Hospital Services – Cardiothoracic Surgery
Cardiothoracic surgery is the surgical treatment of organs inside the chest, generally including the treatment of conditions affecting the heart and lungs. The team at Hattiesburg Clinic Heart & Vascular is committed to providing surgical care for a variety of thoracic treatments, including but not limited to:
- Coronary arterial bypass
- Heart valve repair and replacement
- Septal defect repair and closure
- Cardiac tumor / mass excision
- Cardiac ablation
- Thoracic aortic aneurysm
For Hattiesburg Clinic Heart & Vascular patients with coronary heart disease, they may need coronary arterial bypass surgery. Coronary heart disease happens when plaque builds along the walls of the coronary arteries. Arteries are the blood vessels that carry oxygen-rich blood through the body. The buildup of plaque can cause a variety of complications, including angina (chest pain), blood clots and even heart attacks. The plaque can also cause the arteries to harden and become narrow, which restricts blood flow through the heart.
Coronary arterial bypass surgery is a procedure where the blocked arteries are “bypassed” by connecting or grafting an unblocked artery above and below the one that is blocked. The grafted artery may come from another location on the patient’s body, including the wrist or the leg. When surgery is complete, blood will flow through the newly placed artery. Sometimes patients need multiple grafts in the same surgery, depending on the severity of the blocked arteries. This surgery is performed under anesthesia, and patients who have bypass surgery will spend multiple nights in the hospital for post-operative supervision and care.
The goal of coronary arterial bypass surgery is to improve the patient’s quality of life and reduce symptoms of coronary heart disease. Surgery may also improve the pumping action of the heart, lower the risk of heart attacks and potentially improve the chance of survival in the case of a heart attack.
After the procedure, patients should make positive changes to their lifestyle to ensure continuing success of the procedure. Patients should talk with their doctor about specific lifestyle changes, some of which may include:
- Increasing physical activity
- Maintaining a healthy weight
- Eating more whole foods
- Lowering stress level
- Avoid unhealthy lifestyle options, such as smoking and alcohol consumption
Please consult with your Heart & Vascular provider if you have additional questions or concerns about coronary arterial bypass surgery.
Hattiesburg Clinic Heart & Vascular surgeons offer a variety of options when it comes to heart valve repair and replacement.
There are four valves in the human heart (aortic, mitral, pulmonary and tricuspid), which act as a one-way gate managing blood flow. Heart valve repair or replacement surgery may be recommended when valves are damaged or diseased. Valves can become stiff (stenosis) or they can leak (regurgitation).
A stiff / narrow valve, or one that is stenontic, causes the heart to work harder to pump blood. There are several causes of valve stenosis, which may include:
- Congenital heart defect
- Calcium building
- Rheumatic fever
Regurgitation is when a heart valve leaks. Sometimes this condition is minor and does not require surgery, but other times regurgitation can place strain on the heart and require surgical intervention. Regurgitation can develop gradually over time or can happen suddenly. Your cardiologist will determine the severity of regurgitation and recommend treatments accordingly. Regurgitation happens when blood leaks through the valve, even though it should be completely closed. It also happens when blood flows back through the valve while it is closing. Some causes of regurgitation include:
- High blood pressure
- Heart valve infection
- Rheumatic heart disease
- A deformed valve
- Marfan syndrome
REPAIR OR REPLACE?
The decision to repair or replace a heart valve will depend on the recommendation of the surgeon and the severity of the patient’s condition. Stenosis can often be relieved by balloon valvuloplasty, which is less invasive than open-heart surgery.
SURGICAL OPTIONS FOR REPAIRING OR REPLACING A HEART VALVE
The type of surgery chosen for the patient will depend on the particular valve that needs to be repaired/replaced as well as the severity of the symptoms and risk of surgery.
Valve Replacement Surgery
Standard valve replacement surgery is an open-heart procedure where the surgeon will open the chest cavity to remove and replace the damaged valve with an artificial valve. Sometimes this can be accomplished without opening the chest but rather through a small incision near the breastbone. Valve replacement surgery is done under anesthesia, and the patient can expect to stay in the hospital for multiple nights for observation and care.
Transcatheter Aortic Valve Replacement (TAVR)
Similar to how a stent can be placed in an artery, a replacement valve can be inserted to the valve site. Once inserted, the new, artificial valve pushes the old valve out of the way and takes over regulating blood flow. TAVR can be performed without opening the chest and may be a good option for patients not able to have open-heart surgery.
Read more from Forrest General Hospital on how this procedure began in Hattiesburg: https://www.forresthealth.org/about/media-news/press-releases/2015/forrest-general-first-to-offer-advanced-heart-valve-replacement-/.
Atrial septal defect is a defect of the heart in which there is a hole in the wall that divides chambers in the heart. According to the Centers for Disease Control and Prevention (CDC), there are an estimated 1,966 babies born each year in the United States with an atrial septal defect. This defect may be identified during pregnancy, but individuals may also not know of their defect until adulthood, and the exact cause of it is not known. Most patients have an audible heart murmur that is caused by the extra blood flow.
An infant with an atrial septal defect identified before or at birth may not need immediate intervention and on some occasions, the defect may repair itself over time. Surgery may be recommended and is dependent on the advice of a physician. To repair or close an atrial septal defect, catheterization, a keyhole incision or open-heart surgery may be performed. Depending on the size of the defect, it may be repaired by using a suture and sewing it closed, or for larger defects, a patch may be used to cover and close the hole.
For more information on atrial septal defect, please consult with your Hattiesburg Clinic Heart & Vascular provider.
Cardiac tumors are abnormal growths near the heart and valves. Tumors can be either malignant or benign. They are generally very rare, but if your provider identifies a mass on the heart and recommends it to be removed, surgical removal is an option.
MRI or CT imaging can be used to identify cardiac tumors.
Many patients do not experience any symptoms associated with cardiac tumors. Tumors that block blood flow can cause heart failure, stroke, atrial fibrillation, embolism and blood clots. Depending on the severity of the tumor, the exact surgical procedure to remove the mass will be determined by your surgeon.
For more information on the removal of cardiac tumors, please consult your Hattiesburg Clinic Heart & Vascular provider.
When a heart has rhythm issues or arrhythmia, cardiac ablation may be an option. Ablation is one of several options in treating rhythm problems, but your doctor may decide that ablation is the best option. Ablation is intended to stop the electrical signals to your heart in an effort to stop the rhythm problems. After you are properly sedated depending on your level of need, a catheter with specific electrodes at the tips will be fed through your vein to the affected area. Once in position, the surgeon will aim the electrodes at the abnormal heart tissue and destroy or scar the area that triggers the arrhythmia.
For more information about cardiac ablation, please consult your Hattiesburg Clinic Heart & Vascular provider.
A thoracic aortic aneurysm is where the walls of the aorta, the largest blood vessel in the body, become weak or bulge. This leak could potentially spill blood into the body. Aortic aneurysms can cause heart attacks, stroke, kidney damage or death. Some patients are born with an aortic aneurysm. Other causes may include high blood pressure, high cholesterol, smoking, traumatic injury, plaque buildup or infection. Aneurysms can be identified by common exams, such as an X-ray, CT scan, ultrasound or echocardiogram.
Not all aneurysms require surgery, but if it grows in size, a provider may recommend surgical intervention. Surgery typically involves opening the chest to expose the damaged section of the aorta. The section of the aorta that is damaged would then be clamped off, cut off and removed. An artificial tube would then be sewn to each end of the aorta to replace the diseased section.
For more information about thoracic aortic aneurysms, please consult your Hattiesburg Clinic Heart & Vascular provider.