Home Medical Procedures Cardiac Heart Procedures All about heart surgeries All about heart surgeries Article Index All about heart surgeries Anatomy of the heart How does the heart function? Heart Valves Cardiac Procedures Minimally Invasive Heart Surgery Cost of Cardiac Procedures Overseas Cardiac Surgery Patient Testimonials Overseas Cardiac Surgeons Page 5 of 9 CARDIAC PROCEDURES Following is the overview of a few common cardiac procedures: Aortic Aneurysms An aortic aneurysm is an abnormal swelling or bulge in the wall of the aorta, the body's largest artery - the blood vessel that carries oxygen-rich blood. Abdominal Aneurysms An aneurysm can develop anywhere along the aorta, most occur in the section running through the abdomen called abdominal aneurysms. Thoracic aneurysms The aneurysms occurring in the section that runs through the chest is called thoracic aneurysms. While the stretched vessel may occasionally cause discomfort, a greater concern is the risk of rupture which causes severe pain, massive internal hemorrhage and, without prompt treatment, results in a quick death. Coronary Angiography Coronary angiography is an X-ray examination of the blood vessels or chambers of the heart. A very small tube (catheter) is inserted into a blood vessel in your groin or arm. The tip of the tube is positioned either in the heart or at the beginning of the arteries supplying the heart, and a special fluid (called a contrast medium or dye) is injected. This fluid is visible by X-ray, and the pictures that are obtained are called angiograms. Another name for this test is coronary arteriography. Carotid Angiography Carotid angiography is a procedure to examine the patient's carotid artery which is an artery in the neck that supplies oxygen-rich blood to the brain. It is an imaging procedure, which involves inserting a catheter into a blood vessel in the arm or leg and guiding it to the carotid arteries with the aid of a special X-ray machine. Contrast dye is injected through the catheter so that X-ray movies of your carotid arteries (the arteries that supply your brain with oxygen-rich blood) can be taken. The X-Rays help in identifying any problems. A carotid artery angiography is performed to identify any problems in the carotid artery of the heart. It may be performed to look for blockage or narrowing of the artery, or for defects in the artery wall such as an aneurysm. Angioplasty Angioplasty, Coronary Angioplasty or Percutaneous Coronary Intervention (PCI) or Percutaneous Transluminal Coronary Angioplasty (PTCA) is a medical procedure to open narrowed or blocked blood vessels of the heart. These blood vessels are called the coronary arteries. Angioplasty is not considered to be a type of surgery. Percutaneous coronary intervention can be performed to reduce or eliminate the symptoms of coronary artery disease, including angina (chest pain), dyspnea (shortness of breath) on exertion, and congestive heart failure. PCI is also used to abort an acute myocardial infarction, and in some specific cases it may reduce mortality. Cardiac Bypass Surgery Cardiac Bypass Surgery, which also goes by the names Coronary Artery Bypass Surgery, Coronary Artery Bypass Graft Surgery (CABG), Heart Bypass or simply Bypass Surgery, is a cardiac procedure performed to reroute or "bypass" blood around clogged arteries to improve blood flow and oxygen to the heart. The arteries that bring blood to the heart muscle (coronary arteries) can become clogged by plaque (a buildup of fat, cholesterol and other substances). This can slow or stop blood flow through the heart's blood vessels, leading to chest pain or a heart attack. Increasing blood flow to the heart muscle can relieve chest pain and reduce the risk of heart attack. Therefore, this surgery is done to improve blood flow and oxygen to the heart. MIDCAB Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) is a minimally invasive approach to coronary artery bypass surgery (CABG). MIDCAB gains surgical access to the heart with a smaller incision than the traditional CABG. MIDCAB is also referred to as "keyhole" heart surgery because the operation is analogous to operating through a keyhole. This approach is limited to patients requiring one or two bypasses; typically bypassing arteries on the front of the heart. OPCAB Off-Pump Coronary Artery Bypass (OPCAB) is a bypass surgery performed without cardiopulmonary bypass (heart-lung machine). During this procedure, the surgeon must cut open the chest and split the breastbone. The surgeon can repair four to five vessels on the beating heart during the same procedure. Off-pump surgery is associated with less blood transfusions, may have a decreased risk of stroke, have a shorter stay in the hospital after surgery, and may be able to return to normal activities more rapidly, but it is technically more challenging than other procedures. Valvuloplasty Valvuloplasty is used to widen a stiff or narrowed heart valve (stenotic heart