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Heart Surgery
Development of the heart-lung bypass machine made it possible for several heart problems to be treated by surgery. The bypass machine provides circulation outside of the patient's body during the operation to remove waste products from the blood and maintain the supply of oxygen. Procedures that are now commonplace at the Saint Francis Heart Center include coronary artery bypass graft surgery and heart valve surgery. Heart transplants are also performed by the Saint Francis Heart Center Transplant Team. The transplant team is part of the nationwide network of transplant teams prepared to respond to transplant situations almost anywhere in the United States. Click on the text below to learn more about these heart surgeries.
Coronary Artery Bypass Graft Surgery
Endoscopic Cornoary Artery Bypass Graft Surgery
Heart Valve Surgery
Heart Transplant Program
Coronary Artery Bypass Graft Surgery
This operation has been performed successfully since the mid-1970s, just prior to the time when balloon angioplasty was developed. Both are well proven options for the patient with coronary artery disease. In the bypass graft operation, the surgeon actually creates a bypass, like a highway, around an obstruction in one or more coronary arteries using a segment of an artery or vein from another location in the body. A leg vein is the most common graft vessel in open heart operations, while a blood vessel from the chest is used in the newer, "closed-chest" operation.
The graft is then connected to an obstructed artery below the site of obstruction, creating the new channel, or bypass, that allows blood to circulate to the affected portion of heart muscle. Both open and closed procedures performed at Saint Francis require the body's blood supply to be circulated outside of the body through the heart-lung bypass machine. This machine allows the surgeon to work on a stilled heart for the delicate procedure of connecting the graft to the diseased vessel(s).
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Endoscopic Coronary Artery Bypass Graft Surgery
This operation is similar to the open procedure except the use of a small scope allows the surgeon to harvest the graft vessel and connect it to the diseased vessel(s) of the heart through small incisions in the chest. The chest is not opened and the sternum remains intact. The heart bypass machine is used allowing the surgeon to perform the delicate work of connecting the graft(s) while the heart is still. Called minimally invasive surgery, the technology is similar to that used for laparoscopic operations and offers the following advantages over the open-heart procedure:
- More rapid recovery from surgery
- Less time in the hospital
- Less blood loss during surgery
- Lower risk of postoperative infection
- Quicker return to usual activities (1-2 weeks vs.4-12 weeks)
- Less cosmetic disturbance
Heart Value Surgery
A variety of techniques are well established for both the surgical repair and the replacement of diseased heart valves.
Valvuloplasty is a term used to describe techniques to repair a valve. One such technique is used to treat a condition called stenosis, or a narrowing of the valve opening. This involves the insertion of a balloon-tipped catheter to the site of the diseased valve. Once the site has been reached, the balloon is inflated to enlarge the opening required for blood flow. Dr. Tom Weisenbaugh, a Saint Francis physician, is one of the worldwide leaders in the number of patients treated with valvuloplasty for mitral valve stenosis.
Valvulotomy is another technique used to surgically treat valve stenosis and involves open chest surgery. In surgical valvuloplasty, the valve may be reconfigured surgically or a ring may be placed at the base of the valve to improve function.
Valve replacement, using a tissue, metal or plastic prosthesis, has been used successfully for many years. In the past, the procedure required an open-chest procedure with use of the heart bypass machine so the blood can be circulated while the heart is stilled. A relatively new technique is being used increasingly to lessen the trauma and lengthy recovery from an open procedure. Referred to as minimally invasive valve replacement, it involves use of a scope, as in laparoscopic surgery, which is guided into the heart from a small incision in the chest. Specific factors that may affect whether or not an open or "closed" operation is performed include the following:
- Patient's age
- Type of valve problem
- Size of valve to be replaced
- Desirability of life-long anticoagulation (anti-clotting) medication required when a mechanical valve serves as the replacement
- Patient and physician preferences
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