Cardiovascular Surgery

At Central Florida Cardiac & Vascular Institute, we offer the very latest in cardiac procedures and surgeries. You can count on us to be pioneers in the procedures and treatment that you need to regain your health. Below are some of our most common procedures, but your cardiologist can advise you about other operations that may be beneficial to you as well.

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Pre-Operative Instructions

Talk to your doctor about any preoperative instructions. Depending on what surgery you are scheduled for, you may need to fast or stop taking certain medications. Before the surgery, you may need a number of diagnostic tests, including x-rays, electrocardiogram, and blood tests. If you have any questions, don’t hesitate to ask your physician.

Complex Mitral Valve Repair

The mitral valve is one of the four valves in your heart. It ensures that blood from your lungs flows from the left atrium to the left ventricle and then is pumped to the rest of your body. If there is a problem with your mitral valve, your blood flow is restricted and your heart has to work harder. This can lead to shortness of breath, fatigue, and serious heart issues.

Some mitral valve problems can be that it does not close correctly or it has become too narrow. In these cases, mitral valve repair can be necessary. Often, this procedure can be performed using minimally invasive techniques.

This operation reports long-term survival rates, and it reduces the risk of stroke.

Coronary Artery Bypass

This surgery restores blood flow to your heart muscle by diverting the blood flow around an area of blocked artery in your heart. The procedure requires that your doctor take a healthy blood vessel from your leg, arm, or chest and connect it to other arteries in your heart. This allows the blood to bypass the damaged artery.

This surgery requires general anesthesia and can take between three and six hours. This surgery usually involves a large incision in the chest, and your surgeon will spread open your rib cage to see your heart. Your heart is temporarily stopped, and your blood flow is diverted through a heart-lung machine.

Your surgeon takes a section of the healthy blood vessel from the other part of your body and attaches it below your blocked artery. During the procedure, a breathing tube will be inserted your mouth and connected to a ventilator, which helps you breathe.

This procedure reduces your risk of having a heart attack, and it can lessen your symptoms of chest pain and shortness of breath.

In some cases, your surgeon may be able to perform coronary artery bypass using minimally invasive techniques.

Endovascular Aortic Aneurysm Repair

An aneurysm is a bulge that occurs in the wall of a blood vessel. When one is present in your aorta, this can lead to a clot that forms and causes stroke. It can also cause plaque to form, which restricts blood flow, or it can rupture, which can be life threatening.

In many cases, the aorta can be repaired by removing the area of weakened blood vessel and replacing it with a graft of artificial material. In most cases, the operation can be completed using minimally invasive procedures.

Minimally Invasive Heart Surgery

When surgeons perform minimally invasive procedures, they use small incisions, often operating between the ribs. This is less invasive than open heart surgery and results in less pain and faster recovery times.

By and large, minimally invasive procedures are quicker than traditional surgery. However, you will still need anesthesia, and you may need to stay in the hospital after the procedure. The length of your stay will depend on your health and the specific operation you have.

Peripheral Vascular Procedures

Peripheral vascular procedures are performed to locate and treat blocked and hardened arteries throughout the body. Using angiography—a test that allows for the visualization of blood vessels via an X-ray, MRI or CT scan—your doctor can determine blocked arteries, and correct the blockage, usually with a balloon angiography or stenting of the artery. In some cases, blood clots may be treated during this procedure as well.

Preparation
Your physician will order blood or lab tests, which will be completed prior to your day or surgery.

You'll begin preparing for your peripheral vascular procedure the night before the surgery by not eating or drinking anything after midnight. As you prepare to go to the hospital in the morning, shower and wash thoroughly with antibacterial soap.

You'll also want to take any morning medications with small sips of water. Diabetes patients should ask their doctors about adjusting or withholding medication or insulin injections before the surgery. Patients who take blood thinners may also need to stop taking these medications prior to surgery.