valve). A catheter is guided through the heart and positioned through the diseased heart valve. Balloons on the catheter are inflated, enlarging the opening through the valve and improving blood flow through the heart and to the rest of the body. This allows the heart to pump more effectively, reduces pressures in the heart and lungs, and reduces symptoms. Valve Repair or Valve Replacement During a heart valve surgery, one or more valves are repaired or replaced. The valves repaired could be aortic valve, mitral valve or tricuspid valve. Heart valve surgery is performed to treat damaged heart valves which do not function properly leading to heart valve disease. A damaged heart valve has problems either opening or closing. This causes blood to not move through the heart's chambers the way it should. Surgery fixes the problem by either repairing or replacing the affected valve. Repair means that the valve is mended to help it work better. Replacement removes the diseased valve and inserts a new valve in its place. Whether a repair or replacement will be required can be judged by your surgeon only when the surgery has begun. Ross Procedure The Ross procedure (or pulmonary autograft) is a type of specialized aortic valve surgery where a diseased aortic valve is replaced with the person's own pulmonary valve. A pulmonary homograft (valve taken from a cadaver) is then used to replace the patient's own pulmonary valve. Bentall Procedure A Bentall procedure is a cardiac surgery involving composite graft replacement of the ascending aorta and aortic valve, with anastomosis of the coronary arteries into the graft. David Procedure David procedure or valve-sparing aortic root replacement is a cardiac surgery procedure involving replacement of the ascending aorta without replacement of the aortic valve. Pulmonary Thromboendarterectomy Pulmonary thromboendarterectomy (PTE) is a thoracic surgery operation that removes organized clotted blood (thrombus) from the pulmonary arteries. Cardiomyoplasty Cardiomyoplasty is a surgical procedure in which healthy muscle from another part of the body is wrapped around the heart to provide support for the failing heart. A special pacemaker is implanted to make the skeletal muscle contract. Dor Procedure The Dor procedure or endoventricular circular patch plasty (EVCPP) is a viable method for restoring a dilated left ventricle to its normal, elliptical geometry. The Dor procedure which uses a circular suture and a Dacron patch to correct LV aneurysms and exclude scarred parts of the septum and ventricular wall is considered the best option amongst other methods of ventricular remodeling. Heart Transplantation Heart transplantation or cardiac transplantation, is a surgical transplant procedure used to replace a patient's heart by a working heart from a recently deceased organ donor. Heart transplant is performed on patients with end-stage heart failure or severe coronary artery disease. Septal Myectomy Septal myectomy is a cardiac surgery treatment for hypertrophic cardiomyopathy (HCM), which is a disease of the myocardium (the muscle of the heart) in which a portion of the myocardium is hypertrophied (thickened) without any obvious cause and leads to sudden cardiac death. Ventricular Reduction Ventricular reduction is a type of operation in cardiac surgery to reduce enlargement of the heart from cardiomyopathy or ischemic aneurysm formation. Pericardiocentesis Pericardiocentesis is a procedure where fluid is aspirated from the pericardium (the sac enveloping the heart). Pericardiectomy Pericardiectomy is the surgical removal of part or most of the pericardium. This operation might be done to relieve constrictive pericarditis, or to remove a pericardium that is calcified and fibrous. Pediatric Cardiac Surgery Diagnosing and treating children's heart diseases requires specialized knowledge and a dedicated approach to care. Pediatric cardiac surgeryor paediatric cardiac surgery refers to heart surgery on children. Blalock-Taussig Shunt The Blalock-Taussig shunt is a surgical procedure to give palliation to cyanotic heart defects which are common causes of blue baby syndrome. In modern surgery, this procedure is temporarily used to direct blood flow to the lungs and relieve cyanosis while the infant is waiting for corrective surgery. Fontan Procedure The Fontan procedure is a palliative surgical procedure used in children with complex congenital heart defects. It involves diverting the venous blood from the right atrium to the pulmonary arteries without passing through the morphologic right ventricle. The Fontan procedure is nowadays used where a child only has a single effective ventricle, due to either defects of the heart valves (e.g. tricuspid atresia or pulmonary atresia) or an abnormality of the pumping ability of the heart (e.g. hypoplastic left heart syndrome). The operation itself is carried out as part of a range of operations for heart defects in children where a child