Heart surgery is often the only way to keep your heart functioning properly, which means that it can literally save your life. In the past, the only way to have heart surgery was open heart surgery. Now, though, it’s possible for cardiologists to perform heart surgery using minimally invasive techniques.
Although there are some situations where open heart surgery is your best choice, in many cases you can get the same or a very similar procedure through minimally invasive techniques. This can reduce your discomfort, reduce infection risk, and shorten your required hospital stay after surgery.
When people think of heart surgery, they often imagine open heart surgery, which requires that the chest be open to expose the heart. However, many types of heart surgery can be performed using minimally invasive techniques.
In open heart surgery, your surgeon will make a long incision down the center of your chest. They will cut the breastbone and open your ribcage to expose the heart. In the traditional form of this surgery, medications are used to stop your heart to make it easier to operate on. While your heart is stopped, a machine will play the role of your heart and lungs. Oxygen-poor blood would leave the heart and receive oxygen while in the machine. The machine will also pump the blood throughout the body so that your organs can receive the vital resources they need.
In a variation on the procedure, your heart is not stopped. The heart keeps beating, though it’s held stable a little bit to make surgery easier.
In minimally invasive heart surgery, your rib cage is not cracked open. Instead, a small incision is made in the chest, arm or groin, depending on the procedure, your anatomy, and the surgeon’s technique. Then a small tube called a catheter is inserted to allow the surgeon to view the area. A camera and tools are inserted through the tube to perform the procedure. When the procedure is complete, the surgeon pulls the tube out and the surgical site is closed.
Not every procedure can be performed using minimally invasive techniques. However, when procedures can be performed in a minimally invasive way, they offer several potential benefits when compared to open heart surgery, including:
For many people, the big benefit of minimally invasive heart surgery is the faster recovery and spending less time in the hospital. People like being able to get back to their normal routine faster. In addition, spending less time in the hospital contributes to the potential for lower cost with minimally invasive heart surgery, though the cost reduction is not always significant.
With smaller incisions, people are likely to experience less blood loss, reduced pain, and have a lower risk of infection. People will also be able to reduce their time spent on a ventilator.
Finally, the smaller incisions used will mean smaller scars, although in some cases the scars might be in more visible areas like the arm.
At South Denver Cardiology Associates, our interventional cardiologists focus on minimally invasive heart surgeries. We offer some of the most advanced minimally invasive heart surgeries available, including:
Cardiac ablation is a treatment for arrhythmias, such as atrial fibrillation.
Often, arrhythmias are due to certain nerves in the heart that trigger irregular or poorly timed heartbeats. Cardiac ablation is a procedure to block the signals from these nerves. Using radiofrequency energy or extreme cold, the procedure creates a small, controlled injury in the heart. As this heals, it creates scar tissue that doesn’t conduct nerve signals, so it blocks the signals causing the irregular heartbeats.
The procedure takes just 2-3 hours, and you may even be able to go home as soon as you recover from general anesthesia. At worst, you might need to spend the night in the hospital.
Another way to deal with irregular heartbeat is to implant a device that can help your heart beat with a regular rhythm. At South Denver Cardiology, we can implant two different types of devices that can achieve this purpose: pacemakers and ICDs.
Pacemakers are small devices that use rhythmic electric shocks to encourage the heart to beat regularly.
Implantable cardioverter defibrillators (ICDs) perform a similar function. However, they aren’t always setting the pace for your heart. Instead, they typically monitor the heart and only apply a shock when the rhythm needs correction. In addition, ICDs can restart your heart if it stops.
Balloon angioplasty is a procedure to widen arteries around the heart that are narrowed by arterial plaque. These plaque deposits are typically soft and fatty, and when the balloon inflates, it can flatten the deposits up against the wall of the artery, increasing the space available for blood to flow to the heart.
You won’t need to be anesthetized during the procedure, which causes little discomfort. The procedure can take as little as 30 minutes, but sometimes takes a few hours. In most cases, you can go home on the same day as the procedure, but you might need to stay overnight, depending on the timing of your procedure and your level of risk.
Heart attacks can occur when the blood vessels supplying the heart get too narrow and can collapse, cutting off the blood supply. Balloon angioplasty can help widen narrow vessels. However, there is a risk that the blood vessel could simply narrow again or collapse after the procedure.
Stents protect against the collapse of blood vessels. These small metal tubes can reinforce your blood vessels, helping to slow or stop the progress toward recollapse. The placement of stents doesn’t add much time to an angioplasty or other blood-vessel-widening procedures.
A patent foramen ovale (PFO) is an opening in your heart that is supposed to close after birth. It’s a change related to converting from getting oxygen through the placenta to getting it from the lungs. However, in some people this opening doesn’t close, allowing blood to travel between the two upper chambers of the heart. This causes a usually minor disruption in the flow of blood through the heart. Most of the time PFO doesn’t have any symptoms, but sometimes it can lead to a stroke.
To close a PFO, we insert a catheter through an incision in your groin, and thread it up to your heart. The catheter deploys a patch over the hole. Over time, the heart will cause its own tissue to grow over the patch, completing the repair.
The left atrial appendage is an irregularity in the shape of the heart that can allow blood to accumulate in the heart. This blood can form clots, which then get sent out to the body, potentially causing a stroke. It’s believed that in people with atrial fibrillation, most stroke-causing blood clots come from this area of the heart. Closing off the atrial appendage can reduce the risk of stroke. We can do this with a special device: the WATCHMAN implant.
A catheter is threaded into the heart with the device inside. The device fits perfectly inside the appendage, and the heart will grow over the device, closing the appendage off so that blood clots won’t form there. The procedure is short, and you usually won’t need to spend more than a day in the hospital.
Aortic stenosis occurs when the aortic valve narrows, limiting the flow of blood from the heart to the body. The treatment is valve replacement, which in the past required open heart surgery. However, with transcatheter aortic valve replacement (TAVR), we can replace the heart’s valve using a catheter inserted via an incision in the groin. Originally used for people who weren’t good candidates for open heart surgery, this procedure is now available for all patients.
The TAVR procedure takes about an hour. You will be sedated but awake. You’ll be able to walk around the same day as the procedure but may need to stay overnight for observation.
Valves in the heart need to open to allow blood flow, then close to allow the blood to pump forward. In mitral regurgitation, the mitral valve doesn’t close properly, which causes a backflow of blood. This can lead to numerous problems, including arrhythmia, blood clots, or even heart failure. The treatment is to replace the mitral valve. Typically, the procedure is performed as open-heart surgery, but there is another option for high-risk patients: the MitraClip. Using a catheter through an incision in the groin, a heart surgeon can place the MitraClip to help the mitral valve close more completely.
The procedure takes from one to three hours. Most patients will go home the next day, but some might have to stay a few days for observation.
South Denver Cardiology Associates are dedicated to taking care of our patients. We utilize minimally invasive procedures to help our patients live better lives without major surgical interventions. Often, these interventions are leading-edge procedures that are available at few clinics around the country, and sometimes at no other clinic in Colorado.
We pair our heart surgery approach with an even softer touch: helping people to make lifestyle choices that will support their heart health. This helps us deliver outstanding results, which means not just that your heart function improves, but also that your quality of life improves.
To learn more about how South Denver Cardiology Associates can help you, please contact us today to schedule an appointment at one of our locations in Littleton, Englewood, Denver, Parker, or Castle Rock.
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