Advanced Cardiac Surgical Suite
The Heart and Vascular Center at Doctors Hospital of Laredo marked a major milestone in 2016 when surgeons performed the 100th open-heart surgery at the hospital.
Doctors Hospital also recently invested $2.7 million renovation to expand and remodel the hospital’s advanced cardiac surgical suite, which is dedicated exclusively to open, or traditional, heart procedures. During these procedures, a surgeon cuts the patient's chest open and surgery is performed on the muscles, valves, or arteries of the heart.
Types of Open Heart Surgery
Two common heart procedures performed at Doctors Hospital are coronary artery bypass grafting and heart valve surgery.
Coronary Artery Bypass Grafting (CABG)
According to the National Heart Lung and Blood Institute, adults needing heart surgery typically undergo coronary artery bypass grafting (CABG), which is used to restore blood flow to the heart muscle, stop chest pain and reduce the risk of a heart attack. The surgeon must divide the breastbone to expose the heart. To complete the bypass, a segment of a vein in the leg is taken and used to build a detour around the blockage. One end of the vein is sewn into the aorta, and the other end is sewn into the coronary artery below the blockage.
The vein can be spared from the leg because there are many others in the area that can perform the same function. In most patients, the surgeon uses the internal mammary artery (IMA) as the bypass graft. There are two IMA's left and right, that lie close to the heart on the back of the breastbone. They can be used alone or along with a vein bypass procedure. The heart muscle should be in a resting state while the bypass grafts are sewn in place. For this reason, a device called the heart/lung machine takes over the function of the heart and lungs during surgery.
Once the bypass grafts are sewn into place, the heart/lung machine is no longer needed, the heart and lungs resume function, and the chest is closed. The operation takes about three to five hours, including preparation time.
Heart Valve Surgery
Valve problems occur in most cases from birth defects, rheumatic fever, age or infection, and impair the valves's ability to open and close properly. Stenosis is a valve problem that happens when the valves narrow and the forward flow of blood is decreased. With regurgitation, valves do not close as they should and some blood flows backward instead of forward. When the valves do not open and close as they should, the heart has to work harder to pump blood which can result in trouble breathing, leg swelling, and heart failure. In some cases, medications alone can improve the heart's pumping and relieve the heart failure.
Heart surgery is often needed to repair or replace a damaged valve. Heart valves may be replaced with either a tissue or mechanical valve. Mechanical valves are very sturdy, so they usually last longer than tissue valves. You may need to take a blood thinner called Coumadin will need to be taken for the rest of your life to prevent clots from sticking to the valve. Patients who take blood thinners need frequent lab tests to observe the drug's action.
A tissue valve is made from an animal source and molded into a ring. The use of this type of valve does not always require medication to prevent the blood from clotting on the valve. There is little risk of rejection, as in transplants, because the valve has been pretreated. In valve repair surgery, the breastbone is divided and the heart/lung machine takes over the work of the heart and lungs until surgery is finished. Your doctor or nurse will be able to describe the kind of valve that will be used for you and answer any questions you have.