cannot have bi-ventricular repair. Norwood Procedure The Norwood Procedure is a cardiac surgery performed most often to treat Hypoplastic Left Heart Syndrome, certain types of mitral atresia, or other conditions that result in single ventricle circulation. Atrial Septostomy Atrial septostomy is a surgical procedure in which a small hole is created between the upper two chambers of the heart, the atria. This procedure is primarily used to treat dextro-Transposition of the great arteries or d-TGA (often imprecisely called transposition of the great arteries), a life-threatening cyanotic congenital heart defect seen in infants. Maze Procedure The maze procedure is a collection of cardiac surgery procedures intended to cure atrial fibrillation (AF), a common disturbance of heart rhythm. Recently, various methods of minimally invasive maze procedures have been developed; these procedures are collectively named minimaze - "mini" versions of the original maze surgery. Pacemaker Insertion or Pacemaker Implantation (Single Chamber and Dual Chamber) Pacemakers are battery-powered implantable devices that function to electrically stimulate the heart to contract and thus to pump blood throughout the body. Pacemakers consist of a pager-sized housing device which contains a battery and the electronic circuitry that runs the pacemaker, and one or two long thin wires that travel through a vein in the chest to the heart. Pacemakers are usually implanted in patients in whom the heart's own "spark plug" or electrical system is no longer functioning normally. Implantable Cardioverter Defibrillator An implantable cardioverter defibrillator or ICD is used in patients at risk for recurrent, sustained ventricular tachycardia or fibrillation. The device is connected to leads positioned inside the heart or on its surface. These leads are used to deliver electrical shocks, sense the cardiac rhythm and sometimes pace the heart, as needed. The various leads are tunneled to a pulse generator, which is implanted in a pouch beneath the skin of the chest or abdomen. These generators are typically a little larger than a wallet and have electronics that automatically monitor and treat heart rhythms recognized as abnormal. Newer devices are smaller and have simpler lead systems. They can be installed through blood vessels, eliminating the need for open chest surgery. Atrial Septal Defect (ASD) treatment Atrial septal defect (ASD) is a form of congenital heart defect that enables blood flow between the left atrium (with high oxygen content) and right atrium (with low oxygen content) via the interatrial septum. The interatrial septum is the tissue that divides the right and left atria. Without this septum, or if there is a defect in this septum, it is possible for blood to travel from the left side of the heart to the right side of the heart, or vice versa. Irrespective of interatrial communication bi-directions, this results in the mixing of arterial and venous blood and may cause shunting. Surgical closure of an ASD involves opening up at least one atrium and closing the defect with a patch under direct visualization. Percutaneous closure of an ASD is currently only indicated for the closure of secundum ASDs with a sufficient rim of tissue around the septal defect. ASD Closure Device (ASD Device) An ASD closure device is used to close the interatrial septum that causes the atrial septal defect (ASD). The ASD device is moved through a catheter or using open heart surgery to the location of the heart wall defect. Once in the correct location, the ASD closure device is allowed to expand its shape to spread out to each side of the hole. The device will remain in the heart permanently to stop the abnormal flow of blood between the two atria chambers of the heart. Examples of ASD closure device include Amplatzer® Septal Occluder System and the HELEXTM Septal Occluder. Ventricular Septal Defect (VSD) treatment A ventricular septal defect (VSD) is a defect in the ventricular septum, the wall dividing the left and right ventricles of the heart. Treatment is either conservative or surgical. Smaller congenital VSDs often close on their own, as the heart grows, and in such cases may be treated conservatively. In cases necessitating surgical intervention, a heart-lung machine is required and a median sternotomy is performed. Percutaneous endovascular procedures are less invasive and can be done on a beating heart, but are only suitable for certain patients. Enhanced External Counterpulsation (EECP) (non-invasive) Enhanced external counterpulsation (EECP) is a procedure performed on individuals with ischemic cardiomyopathy in order to diminish the symptoms of their ischemia. EECP has been shown to relieve angina, improve exercise tolerance, and decrease the degree of ischemia in a cardiac stress test. Treatment of Peripheral Vascular Disease Peripheral vascular disease (PVD), also known as peripheral artery occlusive disease (PAOD) and peripheral