At Mercy, patients are able to take advantage of the latest, leading-edge therapies—including new drugs, medical devices and surgical procedures.
Iowa Heart Center surgeons perform 1,200 heart operations annually – more than two thirds are coronary artery bypass grafts (CABG). This is more than any other group in Iowa, and gives patients the highest level of both experience and expertise. Minimally invasive techniques are used whenever appropriate, including off-pump bypass procedures on a beating heart, and endosaphenous vein harvesting.
Common heart surgeries include:
Coronary Artery Bypass
This surgery is done to improve the blood flow in a narrowed or blocked artery. During CABG, a vein from the leg(s), arm(s) and/or an artery from the chest are used to construct a detour around the blockage. Your doctor will decide which type of graft should be used depending on the number and location of your blockages.
If the left internal mammary artery is used, the artery is re-routed from its original position in the chest to the blocked coronary artery. This surgery allows oxygen rich blood to flow directly from the aorta through the graft, bypassing the obstruction and nourishing the heart muscle. If a leg vein is used, the blood flow to the leg will not be disturbed and your ability to walk will not be bothered.
Once the vein is removed, one end is sewn (“grafted”) into the side of the aorta, and the other is sewn into the coronary artery at a point below the blockage.
Several bypass grafts may be necessary to improve circulation to the heart muscle, relieve symptoms of angina and improve heart function. To help the bypass graft remain open, you need to make lifestyle changes to alter the modifiable risk factors that originally led to the problem.
Heart Valve Repair/Replacement
The function of the heart valves is to direct the flow of blood in the heart chambers and major blood vessels. Normal heart valves are smooth, thin structures that work together to control blood flow through the chambers of the heart in one direction.
Your heart has four valves:
- Tricuspid Valve - allows blood to flow from the right atrium to the right ventricle.
- Pulmonic Valve - allows blood to flow from the right ventricle to the pulmonary artery and then to the lungs.
- Mitral Valve - allows blood to flow from the left atrium to the left ventricle.
- Aortic Valve - allows blood to flow from the left ventricle to the rest of the body
The function of the valves can be affected by several factors—including rheumatic fever, birth defects, scarlet fever, atherosclerosis, trauma and infection. Any of these conditions can result in the failure of the valve to open freely (stenosis) or to close completely (insufficiency or regurgitation). With either of these conditions the heart is forced to work harder. The strained heart may become abnormally large and not function properly. People who have this condition may tire easily and experience shortness of breath with little physical exertion.
Depending on the amount of damage, heart valves may be repaired or replaced. Sometimes the surgeon can restore the valve to its normal function by remodeling the tissue, removing the stretched tissue or sewing the edges. Prosthetic or artificial rings are used to narrow a dilated valve and to reinforce a valve repair. An advantage to this procedure is that your own valve tissue is used.
Heart valves that are seriously deformed or degenerated cannot be repaired and the old valve is removed and replaced with a new valve, comprised of either human or animal tissue, metal or plastic. Your surgeon will discuss what type will be used according to your specific condition. The new valve is attached by sewing it to a rim of tissue kept from the original valve.
Many patients who undergo valve replacement greatly improve after surgery; however, if your heart has been strained for a longer period, recovery time may be prolonged.
Preparing for Surgery
You will be scheduled for surgery after you have consulted with your cardiologist and a cardiac surgeon. A nurse will visit with you and your family about what to expect. Please also watch the realistic and reassuring video above to help you take an active role in preparing for surgery and the recovery.
To help you plan for your surgery and for your post-surgery recovery period, we urge you to think about what you and your family may need to do before, during and after your hospital stay. Your health care team will assist you and your family by addressing discharge needs based on the type of surgery you have and what your recovery needs may be.
Questions to consider
- Will a friend or family member be with you at the hospital? If so, do they have any special needs? Have they planned for lodging and meals?
- Who will be available to answer questions or make medical and other decisions for you should you be unable to do so after your surgery? Do you have a durable power of attorney for making health care decisions? If you have a living will or durable power of attorney, bring a copy of it to the hospital with you.
- While you are in the hospital, have you arranged for someone to care for your home, your pets or pay rent, utilities, etc.? You may also want to let your clergy know that you will be in the hospital.
- Have you asked your doctor about what assistance you may need after discharge? Possible options include home care, a skilled nursing facility and outpatient services. Make arrangements for someone to stay with you for approximately one week when you return home.
- Most patients are not allowed to lift more than 10 pounds for six to eight weeks after surgery. Who will be available to carry your groceries, do your laundry, vacuum or do other chores?
- Most patients are not allowed to drive for four weeks after surgery. Who will be able to drive you to clinic visits and other appointments?
- Do you have financial concerns or questions about insurance coverage for your hospital stay or for any services you may need after you leave the hospital?