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When heart surgery is the best option for the treatment of cardiovascular disease, you want to know that you have access to cutting-edge technologies and medical expertise. The CardioVascular Center's dedicated surgical team offers state-of-the-art, comprehensive surgical interventions for diseases of the heart and aorta. The Chester County Hospital is an affiliate of Cleveland Clinic in cardiac surgery.
Brian P. Priest, MD
Coronary Artery Bypass Graft (CABG)
Coronary artery bypass is a surgical procedure to improve blood flow to your heart muscle. Your doctor may recommend coronary artery bypass surgery if you have coronary artery disease (blocked arteries that supply blood to the heart) that cannot be helped with medication and/or with an interventional catheter procedure, such as balloon angioplasty, which is usually accompanied by placement of a stent in the artery.
In a bypass operation, a blood vessel is taken from another area of the body that can spare it (usually the chest, the leg, and/or the arm) and attached to the obstructed coronary artery upstream and downstream of the blockage. Just like with a highway bypass, the blood now has another pathway to get to and supply the heart muscle with oxygen and fuel.
Typically, more than one coronary artery must be bypassed. Your cardiologist and surgeon will tell you the number of bypass grafts you will need and describe other important aspects of the procedure to you.
Coronary artery bypass surgery is usually carried out through an incision down the middle of the breast bone (a median sternotomy) and with the use of a heart-lung machine. The internal mammary artery (a vessel inside the chest) is almost always used for at least one of the bypasses. To remove a healthy artery or vein from your arm or leg, the surgical team uses a minimally invasive technique that requires only a small incision.
Off-pump Coronary Artery Bypass
In select situations, coronary bypass surgery can be performed without having to put a patient on a heart-lung machine. Your surgeon will discuss options with you prior to your surgery. More than 80% of CABG procedures performed at The CardioVascular Center were off-pump. Off-pump bypass surgery leads to fewer post-operative complications and decreased recovery time.
SAVER Surgery (Dor Procedure)
Some patients with heart failure after a heart attack may be candidates for the SAVER (surgical anterior ventricular reconstruction) operation or Dor procedure. This surgery, which is usually combined with coronary bypass, remodels the size and shape of the heart damaged by heart attack so that it functions more efficiently.
The valves in your heart and aorta are made of thin, strong flaps of tissue that open and close as your heart pumps. Valve problems can be caused by a birth defect that has worsened later in life or by diseases or infections that scar or destroy valves. Heart valve repair and heart valve replacement operations have become very common. Sometimes the surgeon can restore the valve to normal function by repairing it. Other times the heart valve is seriously damaged and cannot be repaired, in which case it is replaced. Tissue (usually from animals) or mechanical valves can be used for replacement. Each has advantages and disadvantages which your surgeon will discuss with you prior to your surgery.
The CardioVascular Center team has special expertise in mitral valve repair. In many patients who suffer from a leaking mitral valve, the surgeon can repair the valve rather than replace it, thus avoiding the potential long-term limitations of a valve replacement device. Not all valves are suitable for repair and your surgeon will discuss these options with you as well. Valve repair or replacement usually requires an incision down the breastbone (a median sternotomy). Sometimes, however, it may be possible to perform a valve operation through a smaller incision. Mitral valve surgery can sometimes be done through a smaller incision in the right side of your chest (limited right thoracotomy). There are a variety of potential options for small incision aortic valve surgery as well. Your surgeon will discuss options with you prior to your operation.
Cardiac tumors are rare but sometimes cause problems. They are often detected by accident during testing for another problem. Myxoma is the most common cardiac tumor in adults. Myxomas are usually benign (non-cancerous). They can be asymptomatic (without symptoms) or cause a variety of symptoms including chest pain, shortness of breath, difficulty breathing while lying flat, dizziness, fainting, and a sensation of feeling your heart beat. Sometimes they can cause neurological (brain) symptoms if a piece of the tumor breaks free and is carried by the circulation to the brain. Surgical excision (removal) of the tumor is the only effective treatment and usually can be accomplished with relatively low risk.
Ascending Aortic and Aortic Root Repair Surgery
The aorta is the large vessel that comes directly out of the heart and supplies blood to the entire body. The two primary diseases that affect the aorta are aneurysm (a weakened and bulging area in the aorta) and dissection (a tear in the inner lining of the aorta that allows blood to escape into the muscle layer of the aorta, creating a false channel).
These conditions may require emergency operations in some instances, while at other times the disease is asymptomatic and an elective procedure may be recommended. In the case of small aneurysms (less than 5.5 cm in diameter), the usual procedure is to monitor the disease with periodic testing, such as a CT scans or an MRI. Operations on the aorta, whether elective or emergency, are major surgery. Fortunately, modern techniques offer high rates of success and recovery for patients with these potentially very difficult problems.
Congenital Heart Disease
Congenital heart disease constitutes a defect in one or more structures of the heart or blood vessels that occur before birth. Some conditions do not cause problems until adulthood, when they may be first detected. The most common congenital heart disorders affecting adults are:
Treatment is based on the severity of the symptoms and the abnormalities of heart function. A few mild heart defects do not require any treatment. Others can be treated with medications or catheter procedures. In some patients, surgery may be needed.
Ablation for Atrial Fibrillation
Atrial fibrillation (AF) is a heart-rhythm disorder that creates a very fast and disorganized heartbeat. The condition often causes uncomfortable symptoms and can lead to stroke or heart failure. Ablation for AF is an interventional procedure that uses an energy source to create areas of scar tissue on the inside or outside of the heart. Because abnormal electrical signals cannot pass through scar tissue, the irregular signals stop and, in many cases, normal rhythm returns. This procedure may reduce the number of medications needed. AF ablation is the most recent addition to the spectrum of complex ablations that are provided at The Chester County Hospital. Other ablations performed at the hospital include catheter ablation, surgical ablation-stand alone, and surgical ablation.
The Cardiovascular Center at The Chester County Hospital continues to receive the highest outpatient satisfaction scores, and is affiliated with Cleveland Clinic's Department of Thoracic and Cardiac Surgery. Our physicians, staff, and patients benefit from the knowledge and experience of one of the top cardiac surgical teams in the world and have access to information from Cleveland Clinic's Heart Center Research.
Last Updated: 10/11/2012