Cardiac surgery
Coronary Artery Bypass Grafting (CABG)
This is one of the most common heart surgeries, performed to treat coronary artery disease (CAD) when the arteries supplying blood to the heart muscle become narrowed or blocked.
- Traditional CABG: A surgical procedure where a healthy blood vessel (usually from the chest, leg, or arm) is grafted to bypass blocked coronary arteries and restore blood flow to the heart.
- Off-Pump CABG (OPCAB): A type of CABG performed without stopping the heart (on a beating heart), often used to reduce risks associated with traditional bypass surgery.
- Minimally Invasive CABG: A technique that uses smaller incisions and specialized instruments to perform the bypass without opening the chest fully.
Valve Surgery
Heart valve surgery treats conditions where one or more of the heart’s valves are not functioning properly. This can involve repair or replacement of the valve.
- Valve Repair: The surgeon repairs the damaged heart valve to restore its normal function, which can be done for the mitral valve, tricuspid valve, or aortic valve.
- Mitral Valve Repair: Most commonly performed for mitral valve prolapse or regurgitation (leakage of the mitral valve).
- Aortic Valve Repair: Repair of an aortic valve that is narrowed (stenotic) or leaking (regurgitation).
- Valve Replacement: In cases where a valve cannot be repaired, it is replaced with a prosthetic valve.
- Mechanical Valves: Made from durable materials like carbon or titanium.
- Biological (Tissue) Valves: Made from animal tissue (usually porcine or bovine) or human tissue.
Aortic Surgery
Aortic surgeries treat conditions affecting the aorta, the large blood vessel that carries blood from the heart to the rest of the body. This includes aneurysms, dissections, and congenital defects.
- Aortic Aneurysm Repair: A surgery to repair an enlarged or weakened section of the aorta, typically done via:
- Open Surgery: Involves making an incision in the chest or abdomen to remove the aneurysm and replace the damaged section with a graft.
- Endovascular Aneurysm Repair (EVAR): A minimally invasive procedure that uses a catheter to place a stent-graft inside the aorta to reinforce the wall and prevent rupture.
- Aortic Dissection Repair: Aortic dissection occurs when there’s a tear in the aorta’s inner layer, causing blood to flow between the layers. Surgery is required to repair the tear or to replace the affected segment of the aorta.
- Aortic Valve Surgery: Involves the repair or replacement of the aortic valve, often performed for conditions like aortic stenosis (narrowing) or aortic regurgitation (leakage).
Heart Transplantation
A heart transplant is a procedure where a failing or diseased heart is replaced with a healthy donor heart. This is typically performed for patients with end-stage heart failure who are not responding to other treatments.
- Orthotopic Heart Transplant: The most common type of heart transplant, where the diseased heart is removed and replaced with a donor heart.
- Heart-Lung Transplant: In cases where both the heart and lungs are affected (e.g., in certain cases of cystic fibrosis or pulmonary hypertension), both organs may be transplanted together.
Arrhythmia Surgery
This involves procedures to treat abnormal heart rhythms (arrhythmias), particularly when medications or other non-surgical treatments are ineffective.
- Maze Procedure: A surgical treatment for atrial fibrillation (AF), where the surgeon creates a series of scar tissue “maze” lines in the heart to block erratic electrical signals and restore normal rhythm. The procedure can be done using traditional open surgery or minimally invasive techniques.
- Ablation: Surgical or catheter-based procedures that destroy (ablate) small areas of heart tissue that are causing abnormal electrical signals. This can be used for atrial fibrillation, atrial flutter, or other arrhythmias.
- Catheter Ablation: A minimally invasive procedure performed through a catheter inserted into the heart, often used to treat arrhythmias like atrial fibrillation, ventricular tachycardia, or atrial flutter.
Congenital Heart Disease Surgery
Congenital heart surgery treats heart defects that are present at birth. These defects may involve structural issues such as holes in the heart, valve abnormalities, or problems with the heart chambers.
- Septal Defect Repair: Surgery to close holes in the heart’s septum (the wall dividing the left and right sides of the heart), such as atrial septal defects (ASD) or ventricular septal defects (VSD).
- Tetralogy of Fallot Repair: A surgery to correct the combination of four heart defects (ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and overriding aorta) that affect blood flow to the lungs and body.
- Palliative Surgery for Hypoplastic Left Heart Syndrome: In this condition, the left side of the heart is underdeveloped. Palliative surgeries like the Norwood procedure may be performed to manage the condition, though a heart transplant is often required for long-term survival.
Coronary Artery Disease (CAD) and Angioplasty
While these procedures are more commonly performed in interventional cardiology, they are related to surgical care in some cases:
- Percutaneous Coronary Intervention (PCI): Also known as angioplasty, PCI involves the use of a balloon catheter to open blocked coronary arteries, often accompanied by the placement of a stent to keep the artery open.
- Coronary Stent Placement: A minimally invasive procedure to insert a stent into a blocked artery, keeping it open to restore normal blood flow to the heart.
Heart Valve Repair and Replacement
For patients with valve disorders such as stenosis (narrowing) or regurgitation (leakage), surgeries can involve:
- Mitral Valve Repair: Correcting mitral valve prolapse or leakage, preserving the patient’s natural valve.
- Tricuspid Valve Repair: Repairing the tricuspid valve to treat regurgitation or stenosis.
- Aortic Valve Replacement: Replacing a damaged aortic valve, often performed for patients with aortic stenosis or regurgitation.
Left Ventricular Assist Device (LVAD) Implantation
LVADs are mechanical pumps implanted to assist the left ventricle in pumping blood to the rest of the body. This is often used for patients with severe heart failure who are not candidates for a heart transplant.
- LVAD Implantation: A device is implanted to help pump blood, supporting the heart’s function either temporarily or long-term while waiting for a transplant.
Heart Failure Surgery
Surgical procedures aimed at improving heart function in patients with severe heart failure.
- End-stage Heart Failure Surgery: For patients with end-stage heart failure who are not candidates for a heart transplant, surgeries like ventricular assist devices (VADs) or total artificial hearts (TAH) may be used.
Minimally Invasive Cardiac Surgery
Minimally invasive techniques involve smaller incisions and less trauma to the body, leading to faster recovery times and reduced risk of complications.
- Minimally Invasive CABG: A smaller incision is made between the ribs to perform a coronary artery bypass graft.
- Minimally Invasive Valve Surgery: A smaller incision is made to repair or replace heart valves, reducing the need for large chest incisions.
Cardiac Tumor Surgery
In rare cases, heart tumors (such as myxomas, the most common benign heart tumor) may require surgical removal.
- Myxoma Removal: A procedure to remove a benign tumor from the heart, often performed through open surgery.
Cardiac surgery encompasses a wide range of procedures, from bypass surgeries and valve repairs to highly specialized surgeries like heart transplants and congenital defect corrections. Each procedure requires expertise to manage the complex structure of the heart and circulatory system, as well as to address the individual needs of the patient.
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