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Should your physician recommend heart or vascular surgery,
St. Anthony Hospital is ready with the comprehensive care you need and deserve.
Heart and Vascular program brings together highly skilled specialists,
award-winning services, the advanced technology of our state-of-the-art
facility and a dedicated cardiovascular ICU. We are also innovators in new
procedures and approaches to care that assure optimal outcomes. The information provided here is for educational
purposes only. Your health care provider will provide information specific to
Coronary Artery Bypass Surgery (CABG)
What is a coronary artery bypass surgery?
surgery can be performed on any artery, the coronary arteries—those supplying
blood to the heart muscle—are the most common site. The surgery involves
removing a healthy vein or artery from another area of the body and then
surgically grafting it below or above the artery that is not functioning
correctly. This allows the blood to “bypass” the blocked vessel.
The two types of coronary artery bypass surgeries
Both types of coronary
bypass surgery are performed in the operating room under general anesthesia.
Surgical times vary by individual, but generally are from two to six hours.
What types of graft sources are used in a bypass surgery?
The most common vein used in a bypass graft is the saphenous vein from the leg. This can be
harvested endoscopically with small incisions for less scarring and pain. Other
options include either the left or
right mammary artery, the radial artery from the arm, and the gastroepiploic
artery near the stomach. In some instances, a surgeon will use a donor
saphenous vein from a tissue bank or a sutureless
anastomic device. Such devices are inserted through a small hole in the
patient’s aorta, then deployed to release a tiny wire web that serves as a
rivet in the repair process.
Why is heart valve replacement surgery important?
When heart valves
function poorly—either due to narrowing (called stenosis) or leakage (called insufficiency),
blood flow is compromised and the heart has to work harder. Replacing the problem valve can resolve this.
The aortic valve is the heart valve most commonly replaced. The mitral valve
can be replaced, but usually requires only repair.
replacement surgery, a heart-lung machine replaces the natural pumping and oxygenation function of the heart. Medications
are given, as well, so the heart can be completely at rest during the surgery.
The aortic valve can fail to
function properly because of a congenital abnormality (abnormal from birth) or due
to an acquired disease or aging. In the
This valve opens during systole (when the ventricle squeezes
blood out into the aorta to flow to the rest of the body). Narrowing or
obstruction makes the ventricle work harder and, over a period of time, require
extra blood flow to the heart, itself. When blood flow is insufficient,
fatigue, shortness of breath and chest pain (angina) can occur. Also, if the
heart can’t keep up with the requirements, fluid will begin to collect in the
lungs, leading to congestive heart failure.
A similar problem arises when the
aortic valve leaks. While the heart generally can compensate for this extra
workload for some time, eventually it will begin to fail. Shortness of breath
and fatigue are signs this is happening.
valve used for replacement in such cases is called a prosthetic valve. Two types may be considered,
depending upon the individual’s medical needs:
generally do not last as long (10-15 years, on average), but anticoagulants are
usually not needed. For most patients age 65 and older, a bioprosthetic valve
Why is heart valve repair surgery important?
A heart valve that functions poorly compromises the flow of blood
through the heart and increases the heart’s normal workload. While all three
types of heart valve—the mitral, aortic and tricuspid—can be repaired, the
mitral valve is the one most commonly corrected in this way. In most cases, no
mechanical or biologic parts are required. Instead, surgeons use the procedure
In some cases, the surgeon uses a synthetic ring to tighten or reshape
the valve opening.
Until recently, heart valve repairs required an open-chest procedure.
Now, minimally invasive surgery is an option for many patients. Minimally
invasive mitral heart valve repair surgery is being performed at St. Anthony
Several heart procedures that once required open
surgery can now be performed with minimally invasive techniques at St. Anthony
Hospital. Our cardiothoracic surgeons regularly perform minimally invasive
heart valve repair and replacement surgeries using specialized instruments and
without dividing the breastbone. Instead,
keyhole incision is made in the patient's chest and the procedure is performed
Minimally invasive surgery is often an option for
the individual requiring repair or replacement of only one valve.
What is the TAVR procedure?
A transcatheter aortic valve replacement (TAVR)
procedure is a minimally invasive option. Instead of removing the damaged heart
valve, surgeons use small catheters to deliver a replacement valve to the site.
Once in place, the new valve is expanded to wedge into the old aortic valve’s
position. This works something like a stent, pushing the old valve leaflets
aside and allowing the new valve to regulate blood flow.
When a thoracic aortic
aneurysm becomes large, causes symptoms or appears to be expanding rapidly,
repair is needed to reduce the risk of a life-threatening rupture. During the
procedure, the surgeon repairs the weakened area using a man-made graft.
Depending on the size and
location of the aneurysm, the repair may be made by open surgery or a
less-invasive method called endovascular repair.
Jason Fitzgerald, MD, FACSBoard-Certified: Thoracic SurgeryFull Bio
John Mehall, MD, FACS
Board-Certified: Thoracic Surgery
Patrick Rudersdorf, MD
Board-Certified: Thoracic Surgery & General Surgery
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