There are Significant Technical Advances in Heart Surgery

Bird, looking for something? (Dr. Noorali Bharwani)
Bird, looking for something? (Dr. Noorali Bharwani)

I met a gentleman who has had a stroke, suffers from coronary artery disease and has a malfunctioning aortic valve – a valve in the left lower chamber of the heart from where the blood is pumped out to the rest of the body.

I also read in my book (Dr. B’s Eight Steps to Wellness – page 90) that the heart muscle is the hardest-working muscle in the body. It pumps out 60 milliliters of blood at every heartbeat. Every day, the heart pumps out at least 10,000 liters of blood. The heart has the ability to beat over three billion times in a person’s life. Isn’t that something?

The heart is like a grand central station. If the central station breaks down then all the lines come to a stop. We don’t want that. So we need to keep our heart healthy. But if you are unlucky like the gentleman I mentioned earlier, then you have to look for medical and/or surgical help.

Pursuing a healthy life style in terms of regular exercise, healthy eating and no smoking is a good thing. If you inherit bad genes then you have to increase your efforts to prevent the disease. If you need medications then your good doctor will help you with that.

There are surgical options for coronary artery disease. If putting stents in plugged vessels does not help then surgical treatment is required. Coronary artery bypass graft (CABG) surgery has become a routine procedure.

The majority of coronary surgical procedures are performed for multiple vessel disease. Overall, the mortality rate of coronary artery surgery is low, at around two to three per cent, although this benefit is offset by a complication rate of 20 to 30 per cent. It is important to evaluate various physical, psychological and social side effects of CABG as well.

Now the technology has improved to a point where patients with more advanced coronary artery disease and extensive coexisting conditions are taken care of. “Off-pump” procedures, in which the heart does not have to be stopped, were developed in the 1990s. These patients generally have fewer complications, less leg pain, and shorter hospital stays.

Options for treating damaged aortic valve are many. The valve can be repaired or replaced in many ways. In the United States, surgeons perform about 99,000 heart valve operations each year. Valve replacement is most often used to treat aortic valves in the left lower chamber of the heart. Your surgeon may choose a mechanical valve, which is usually made from materials such as plastic, carbon, or metal. Mechanical valves are strong, and they last a long time.

Your surgeon may choose a biological valve, which is made from animal tissue or taken from the human tissue of a donated heart. The procedure may be open-heart surgery or the new technique of minimally invasive valve surgery thorough small openings in the chest wall. In some cases, minimally invasive valve surgery can be done using a robot.

Minimally invasive surgery cannot be done in patients who have severe valve disease, have clogged arteries or are overweight.

Research shows around two per cent of people treated with aortic valve replacement will die in the first 30 days after surgery. However, the risk of death from surgery is far lower than that associated with not treating severe aortic disease.

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