Open Heart Surgery
Dallas Regional Medical Center offers open heart surgery services. Our
board certified cardiothoracic surgeons are specially trained to provide
patients suffering from heart disease the best possible outcomes. This
commitment to quality stems from our longstanding history of cardiac care
in the Dallas region.
Types of Heart Surgery
The most common types of heart surgery performed by cardiovascular surgeons
at Dallas Regional are:
Coronary Artery Bypass Graft (CABG): Treatment for coronary artery disease and atherosclerosis. Here, we take
a portion of a healthy blood vessel from somewhere else in the body and
use it to create a new route around the blocked part of a blood vessel
and into the heart. This process is also called revascularization, because
it brings blood back to the heart.
Heart valve procedures: Correct defective heart valves from stenosis (narrowing/blockage) or regurgitation
(leaking). This type of surgery repairs defective heart valves. If we
can’t repair the valve, we replace it with a donor, either a biological
(human or animal) or mechanical (man-made) valve.
Thoracic aortic aorta procedures: Surgical treatment for all types of thoracic aortic aorta conditions,
including asscending aortic pathology in Marfan's Disease, dissection
of the aorta and thoracic and arch aneurysms using circulatory arrest
Coronary Artery Bypass Grafting (CABG)
The most common procedure is Coronary Artery Bypass Grafting. Surgeons
perform coronary artery bypass grafting (CABG) to bypass blockages or
obstructions in the coronary arteries, thereby restoring the flow of oxygen
and nutrients to the heart. This process is also known as revascularization.
During open heart surgery, surgeons must open the chest and temporarily
stop the beating of the heart. The patient’s life is maintained
through a cardiopulmonary bypass (also called the heart-lung machine).
A device called the heart-lung machine then keeps the blood pumping through
the body, adding the necessary oxygen and nutrients. There are risks associated
with the use of the heart-lung machine, such as organ damage and blood
clots, so every effort is made to keep each patient's time on this
machine to a minimum.
To perform a CABG, arteries from the chest and arm and veins from the leg
are used to create a detour around the obstruction in the coronary artery.
The artery and/or vein are connected to both the aorta and coronary artery,
thereby creating a bypass around the blockage.
New CABG Techniques
At Dallas Regional, we are always researching new ways to perform surgery
with less patient discomfort, better heart function, and faster recovery.
The procedures are called minimally invasive because they minimize the
trauma of surgery. Statistics are showing that these new techniques also
reduce the need for repeat operations in the future.
Endoscopic vein harvesting: A minimally-invasive procedure where we create a small incision to remove
veins from the leg.
Multiple arterial grafts: Techniques to increase the utilization of arterial grafts continue to
evolve. The use of both internal thoracic arteries and artery from the
forearm (radial artery) is frequently used for long-term revascularization
in appropriate patients.
Off pump surgery: We’re also excited about the ability to perform bypass surgery without
using the heart-lung machine. This is known as off pump coronary revascularization.
In this surgery, we operate on the beating heart without relying on cardiopulmonary
bypass (stopping the heart and using the heart lung machine to pump blood
to the organs). As a result, we greatly reduce the risks associated with
the heart lung machine, such as blood clots.
Smaller incisions: By using smaller incisions, we decrease the chances of infection, lessen
pain, speed healing, and minimize scarring. For example, in Port Access
Coronary Artery Bypass Surgery, we create small incisions, known as “ports,”
in the chest. Then the surgical team uses special instruments to reach
through the ports to perform the surgery. The surgery involves taking
chest arteries or veins from the leg (femoral vessels) to create a detour,
or bypass, around the clogged artery or arteries. The surgeon views the
operation through video monitors, rather than directly, giving him/her
a much improved view of this intricate work.
Who Should Have a CABG?
Every patient and situation is unique, so please discuss your health and
heart care with your doctor. In general, CABG is recommended for patients with:
- Disease of the left main coronary artery or all three major coronary arteries
- Defective left ventricles
- Severe angina (not helped by medication)
- Patients unable to be helped by aggressive medications and balloon angioplasty
Risks of CABG
As with any surgical procedure, there are risks involved. The specific
risks of CABG include:
- Kidney failure
- Needing repeat surgery (usually after 10 years)
The potential for complications varies, depending upon the patient's
overall health, age, smoking history, medical conditions, and heart function.
If you are facing cardiac surgery of any type, discuss these risk factors
with your doctor to determine the best treatment for you.
Long-term Success of CABG
The majority of our CABG surgery patients experience long-term success.
They no longer have symptoms of angina and most feel more energetic. For
most people, the procedure extends the length and quality of their life.