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Cardiovascular (heart) srugery is surgery on the heart or great vessels performed by cardiac surgeons. The surgery is performed to relieve patients from Coronary Artery Disease (CAD) or to correct Congenital Heart Disease or treat Valvular Heart Disease.
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It is due to a "hole" in the wall that separates the top two chambers of the heart.(atrium).Small ASDs that are discovered in infants often close or narrow on their own.If the ASD is large, it can be closed with open-heart surgery, or by cardiac catheterization using a device inserted into the opening to plug it.
VSD is a hole in the wall separating the two lower chambers of the heart(ventricles). Small VSDs often close on their own. The symptoms continue, even with medication, therefore a surgery to close the defect with a patch is needed. Some VSDs can be closed with a special device during a cardiac catheterization, which avoids the need for surgery, but only certain types of defects can successfully be treated this way.
Patent ductus arteriosus (PDA) is a condition in which the ductus arteriosus does not close. The word "patent" means open. The ductus arteriosus is a blood vessel that allows blood to go around the baby's lungs before birth.
Soon after the infant is born and the lungs fill with air, the ductus arteriosus is no longer needed. It usually closes in a couple of days after birth. If the vessel doesn't close, it is referred to as a PDA. PDA leads to abnormal blood flow between the aorta and pulmonary artery, two major blood vessels that carry blood from the heart.
PDA may close on its own. It often closes within the first 2 years of life. Medicines can work very well for some newborns.
Transcatheter device closure is a procedure that uses a thin, hollow tube placed into a blood vessel. The doctor passes a small metal coil or other blocking device through the catheter to the site of the PDA. This blocks blood flow through the vessel. These coils can help the baby avoid surgery. Surgery may be needed if the catheter procedure does not work or it cannot be used due to the baby’s size or other reasons.
Infants and young children with unrepaired Tetralogy of Fallot are often blue (cyanotic).
Tetralogy of Fallot is treated surgically. A temporary operation may be done at first if the baby is small or if there are other problems. Complete repair comes later. Sometimes the first operation is a complete repair.
In some infants, a shunt operation may be done first to provide adequate blood flow to the lungs. This is not open-heart surgery and doesn't fix the inside of the heart. The shunt is usually a small tube of synthetic material sewn between a body artery (or the aorta) and the pulmonary artery. The shunt is closed when a complete repair is done later.
Complete repair tends to be done early in life. The surgeon closes the ventricular septal defect with a patch and opens the right ventricular outflow tract by removing some thickened muscle below the pulmonary valve, repairing or removing the obstructed pulmonary valve and, if needed, enlarging the branch pulmonary arteries that go to each lung.
Sometimes a tube is placed between the right ventricle and the pulmonary artery. This is sometimes called a Rastelli repair. It's similar to the type of repair used for some other heart defects.
CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. This buildup is called atherosclerosis. This can lead to chest pain (angina) or a heart attack. Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with rest. Emotional stress also can trigger the pain. Another common symptom of CHD is shortness of breath. This symptom occurs if CHD causes heart failure. When you have heart failure, your heart can't pump enough blood to meet your body’s needs. Fluid builds up in your lungs, making it hard to breathe. The severity of these symptoms varies. They may get more severe as the buildup of plaque continues to narrow the coronary arteries.
How Is Coronary Heart Disease Treated (click to see details)?
Your doctor may recommend coronary angiography if other tests or factors show that you're likely to have CHD. This test uses dye and special x rays to show the insides of your coronary arteries.
A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. The tube is threaded into your coronary arteries, and the dye is released into your bloodstream.
Special x rays are taken while the dye is flowing through your coronary arteries. The dye lets your doctor study the flow of blood through your heart and blood vessels.
Cardiac catheterization usually is done in a hospital. You're awake during the procedure. It usually causes little or no pain, although you may feel some soreness in the blood vessel where your doctor inserts the catheter.
You may need a procedure or surgery to treat coronary heart disease. Both PCI and CABG are used to treat blocked coronary arteries. You and your doctor can discuss which treatment is right for you.
Percutaneous coronary intervention, commonly known as angioplasty, is a nonsurgical procedure that opens blocked or narrowed coronary arteries. A thin, flexible tube with a balloon or other device on the end is threaded through a blood vessel to the narrowed or blocked coronary artery. Once in place, the balloon is inflated to compress the plaque against the wall of the artery. This restores blood flow through the artery.
During the procedure, the doctor may put a small mesh tube called a stent in the artery. The stent helps prevent blockages in the artery in the months or years after angioplasty.
CABG is a type of surgery in which arteries or veins from other areas in your body are used to bypass (that is, go around) your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack.
This type of CABG is similar to traditional CABG because the chest bone is opened to access the heart. However, the heart isn't stopped, and a heart-lung bypass machine isn't used. Off-pump CABG sometimes is called beating heart bypass grafting.
There are four valves in your heart:
The aortic valve is the most common valve to be replaced because it cannot be repaired. The mitral valve is the most common valve to be repaired. Only rarely is the tricuspid valve or the pulmonic valve repaired or replaced.
