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Surgical Cardiac Procedures

The Cardiac Surgery Team is available 24 hours a day, 365 days a year. Experienced and dedicated Cardiovascular and Thoracic Surgeons lead a team of lifesaving healthcare professionals. The team comprises Cardiac Anesthesiologists, Perfusionists, registered nurses, and a Surgical Scrub Team. The Center's high volume of surgeries and low morbidity and mortality attest to the quality of care provided by our expert team.

Procedures performed include, but are not limited to:

  • Coronary Artery Bypass Grafting – CABG
  • Heart Valve Repair or Replacement Surgery
  • MAZE Procedure
  • Transmyocardial Revascularization
  • Robotic-assisted Minimally Invasive Cardiac Surgery
  • Aortic Aneurysm Repair
  • Heart Defect Repairs
  • Minimally Invasive Surgeries

Heart Valve Repair or Replacement Surgery:

Heart valve repair or replacement surgery is a specialized cardiac procedure that addresses issues with heart valves that may be causing dysfunction. Surgeons gain access to the heart through the breastbone, or if the patient is a candidate for minimally invasive open-heart surgery, the surgeon gains access through a smaller incision between the ribs on the right or left side of the chest. This surgery can involve repairing a damaged valve using an annuloplasty ring or replacing the valve with either a tissue or mechanical valve. Valve surgery aims to improve the heart's function as a pump, restore normal blood flow, and alleviate symptoms associated with valve disorders.

Coronary Artery Bypass Grafting (CABG):

Coronary artery bypass grafting (CABG) is a standard surgical procedure performed to improve blood flow to the heart muscle in individuals with coronary artery disease. During CABG, a section of veins from the leg, chest, or body part bypasses a coronary artery's blocked or diseased portion. This creates a new pathway for blood to flow, delivering oxygen to the heart muscle and allowing it to function correctly. CABG is often referred to as single, double, triple, or quadruple bypass surgery, depending on the number of blocked arteries that require bypassing. The surgery involves:

  • Stopping the heart temporarily
  • Diverting blood through a heart-lung machine
  • Attaching the graft to reroute blood flow around blockages

CABG is a well-established procedure that helps relieve symptoms, improve heart function, and enhance the quality of life for patients with coronary artery disease.

Understanding Heart Surgery

The cardiac surgery team performs elective and emergency heart surgeries. The most common procedures performed by the team are coronary artery bypass graft surgery and heart valve repair or replacement. The surgeons gain access to the heart through the breastbone, or if the patient is a candidate for minimally invasive open heart surgery, the surgeon gains access through a smaller incision between the ribs on the right or the left side of the chest. The heart is stopped and cooled. The blood usually pumped by the heart is sent through a heart-lung machine. In coronary bypass surgery, the saphenous (leg) vein, radial (forearm) artery, and/or the internal mammary (chest wall) artery are used to bypass the blocked heart arteries called a graft. One end will be attached to the ascending aorta, the large artery that carries oxygen-rich blood from the heart to the rest of the body. The other end of the graft will be attached to a coronary artery below the blocked area. It is like being on the freeway with bumper-to-bumper traffic; you would take the exit to bypass the blocked area. This procedure improves the blood supply to the heart muscle, intended to relieve symptoms and prevent damage. Valve repair with an annuloplasty ring or valve replacement surgery with either a tissue or mechanical valve improves the heart's function as a pump. Before any valve surgery, patients need to complete all dental work. Dental infections can allow bacteria to enter the bloodstream and infect the new heart valve. This condition is challenging to treat.

After Valve surgery, patients need to:

  • Possibly take a blood thinner
  • Take antibiotics about an hour before going to the dentist or before any invasive procedure or surgery
  • Report any skin, foot, or hand infections to the doctor so that they can be treated aggressively to prevent spreading the infection to the blood or the heart valve.
  • You should report high fevers that last a long time or keep coming back because fevers may indicate an infection that could spread to the blood or a new heart valve. The main goal of heart surgery is to enable patients to resume an active and satisfying life.

Preparation For Heart Surgery

Surgery Scheduled Electively With Pre-admission

After meeting with the heart surgeon at the hospital or their office, surgery is scheduled through the Cardiac Surgeon's Office. Pre-surgery education is provided to you and your family before your scheduled procedure.

