomplished?

Your surgeon will meet with you and explain the operation and its risks and benefits. You will have the opportunity to ask any questions you or your family may have. After we receive your signed consent form, your surgery will proceed. You will be transported to a sterile operating room, sedated and placed under anesthesia by the cardiac anesthesiology team. In the traditional approach to heart surgery, the surgeon opens the chest by dividing the breastbone (sternum) and connects you to the heart-lung machine. By performing the functions of the heart and lungs, this machine allows the surgeon to operate directly on the heart. When the operation is finished, the heart resumes beating on its own and the heart-lung machine is disconnected. Then the divided breastbone is wired together so it can heal, which requires at least six to eight weeks. Finally, the skin is closed by stitches, staples or a special glue, depending on the surgeon’s preference. The sternal wires will remain in the chest bone and are not removed. If staples are used, they will be removed between seven to 14 days after surgery. The glue wears off by itself over several weeks. You may also speak with your surgeon to see if you are a candidate for less invasive therapies.


Recovery Period

Open heart surgery is a major operation that requires close monitoring and immediate post-operative support.It is normal for a person to remain in the intensive care unit (ICU) for a couple of days after the procedure to receive further care.After the operation, a breathing tube will remain in place for a period to assist with breathing. A line also stays in the vein to administer pain relief. A person may find themselves attached to a variety of other monitoring equipment.After leaving ICU, a person will probably stay in the hospital for about a week. Recovery at home after leaving the hospital usually takes between 4 to 6 weeks.the healthcare team will guide rehabilitation and advise on medications and restrictions on physical activity.

During recovery:

It is perfectly normal to experience tiredness and some pain.

Follow the advice of the medical team on wound care, and look out for signs of infection around the chest wound, such as redness or discharge.

Seek urgent care for any potentially serious symptoms of infection. Symptoms include difficulty breathing, fever, and excessive sweating.

Some doctors might offer specialist support for daily activities and other aspects of recovery as part of a specific cardiac rehabilitation program.

Aftercare varies for each individual but might include blood tests, heart scans, and stress tests. A stress test involves monitoring the heart during a treadmill exercise.

Medication might include blood-thinning drugs.

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