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PROCEDURES
Coronary Artery Bypass Grafting
This procedure is
the most common cardiac operation performed in the United States. It is
done to correct blockage of the coronary arteries due to atherosclerosis
(hardening of the arteries). The typical patient has one or more of the
following:
Chest pain/pressure
Heart attack
Positive stress test
During the procedure,
usually the internal mammary artery as well as
the saphenous vein (from the leg) are used to bypass the coronary arteries.
These bypasses deliver blood beyond the blockages significantly reducing
subsequent chest pain and risk for heart attack & death.
Due to recent advances in
equipment and techniques, in certain patients, this procedure can be
done without the use of heart-lung machine (beating heart or off-pump).
This reduces some of the stresses associated with the use of heart-lung
machine.
Valve Repair/Replacement
This is the 2nd most common
cardiac surgical operation. Each side of the heart (right or left) has two
valves. An inflow valve (mitral or tricuspid) and an outflow valve (aortic
or pulmonic). Many conditions can cause leakage or narrowing of one or
more of these valves. The aortic and mitral valve are most commonly affected.
Aortic Valve Replacement
This is the most common heart
valve operation. It is usually done for severe narrowing of the valve
(stenosis). The valve is replaced with either a mechanical or tissue valve.
The choice is usually based on patient's age and other medical conditions.
Mitral Valve Repair/Replacement
The reason for this procedure is
usually leakage (regurgitation). In certain conditions, the patient's own valve
can be preserved and repaired. This is the preferred approach. Sometimes the
valve has severely deteriorated and needs to be replaced with either a mechanical
or tissue valve.
Maze Procedure for Atrial Fibrillation
Atrial fibrillation is a condition
where the rhythm of the heart is irregular. As a result, clots can form in
chambers of the heart. If these clots move out of the heart, they can block blood
flow of other organs such as the brain causing a stroke. Patients with this
condition are frequently on blood thinners to prevent the risk of stroke. However,
blood thinners increase the risk of bleeding and can be difficult to manage. Maze
procedure restores the regular rhythm of the heart in up to 80% of the patients
significantly reducing the risk of stroke. It also improves the efficiency of
cardiac function. This procedure is indicated in patients with atrial fibrillation
who are to undergo another cardiac surgery procedure such as coronary bypass
and/or valve repair/replacement. For
more . . .
Lung Cancer
Lung cancer is the most common
malignancy afflicting both men and women in the United States. The only possibility
for cure is provided if the portion of the lung containing the tumor can be totally
removed. Lymph nodes are regularly sampled during surgery. This allows accurate
staging of the tumor that is important in determining the prognosis and need for
additional treatment with chemotherapy and/or radiation.
Lung Biopsy
This procedure is aimed and removing
an area of abnormality in the lung in order to determine its exact nature. This is
most commonly performed to rule out cancer. The procedure can frequently be performed
using minimally invasive techniques aimed at reducing pain as well as the time
required to return to normal activity. The procedure is done through small incisions
in the chest without spreading of the ribs.
Sympathectomy
This procedure is performed for
hyperhydrosis (excessive sweating) of the arm/hand or Raynaud's Syndrome causing
severe spasm of arteries to the fingers. The procedure is done using minimally invasive
techniques to cut the nerves in the chest that influence sweat production and spasm of
the arteries to the arm. It typically requires an overnight hospital stay.
Pneumothorax
In this condition, air escapes from the
lung for a variety of reasons causing collapse of the lung that could be life threatening.
Frequently air needs to be evacuated by insertion of a tube in the chest cavity. If there
is evidence of ongoing leakage of air, several procedures, most of which can be done with
minimally invasive techniques, are available to remove the abnormal area of the lung and
reduce risk of recurrent pneumothorax.
Aortic Aneurysm Repair (Vascular Surgery)
In this condition, the aorta (main blood
vessel carrying blood in the body) enlarges. Once the diameter exceeds 2 inches, the risk
of rupture significantly increases. Ruptured aneurysm is a life-threatening condition with a
greater than 50% risk of death. An unruptured aneurysm almost always causes no symptoms. It
is frequently discovered through physical examination or X-ray studies. There are two main
methods to repair the aneurysm using either a stent-graft or open surgery to replace the
segment of the aorta with aneurysm. The choice depends on many factors such as patient's age,
other medical conditions, and shape of the aneurysm.
Carotid Endarterectomy (Vascular Surgery)
Carotid arteries reside in the neck and
are the main blood vessels to the brain. Severe blockage in carotid arteries carries a
significant risk of stroke. Carotid endarterectomy is performed through an incision in the
neck. The artery is opened while a shunt provides blood flow to the brain. The diseased
lining of the artery is removed and artery repaired with a patch. Patient is typically
discharged the next day with full recovery in 1-2 weeks.
Leg Bypass (Vascular Surgery)
These procedures are designed to provide
blood flow to the lower leg in patients who have severe blockage/narrowing of arteries in
the leg. The indications for surgery are severe pain, non-healing wounds/ulcers, or gangrene
of the feet/legs. At surgery, the bypass is done using either the patient's own vein or an
artificial graft. By providing additional blood flow, future risk of leg amputation is
significantly reduced.
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