You will be required to come to the hospital as an outpatient before your heart surgery to have preoperative testing completed the day before surgery. You will need to bring your insurance information and a list of your current medications with you. You will visit the departments listed below in the following order:

1. Pre-Admit Unit (PATS)

PATS is located in the Robert and Beverly Lewis Outpatient Pavilion right next to the hospital. You will register and complete your pre-admission testing, which includes blood work, EKG, and chest x-ray. Do not remove the red wristband. PATS hours are from 8:00 am to 4:30 pm.

2. Admitting

On the day of surgery, you will come to the hospital at 5:00 am. Check-in with the front desk; they will direct you to the Admitting Office. It is located just off the front lobby on the first floor and is open Monday through Friday at 5:00 am.

Preparation

You should not eat or drink anything after midnight the night before your scheduled surgery. Check with your doctor about taking your regular medications on the day of the procedure. If you take any blood thinners, vitamins, or supplements, you will need to stop them one week before surgery.

The Day of Admission/Surgery

You must arrive at the hospital at 5 am on the day of surgery. This allows for admission and preparation. Upon arrival, please go directly to the Admitting Office located just off the front lobby on the first floor. You will then be escorted to your room. In preparation for surgery, you will have your hair removed with clippers from your neck to your ankles. You will meet other members of the Cardiac Surgery Team, including the nursing staff and anesthesiologist. An intravenous line will be started in your arm.

Family Support

For comfort and privacy, many families return home during the surgery. Your family will be updated regularly during the surgery to inform you of the progress of the surgery. As surgery nears completion, family members are given information regarding the patient's time of arrival out of surgery and when they may visit. Family members are welcome to wait in the Intensive Care Waiting Room on the 2nd floor by elevator E, or the front lobby, should they desire. Visits from family and close friends can help speed recovery. For information regarding visiting, please refer to the hospital Visitors Guide.

Recovery and Rehabilitation

Recovery begins in the CVICU (Cardiovascular Intensive Care Unit). You can expect to be in the hospital for 5-7 days, including 1-2 days in the Intensive Care Unit. Each patient's temperature, blood pressure, heart rate, heart rhythm, and other parameters are closely monitored. A breathing tube in the windpipe aids breathing. The patient cannot talk during the time this tube is in place. A stomach tube in the nose or mouth prevents nausea and vomiting. The nurses and respiratory therapists instruct the patients to cough and help them perform deep breathing exercises to clear their lungs and upper airways.

For the first 1-3 days of recovery, patients will have chest tubes to help keep the lungs expanded and drain any fluid from the surgery site. Pressure monitoring lines in the blood vessels allow close surveillance of blood pressure and heart function. Patients may also have temporary pacemaker wires in case the heart rate slows.

Throughout the post-operative recovery period, patients can anticipate assistance from several members of the Cardiac Care Team. In addition to doctors and nurses, a respiratory therapist, dietician, physical therapist, Cardiac Surgery coordinator, and, if necessary, social worker will visit. A caseworker from your health insurance provider may assist you and your family with home and discharge planning.

As recovery progresses, patients and their families are educated about the causes and treatment of heart disease, the healing and rehabilitation process, nutrition, exercise, stress management, emotional adjustments, and smoking cessation. They are also given information on our Outpatient Cardiac Rehabilitation Program.

The cardiac surgery team performs elective and emergency heart surgeries. The most common procedures performed are coronary artery bypass, graft surgery, and heart valve replacement. Surgeons gain access to the heart through the breastbone, or if the patient is a candidate for minimally invasive open heart surgery, the surgeon gains access through a smaller incision between the ribs on the right of the left side of the chest. In coronary bypass surgery, the saphenous (leg) vein radial (forearm) artery and/or the internal mammary (chest wall) artery are used to bypass the blocked heart arteries. This procedure improves the blood supply to the heart muscle, intended to relieve symptoms and prevent damage. Valve repair or replacement surgery with either a tissue or mechanical valve enhances the heart's function as a pump. The main goal of heart surgery is to enable patients to resume an active and satisfying life.