Cardiovascular Surgery

This open-heart surgery restores and reroutes blood flow to the heart when arteries become damaged or severely blocked. Cottage Health surgeons—uniquely skilled in the coronary artery bypass graft (CABG) procedure—almost exclusively use a technique called total arterial revascularization (TAR) to achieve success.

During the procedure, the surgeon chooses replacement arterial vessels from the chest, abdominal area, or leg(s) and sews one end of the graft to the aorta and the other end to the coronary artery below the blockage. The grafted vessels serve as the “bypass” for the blocked coronary arteries. With a new channel established, blood can freely flow to the heart and relieve symptoms.

Less invasive than a traditional coronary artery bypass surgery, the OPCAB—also known as beating-heart surgery—doesn’t use the heart-lung bypass machine. Instead, this surgery employs a stabilizing device that helps reduce heart movement during the procedure. In the right patient, the OPCAB may have more benefit than other standard procedures.

You benefit from fewer complications and scarring and improved recovery time. Talk with your surgeon about other benefits of OPCAB and whether you may be a candidate.

If you require CABG, your doctor may determine that a less invasive bypass surgery would also be effective. You may be a candidate if you have only one or two clogged arteries.

During the procedure, small keyhole incisions are made in the chest and, usually, the doctor uses an artery from inside the chest for the bypass. The key difference with this technique is that the doctor performs the surgery while your heart is beating, which means the heart-lung bypass machine is not needed.

When the four heart valves—tricuspid, pulmonary, mitral and aortic—function properly, blood pumps from the upper and lower chambers of the heart and circulates to large arteries. A healthy heart’s valves open and close tightly. Diseased or damaged valves may leak and cause backflow, or narrow and restrict flow. Both conditions can be life threatening.

When damaged or diseased heart valves don’t function properly, you and your doctor may choose heart valve repair or replacement as a corrective option. Depending on your particular situation, a valve may be repaired or replaced.

Common Causes of Heart Valve Disease

The most common causes of heart valve disease are:

• Stenosis– Narrowing and hardening of a valve, which obstructs blood flow and makes the heart work harder to pump blood. Common causes for stenosis include:
  • Age
  • Rheumatic fever
• Regurgitation – A valve that doesn’t close properly and allows pumped blood to leak. Common causes for regurgitation are:
  • Age
  • Genetics
  • Infections

Heart Valve Disease Symptoms

Common symptoms of heart valve disease include:

• Dizziness Chest pain
• Difficulty breathing
• Palpitations
• Edema (swelling) of the legs, ankles and abdomen
• Rapid weight gain due to fluid retention

Heart Valve Repair Procedures

There are three approaches to heart valve repair or replacement:

• The standard or traditional heart valve repair or replacement typically uses open-heart surgery. Recovery time from this approach are often longer, require longer hospital stay, and recovery time due to a larger more painful incision.
• Minimally invasive aortic and mitral valve repair or replacements are becoming more common and desirable surgical techniques. A minimally invasive valve repair/replacement offer you benefits from smaller incisions, less pain, shorter hospital stays and faster recovery time.
• Transcatheter Aortic Valve Replacement (TAVR) - (also known as TAVI or transcatheter aortic valve implantation) is a new, minimally invasive technology for use in treating aortic stenosis. TAVR is a valve-within-a-valve approach where A bio-prosthetic valve is inserted percutaneously using a catheter and implanted in the orifice of the native aortic valve.

Talk with your physician to determine which approach works best for your specific situation.

Valve Replacement

You and your physician may choose valve replacement to address severe heart valve damage. Replacement valves may be mechanical (metal and plastic)—such as a St. Jude valve—or made of tissue. Tissue valves most often come from a pig (porcine valve) or a cow (bovine valve). Tissue valves may also be supplied by a human donor.

During the three-to-five-hour replacement procedure, an incision along the length of the breastbone exposes the heart. A heart-lung machine takes over the working function of your own organs, so your heart can be stopped. During surgery, the surgeon removes the diseased valve and sews the replacement valve in place.