Open Heart Surgery
When open-heart surgery is required, the surgeons and staff at the Tommy Lasorda Heart Institute are dedicated to providing their support and expertise throughout a patient’s stay in the hospital. Our Board Certified surgeons have earned national recognition for their expertise in achieving optimal results for open-heart surgery patients. Their skills are complemented by the expertise of the Institute’s cardiologists, anesthesiologists, nurses and other clinical staff.
This multi-disciplinary team of professionals provides not only for the clinical needs, but also the emotional needs of the patient and their family. Cardiac surgery services include:
Coronary Artery Bypass Graft (CABG) Surgery
CABG is a surgical procedure in which one or more blocked coronary arteries are bypassed by a blood vessel graft to restore normal blood flow to the heart. These grafts usually come from the patient’s own arteries and veins located in the chest (thoracic), leg (saphenous) or arm (radial). The graft goes around the blocked artery (or arteries) to create new pathways for oxygen-rich blood to flow to the heart.
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Valve Replacement and Repair
There are four valves in your heart:
- Aortic valve
- Mitral valve
- Tricuspid valve
- Pulmonary valve
The valves control the direction of blood flow through your heart. The opening and closing of the heart valves produce the sound of the heartbeat. Heart valve surgery is open-heart surgery that is done while a patient is under general anesthesia. A cut is made through the breast bone (sternum). Blood is routed away from the heart to a heart-lung bypass machine. This machine keeps the blood circulating while the heart is being operated on.
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.
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Atrial Septic Defect Repair
An atrial septal defect is a hole in the wall (septum) between the left and right atria. If there is a large hole, oxygen-rich blood from the left atrium flows back into the right atrium and gets pumped back to the lungs again. This causes more work for the heart.
If the defect does not close on its own, heart surgery is required to close the hole. This is achieved through sutures, or in some cases, through the use of a closure device such as a Dacron patch.
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Aortic Aneurysm
A vascular surgeon may recommend that a surgical procedure called open aneurysm repair if an aneurysm is causing symptoms, or is larger than about 2 inches, or is enlarging under observation. During an open aneurysm repair, also known as surgical aneurysm repair, the surgeon makes an incision in the abdomen and replaces the weakened part of your aorta with a tube-like replacement called an aortic graft. This graft is made of a strong, durable, man-made plastic material, such as Dacron®, in the size and shape of the healthy aorta. The strong tube takes the place of the weakened section in the aorta and allows blood to pass easily through it.
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Off Pump Bypass
Off-pump coronary artery bypass surgery differs from traditional coronary artery bypass surgery, because the heart-lung machine is not used. Rather than stopping the heart, technological advances and new kinds of operating equipment now allow the surgeon to hold stabilize portions of the heart during surgery. With a particular area of the heart stabilized, the surgeon can go ahead and bypass the blocked artery in a highly controlled operative environment. Meanwhile, the rest of the heart keeps pumping and circulating blood to the body.
Off-pump coronary artery bypass surgery may be performed in certain patients with coronary artery disease. With present technology, all arteries on the heart can be bypassed off-pump. It may be ideal for certain patients who are at increased risk for complications from cardiopulmonary bypass, such as those who have heavy aortic calcification, carotid artery stenosis, prior stroke, or compromised pulmonary or renal function. Not all patients are a candidate. The selection of patients who undergo off-pump surgery is made at the time of surgery when the patient's heart and arteries are evaluated more closely
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Carotid Artery Surgery
Carotid artery surgery (called an endarterectomy) is a procedure used to remove plaque and clots from the carotid arteries, located in the neck. Endarterectomy may help prevent a stroke from occurring, particularly in persons with a high level of carotid artery narrowing. Surgery on the carotid artery is usually performed under general anesthesia with continuous brain wave monitoring, but is can also be performed with a regional cervical block. |
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