artery disease (PAD), is a collator for all diseases caused by the obstruction of large peripheral arteries, which can result from atherosclerosis, inflammatory processes leading to stenosis, an embolism or thrombus formation. It causes either acute or chronic ischemia. Medical treatments for peripheral vascular disease include angioplasty (PTA or percutaneous transluminal angioplasty), plaque excision, bypass grafting, and others. Treatment for Patent Ductus Arteriosus (PDA) Patent ductus arteriosus (PDA) is a congenital heart defect wherein a child's ductus arteriosus fails to close after birth. Symptoms are uncommon but in the first year of life include increased work of breathing and poor weight gain. In older children or adults the PDA may lead to congestive heart failure if left uncorrected. Symptomatic PDA can be treated with both surgical and non-surgical methods. The premature neonate with a significant PDA usually is treated with intravenous indomethacin. After the first birthday, the most common treatment for a PDA is occlusion at cardiac catheterization. Many techniques and devices are available for PDA occlusion. Surgical ligation or surgical ligation and division remain the standard treatment of large PDAs that require treatment in infancy. Robotic Cardiac Surgery (da Vinci Telemanipulation) Robotically-assisted heart surgery is a minimally invasive surgery performed by passing an endoscope (a small tube containing an advanced optical system) through a tiny incision in the chest wall, and two surgical instruments are passed through additional tiny incisions. Robotically-assisted endoscopic heart surgery is aimed at making endoscopic heart operations feasible. With this technology, the surgeon manipulates the surgical instruments with the help of a computer. The surgeon views the image provided by the endoscope on a computer screen and manipulates the surgical instruments via a computer console. The computer interprets the surgeon's hand movements and causes the surgical instruments to respond accordingly. Robotic procedures have been successfully performed for bypass surgery, in mitral valve repair, in repairing atrial septal defects (ASD) and in repairing patent ductus arteriosus (PDA). The main advantage of robotic heart surgery is that the incisions that are made are tiny, and therefore recovery from surgery is extremely quick. One of the robotic surgical systems currently available is known as the da Vinci Surgical System or da Vinci Telemanipulator. Stenting The main purpose of a stent is to counteract significant decreases in vessel or duct diameter by acutely propping open the conduit by a mechanical scaffold or stent. Stents are often used to alleviate diminished blood flow to organs and extremities beyond an obstruction in order to maintain an adequate delivery of oxygenated blood. The most widely known stent use is in the coronary arteries (coronary stent) with a bare metal stent, a drug-eluting stent or occasionally a covered stent. A Coronary Stent is a small wire mesh tube that is used to help keep coronary (heart) arteries open after angioplasty. Stents are used in a variety of vessels aside from the coronary arteries. Stents may be used as a component of peripheral artery angioplasty. Totally Endoscopic Coronary Artery Bypass surgery (TECAB) Totally Endoscopic Coronary Artery Bypass Surgery (TECAB) is an entirely endoscopic robotic surgery used to treat coronary heart disease. It is an advanced form of Minimally Invasive Coronary Artery Bypass Surgery, which allows bypass surgery to be conducted off-pump without opening the ribcage. The technique involves three or four small holes in the chest cavity through which two robotic arms, and one camera are inserted. TECAB surgery uses the da Vinci tele-robotic Stereoscopic 3-D Imaging system. The system is comprised of a robotic "slave" system at the bedside. The robot relays its information to an external surgical control unit, where a cardiac surgeon has a three-dimensional view of the chest cavity, and twin-controllers for the robotic arms. The procedure frequently involves grafting of the internal mammary artery to the diseased coronary artery, and therefore does not require external harvesting of blood vessels. Trans Myocardial Laser Revascularisation (TMLR) Transmyocardial laser revascularization (TMR) is a new procedure used to treat inoperable heart disease in people with persistent angina that isn't relieved by any other method. It is aimed at improving blood flow to areas of the heart that were not treated by angioplasty or surgery. A special carbon dioxide (CO2) laser is used to create small channels in the heart muscle, improving blood flow to the heart muscle. For FREE cost/quote information about any of the above cardiac procedures and other cardiac procedures, log on to Healthbase's Exclusively for Member's area or register. << Prev - Next >>   < Prev [ Back ]

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