New Trends in Heart Surgery
Operations for cardiac arrhythmias such as atrial fibrillation (the MAZE procedure), are also performed at Baystate Medical Center. These are performed to treat persistent rhythm irregularities of the heart, namely atrial fibrillation, that produce symptoms or in patients who are intolerant to medications given to control rhythm irregularities. The MAZE procedure is reported to have a 70-80 percent success rate in eliminating atrial fibrillation in the long term. Resumption of regular rhythm may eliminate the need for Coumadin anticoagulation (Thinning of blood).
Minimally Invasive Operations are being performed at BMC such as "Off Pump" Coronary Bypass procedures repairs that avoid the use of the heart lung machine and cardiopulmonary bypass in selected patients. Also a number of selected patients undergo minimally invasive valve operations, with smaller incisions that may lead to a quicker recovery.
Valve Repairs - We put our emphasis at BMC on repairing as many mitral and tricuspid valves as possible.
The surgeons within Cardiac Surgery Division at Baystate Medical Center have been performing minimally invasive surgeries in selective patients and have incorporated new modalities and performed new operations as soon as these have been proven to be effective.
Coronary Artery Bypass Grafting (CABG)
- Minimally invasive coronary artery bypass grafting
Mini incisions have been utilized when appropriate to avoid the larger midline division of the sternum. - Use of the beating heart or "off pump" coronary artery bypass grafting
The heart lung machine is not utilized and the operation is performed with the heart functioning as usual. This operation is performed in a significant number of selected patients who either have preexisting lung, kidney, neurologic or vascular complications that may benefit from such an approach. - Use of arterial grafts
The cardiac surgeons have incorporated the principle of using as many arterial grafts as possible such as the radial artery (taken from the forearm) and/or mammary arteries taken from behind the breast bone to improve long-term patency of the grafts and long-term longevity of the patients.
Valve Operations
- Complex repairs
Complex repairs are being performed in a large number of patients with mitral valve disease whenever possible. Such a complex repair may involve the use of artificial chordae to replace a patient's diseased native chordae that support the mitral valve. Additionally a ring is routinely used to support the repair. A successful repair avoids use of a prosthetic valve. - Human homografts
Homografts are being used, mostly in cases of infection of the cardiac valve. - Mechanical and or Animal valves
New and improved mechanical and/or animal tissue valves are used and tailored to each individual patient. - Minimally invasive approach to valve repairs and/or replacements
Minimally invasive approaches (mini incisions) have been used in selected patients. The advantages are smaller chest incisions and reduced side effects and earlier recovery.
Arrhythmia Surgery
New and simplified surgical procedures (the MAZE operation developed and perfected by Dr. James Cox) have been reported to have significant success in eliminating atrial fibrillation and the need for Coumadin anticoagulation in patients with this disorder. This simplified operation has been incorporated in our practice in 2002 which has benefited a large number of patients with this disorder, either as the primary operation or as part of the operation for valve and or other pathology.
Left Ventricular Reconstruction, previously performed only in patients with Left Ventricular aneurysms; is now being performed in patients with large ventricular scars. These scars lead to sub-optimal heart function resulting in heart failure symptoms.
New Products
New products incorporated in the cardiac surgical practice at Baystate Medical Center include the most up-to-date instrumentation for performing beating heart (off-pump) surgery to stabilize the heart and make these operations possible and safe, the use of recently FDA-approved surgical glues to eliminate or minimize bleeding from the suture lines and other sites within the chest following operations etc., and the use of endoscopes for minimally invasive vein removal from the lower extremities for the performance of CABG operations.
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