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Cardiothoracic and Vascular Surgery (CTVS) | |
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What is Cardio Thoracic Surgery? " |
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Cardiothoracic surgeryiothoracic surgeryiothoracic surgery is the field of medicine dealing with surgical treatment of diseases affecting organs enclosed within the thorax (the chest) or thoracic region. Generally, treatment of conditions of the heart (heart disease) and lungs (lung disease). Cardiac surgery (involving the heart and great vessels) and thoracic surgery (involving the lungs and any other thoracic organ) are separate surgical specialties.
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CARDIAC SURGERY |
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Cardiac surgeryng>Cardiac surgery is surgery on the heart and/or great vessels performed by a cardiac surgeon or team of cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease (for example, coronary artery bypass grafting), correct congenital heart disease, or treat valvular heart disease created by various causes including endocarditis. |
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Open heart surgery |
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This is a surgery in which the patient's chest is opened and surgery is performed on the heart. The term "open" refers to the chest, not to the heart itself. The heart may or may not be opened depending on the particular type / nature of surgery. |
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Modern beating-heart surgery |
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It all began in the 1990s, when surgeons began to perform "off-pump bypass surgery" –i.e coronary artery bypass surgery without the aforementioned cardiopulmonary bypass. In these operations, the heart is beating during surgery, but is stabilized to provide an almost still work area.
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Coronary ArterIAL Bypass GRAFT (CABG) Surgery: Conventional vs. Beating Heart |
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Coronary artery bypass grafting surgery gives beneficial results to patients with coronary heart disease by restoring adequate blood flow and normal delivery of oxygen and nutrients to the heart. Bypass surgery reroutes the blood around a blockage in the coronary artery, creating an alternate pathway for blood to deliver important nutrients and oxygen to the heart muscle. The two main types of bypass surgery, conventional (arrested heart) and Beating Heart, are different in their approaches, as outlined below. |
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Conventional Bypass Surgery |
Beating Heart Bypass Surgery |
- Conventional bypass surgery is performed on an arrested (stopped) heart through an incision down the middle of the chest. Patients are placed on a heart-lung machine during the procedure.
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When a patient is placed on the “bypass” heart-lung machine, the blood is routed outside the body through the heart-lung machine. The patient may need to receive transfusions (in a recent study by Puskas, more than half of the patients receiving a conventional CABG required some blood products) to replenish blood volume, red blood cells, or platelets.
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Conventional surgery requires considerable resources in terms of staff, time, products and equipment, medications and other items that impact total cost of the procedure.
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Shorter ICU use and hospital stay. Significant reduction in the need for blood products and in postoperative complications. Ascione, et al., reported significantly lower transfusion requirements and costs, significantly lower operative costs, lower material and bed occupancy costs, and lower costs related to managing postoperative complications.
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In the medical literature, surgeons refer to “high risk patients”— patients whom they consider poor candidates for conventional bypass surgery because they are too ill, or have preexisting medical conditions that make exposure to the heart-lung machine too risky. These “high-risk” patients may include the elderly, and those with renal problems, diabetes, previous history of strokes or heart attacks, etc.
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Beating Heart surgery, which avoids use of the heart-lung machine, may make it possible for high-risk patients to have bypass surgery. Off-pump CABG carries a significantly lower mortality rate in the high-risk population than conventional CABG
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