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Cardiac Surgery

The cardiac surgery division performs a wide spectrum of cardiac surgical operations for adult-acquired and congenital cardiac diseases, which include:
 
Coronary Artery Bypass Grafting (CABG)
Patients with Coronary Artery Disease, Angina, and/or Myocardial Infarction may benefit from bypass surgery. The purpose of coronary artery bypass graft surgery (CABG) is to make a new path around your blocked coronary artery (or arteries) using a healthy artery or vein from your chest wall, arm, or leg. These healthy blood vessels are connected or “grafted” onto your aorta and your coronary artery beyond the blockage. This new path lets oxygen-rich blood go around, or “bypass,” the blockage to reach your heart. The healthy arteries and veins may come from several places in your body.
 
Heart Valve Surgery
Patients with diseased heart valves that could lead to congestive heart failure may benefit from valve surgery. Such operations involve either repairing or replacing the abnormal valves. Aortic valve disease is most commonly treated by valve replacement. The mitral and tricuspid valves are commonly repaired when appropriate. Valve replacement may involve the use of a mechanic or animal (cow) tissue valve. Both types of valves have advantages and disadvantages and the choice is tailored to individual patients. The type of valve used or the potential repair of a valve will be discussed prior to surgery. Patients with aortic heart valves (endocarditis) may benefit from a homograft, tissue taken from a cadaver. These grafts have proven more resistant to recurrent infection. Combined operations, such as CABG and valves, are common. Less frequently, corrections are preformed for adults with congenital defects between the right and left side of the heart to prevent enlargement of the heart, congestive heart failure and/or neurologic complications.
 
Thoracic and Aorta Surgery
Elective or emergency operations are performed for aortic and other great vessel pathologies. Damage to these vessels can result from penetrating or blunt injuries to the chest or from degenerative disease of the vessels, such as aneurysms of the ascending and descending aorta. To correct these problems, a portion of the aorta is replaced or tears (dissection) in these large blood vessels are repaired. Baystate cardiac surgeons repair aortic aneurysms using either endovascular surgery or open surgery, both with excellent results.
 
Cardiac Arrhythmias
The Maze procedure is performed for the treatment of cardiac arrhythmias such as atrial fibrillation or flutter. These abnormal rhythms can produce shortness of breath or palpitations. The MAZE procedure eliminates atrial fibrillation in 70 to 80 percent of cases. Resumption of a regular rhythm may eliminate the need for blood thinning medications such as Coumadin. The Maze procedure may be performed with other cardiac surgery procedures or as an isolated procedure..
 
Transcatheter Aortic Valve Replacement (TAVR Procedure)
While open aortic valve repair has been the standard of care for symptomatic, severe aortic valve stenosis for decades, it is not an option for many patients deemed too high a risk for open-heart surgery, typically because of aortic calcification, underlying lung disease, or frailty. About one-third of those diagnosed with aortic stenosis are deemed inoperable or too high risk for the procedure due to other health conditions. A new procedure, called transcatheter aortic valve replacement (TAVR), is now available for inoperable and high risk patients. The TAVR procedure is similar to the angioplasty and stent procedure. Under general anesthesia, a catheter is inserted into a blood vessel in the patient’s groin. A replacement valve is placed on a stent, which is advanced through the blood vessel and into the heart. Once it reaches the aortic valve, a balloon is inflated, pushing the calcification and the faulty valve against the aortic wall, making room for the new valve. It’s not a true replacement valve, since the old valve is not removed, but an implanted valve inserted into the old valve. TAVR can also be performed with a transthoracic approach, using a small incision in the chest to access the aortic valve directly through the tip of the heart, which further opens up the procedure to patients who also have blood vessel diseases in the leg that would prohibit the catheter approach. TAVR has many benefits for patients, including a quicker recovery, and outcomes for the procedure are superior in inoperable patients compared to medical therapy alone. Baystate Medical Center in Springfield is the only hospital in western and central Massachusetts to offer the TAVR procedure.