Understanding Major Types of Cardiac Surgery

Every day in the United States, thousands of cardiac surgeries are successfully performed. Most of them involve replacing a defective valve or vessel with a functioning one. Sometimes, a single procedure is performed during surgery. In other cases, multiple procedures are implemented. A cardiologist will work with each patient individually in order to determine the best options for him or her. Diagnostic procedures such as echocardiography and cardiac stress testing can help doctors chart the safest and most effective course of action. Read on for a brief explanation of some of the most common types of cardiac surgery.

CABG Surgery

CABG, or coronary artery bypass grafting, is the most commonly performed type of cardiac surgery. It is primarily used to treat coronary artery disease (CAD). CAD sufferers have narrowed or "hardened” arteries, which limit the supply of oxygen-rich blood to the heart. During CABG, surgeons bypass the clogged section of artery by grafting in a donor blood vessel. This is usually a vein harvested from elsewhere on the patient’s body. Traditionally, bypass surgery requires that the heart be stopped while blood is pumped through the patient’s body using a cardiopulmonary bypass machine, also known as a heart-lung machine. CABG procedures are generally, but not always, "open-heart” surgeries, meaning that the surgeon opens the patient’s chest in order to access the heart. According to the NIH, roughly 80 percent of CABG patients remain angina-free 5 years after surgery.

Off-pump Bypass Surgery

Off-pump bypass surgery, sometimes called OPCAB (off pump coronary artery bypass), are very similar in nature to CABG surgery. Both seek to replace a non-functioning vessel with a healthy one. The off-pump method is intended to be less invasive, and carries the nickname "beating heart bypass” because it does not require the patient’s heart to be stopped during the procedure. Doctors use a tissue stabilization system to help them perform accurate grafts on a beating heart. Part of this system is heart positioner that holds the heart in the ideal position for surgeons to access the damaged artery.

Valve Replacement

A valve replacement is much like it sounds. The procedure involves the removal of a defective valve and replacing it with a new, synthetic one. Valve replacement is usually an open-heart procedure, though in some cases it can be performed in a minimally invasive way. Often, the heart is stopped and a heart-lung machine used to keep the patient supplied with blood and oxygen throughout the procedure. Off-pump methods are sometimes used in valve replacement, depending on the particular situation.

Cardiac Surgery Recovery

Any type of cardiac surgery entails a significant recovery process, particularly in the case of open-heart procedures. Patients are typically kept in an ICU in the hours immediately following surgery, and will stay in the hospital for monitoring as determined by the care team. Once home, post operative patients are generally advised to avoid heavy lifting for several weeks and to engage in regular, routine exercise that is not overly strenuous. Patients will be given, and should strictly adhere to, discharge instructions from their care team. As with any kind of health concern, post-op patients should call their doctor right away if they are experiencing complications.

Part of the state-of-the-art Heart Center, the cardiology department at Slidell Memorial is equipped to perform these surgeries using the latest equipment and innovative techniques.

The prognosis for most patients after these surgeries is very good. However, some patients will not be good candidates for certain types of surgery due to several factors including age, overall health, severity of heart disease, and the presence of other medical conditions.