The valve surgery is used to repair or replace the valve in your heart.
INDICATIONS
Balloon valvuloplasty (also called valvulotomy or valvotomy) is a procedure that widens a heart valve that is narrowed. The cause of this narrowing in the valve is valve stenosis.
Balloon Mitral and Aortic Valvotomy
During this procedure, a thin flexible tube called a catheter is inserted through an artery in the groin or arm and threaded into the heart. When the tube reaches the narrowed heart valve, a balloon at the end of the tube is inflated. The balloon widens the valve opening.
During the procedure, you will be awake. But you will receive local anesthesia where the catheter is inserted as well as intravenous (IV) pain medicine along with a sedative to help you relax.
Valve Repair
Valve repair is the best option for nearly all patients with a leaking (regurgitant) valve and for many with a narrowed (stenotic) valve. Compared to valve replacement, valve repair provides better long-term survival, better preservation of heart function, lower risk of complications, and usually eliminates the need for long-term use of blood thinners (anticoagulants).
Advantages of Valve Repair
A valve replacement surgery is an open-heart procedure. The damaged heart valve is removed and replaced with a new valve. There are two types of replacement valves: a mechanical heart valve made from plastic or metal or a bioprosthetic heart valve made from human or animal (usually pig) tissue.
DOUBLE VALVE REPLACEMENT
Aortic and mitral valve replaced
TRIPLE VALVE REPLACEMENT
Aortic, mitral and tricuspid valve are replaced
An aneurysm is an abnormal widening or ballooning of a part of an artery due to weakness in the wall of the blood vessel.
Aneurysms can occur in any blood vessel, aortic aneurysms affecting the thoracic aorta, and abdominal aortic aneurysms. Aneurysms can also occur within the heart itself.
As an aneurysm increases in size, the risk of rupture increases.
A ruptured aneurysm can lead to bleeding and subsequent hypovolemic shock, leading to death.
True and false aneurysms
A true aneurysm is one that involves all three layers of the wall of an artery (intima, media and adventitia). True aneurysms include atherosclerotic, syphilitic, and congenital aneurysms, as well as ventricular aneurysms that follow transmural myocardial infarctions (aneurysms that involve all layers of the attenuated wall of the heart are also considered true aneurysms).
A false aneurysm, or pseudoaneurysm, is a collection of blood leaking completely out of an artery or vein, but confined next to the vessel by the surrounding tissue. This blood-filled cavity will eventually form either thrombose (clot) enough to seal the leak, or rupture out of the surrounding tissue.
Pseudoaneurysms can be caused by trauma that punctures the artery, such as knife and bullet wounds, as a result of percutaneous surgical procedures such as coronary angiography or arterial grafting, or use of an artery for injection.
TREATMENT
Surgery may involve a large (open) surgical cut. However, some patients may have endovascular stents
DESCENDING AORTA ANEURYSM
ASCENDING AORTA ANEURYSM
AORTIC ROOT ANEURYSM & BENDTALLS PROCEDURE
For minimally invasive heart surgery, heart (cardiac) surgeons perform heart surgery through small incisions in the right side of your chest, as an alternative to open heart surgery.
Surgeons operate between the ribs and don't split the breastbone (sternotomy), which results in less pain and a quicker recovery for most people.
As in open heart surgery, minimally invasive heart surgery requires stopping your heart temporarily and diverting blood flow from your heart using a heart-lung machine.
Surgeons perform many minimally invasive heart surgeries, including:
ADVANTAGES
Minimally invasive heart surgery isn't an option for everyone, but it offers many advantages in those for whom it's appropriate.
Advantages may include:
Lung surgery is surgery done to repair or remove lung tissue. There are many common lung surgeries, including:
Lung surgery can be performed for the following reasons:
Mediastinal tumors are growths that form in the mediastinum. This is an area in the middle of the chest that separates the lungs.
Causes
The mediastinum is the part of the chest that lies between the sternum and the spinal column, and between the lungs. This area contains the heart, large blood vessels, windpipe (trachea), thymus gland, esophagus, and connective tissues. The mediastinum is divided into three sections:
Mediastinal tumors are rare.
The most common location for tumors in the mediastinum depends on the age of the patient. In children, tumors are more common in the posterior mediastinum. These tumors often begin in the nerves and are non-cancerous (benign).
Most mediastinal tumors in adults occur in the anterior mediastinum and are usually cancerous (malignant) lymphomas, germ cell tumors, or thymomas. These tumors are most common in people ages 30 to 50.
Various types like thymoma,lymphomas etc.
TREATMENT
Surgical excision if its operable
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Aakash Cardiac Care is a unit of Aakash Hospital. Aakash Hospital has strived to continuously provide quality care for residents of North Chennai in the last decade. It is a fully equipped 120 bed hospital with a wide range of facilities to ensure the comfort of our patients from all walks of life. Cleanliness is maintained from begining to end of each floor and on every floor of the hospital. It is fitted with the latest technological equipments for faster diagnosis in an aim to start early treatment for best care, immediate treatment and quick cure. It has emerged as the best hospital, for all needs, for all of North Chennai.