A Wide Spectrum of Cardiac Surgical Operations
The Cardiac Surgery Division of Baystate Medical Center performs a wide spectrum of cardiac surgical operations for adult-acquired and congenital cardiac diseases, which include:
Coronary Artery Bypass Grafting (CABG)
Coronary artery bypass grafting is performed on patients with persistent angina, a history of heart attacks, and life-threatening coronary lesions. The procedure can also help patients when medical therapy has failed.
Nearly all patients requiring saphenous vein removal from the leg(s) benefit from the team’s extensive experience with minimally invasive endoscopic saphenous vein harvesting. This technique allows surgeons to remove the saphenous vein through a barely noticeable one-inch incision. Compared to traditional methods, this procedure significantly reduces postoperative healing time, leg pain and risk for infection and is particular beneficial for patients with peripheral vascular disease.
Some patients are candidates for beating heart or "off pump" coronary artery bypass grafting. Performed with the heart functioning as usual, these operations avoid the use of the cardiopulmonary bypass (the heart/lung machine). Off pump operations are a preferred treatment for many patients with preexisting lung, kidney, neurologic or vascular complications.
To improve the likelihood that grafts will remain open and unobstructed, Baystate cardiac surgeons employ arteries for grafts whenever possible instead of veins. Arterial grafts are created using either the radial arteries, which are located in the forearm, or the mammary arteries, found behind the breastbone. Radial arteries can be removed through a one-inch incision at the wrist using minimally invasive approaches. This technique reduces the risk of postoperative pain, healing time and infection risk. Patients with diabetes benefit significantly from this less invasive approach.
Valve Surgery
Patients with diseased heart valves that could lead to congestive heart failure (shortness of breath, fluid accumulation, arrhythmias, etc.) may benefit from valve surgery. Such operations involve either repairing or replacing the abnormal valves. Aortic valve disease is most commonly treated by valve replacement. The mitral and tricuspid valves are commonly repaired when appropriate.
Valve replacement may involve the use of a mechanic or animal (cow) tissue valve. Both types of valves have advantages and disadvantages and the choice is tailored to individual patients. The type of valve used or the potential repair of a valve will be discussed prior to surgery.
Patients with aortic heart valves (endocarditis) may benefit from a homograft, tissue taken from a cadaver. These grafts have proven more resistant to recurrent infection.
Combined operations, such as CABG and valves, are common. Less frequently, corrections are preformed for adults with congenital defects between the right and left side of the heart to prevent enlargement of the heart, congestive heart failure and/or neurologic complications.
Aorta Surgery
Elective or emergency operations are performed for aortic and other great vessel pathologies. Damage to these vessels can result from penetrating or blunt injuries to the chest or from degenerative disease of the vessels, such as aneurysms of the ascending and descending aorta. To correct these problems, a portion of the aorta is replaced or tears (dissection) in these large blood vessels are repaired. Baystate cardiac surgeons repair aortic aneurysms using either endovascular surgery or open surgery, both with excellent results.
Cardiac Arrhythmias
The Maze procedure is performed for the treatment of cardiac arrhythmias such as atrial fibrillation or flutter. These abnormal rhythms can produce shortness of breath or palpitations. The MAZE procedure eliminates atrial fibrillation in 70 to 80 percent of cases. Resumption of a regular rhythm may eliminate the need for blood thinning medications such as Coumadin. The Maze procedure may be performed with other cardiac surgery procedures or as an isolated procedure.
Other Operations
Operations are performed for other pathologies including tumors of the heart and disease of the pericardium, the covering of the heart, which may collect fluid resulting in compression. Occasionally, mechanical assist devices are implanted for irreversible heart failure in patients who may recover or may require heart transplants.
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