What to Expect
Before your procedure begins, hospital staff will ask you a series of medical history questions, and you'll dress for surgery in a sterile hospital gown.

First, you'll start an IV in your arm to receive different medications intravenously during the surgery. The catheter insertion site—usually the groin but sometimes at the wrist—will be shaved and prepped with an alcohol and iodine solution. It's very important to notify your doctor or hospital staff if you're allergic to iodine or shellfish. A sterile drape will be placed over you once you're ready for surgery, and monitors will begin checking your heart rate and blood pressure.

You'll be awake during the procedure, though given sedative medication to keep you relaxed. Your physician will numb the catheter insertion site, and you'll likely experience stinging or pressure that is only mildly uncomfortable. The catheters are then inserted, and the contrast dye injected so you and your doctor can see your blood vessels on the X-ray or other viewing machine.

A peripheral vascular exam generally lasts about 90 minutes, which can vary from patient and depends on the type of specific procedure performed. You'll need to recover from this procedure by lying flat in bed for a few hours; some patients are discharged the same day. Patients who receive a blood angiography or stenting generally spend the night in the hospital.

Robotic Cardiovascular Surgery

Another form of minimally invasive surgery includes the use of robotic technology. During robotic cardiovascular surgery, surgeons use a highly sophisticated robotic device that helps them perform procedures with greater precision and control than in traditional surgery.

During robotic-assisted surgery, tiny incisions are made in the chest cavity. A surgeon sites in a console that is equipped with controls that are used to direct the robotic arms. A tiny camera is attached to each arm, providing the surgeon with highly detailed views of the operating space inside the chest. The arms are like an extension of the surgeons arms and are very flexible and agile.

Our surgical team members are experienced in robotic techniques, and they offer incredible expertise for every procedure.

Post-Operative Instructions

Depending on what surgery you have had, you will need to spend a day or two in the cardiac intensive care unit and then perhaps several days in the hospital. Your physician will advise you on what to expect.

During your hospital stay, you will begin the first phase of cardiac rehabilitation, and then you will continue rehab after you are discharged.

Valve Repair vs. Valve Replacement

Valve repair and valve replacement are two solutions for severe mitral valve regurgitation (MR). One of these two procedures is usually recommended if you have symptoms of heart failure, or when your ejection fraction drops below 60 percent and/or your left ventricle is larger than 40mm at rest.

Valve Repair

  • Valve repairs can be used to treat mitral valve defects, as well as congenital defects. To repair the valve, a physician may do the following
  • Provide more support to the valve by adding tissue to the base of the valve
  • Remove excess valve tissue and reshape the valve
  • Perform a chordal transposition, which involves attaching the valve to adjacent heart tissue

Valve Replacement
Severely damaged valves will need to be replaced entirely, and this approach is used to treat aortic valves and any life-threatening valve diseases. During the replacement procedure, the damaged valve is removed and replaced with an artificial valve. The new valve may be made of plastic, metal, or pig tissue.

Preparation
As your operation date approaches, it's important to alert your surgeon about any health changes, including the cold or flu, or symptoms such as a fever, cough, runny nose or chills. It's also important your physician knows each and every medication you take, including aspirin.

Most patients are admitted to the hospital the night before or the morning of their surgery. Patients should bathe the night before surgery, and not eat or drink anything after midnight. At the hospital, your surgery site will be washed and scrubbed with an antiseptic and shaved, if necessary.

What to Expect
Valve repairs and replacement procedures are performed as open heart surgeries under general anesthesia, and can last from three to five hours. During the surgery, a large incision is made in the chest, and you'll be placed on a cardiopulmonary machine to circulate blood (outside the body) and oxygen. Additional measures might be taken to protect the heart, and the heart could be cooled down or even stopped.

Then, the valve is either repaired or replaced altogether with a prosthetic valve.

You'll spend a few days at the hospital recovering from your surgery. Full recovery is achieved after several months, when the incision site is healed and rebuilt physical endurance and stamina.

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