heart surgery:

Did you know . . .
. . . the heart pumps about 1 million barrels of blood during an average lifetime—that's enough to fill more than 3 super oil tankers.

Heart Surgery

Queen's Heart has 2 operating rooms for heart and vascular surgery. Each year over 450 open heart surgery procedures are done at Queen's. Some of the operations performed include coronary artery bypass grafting (CABG) and valve repair or replacement surgery.

Coronary Artery Bypass Grafting Surgery (CABG)

When the arteries to the heart are narrowed and blocked, oxygen rich blood can no longer go through them, and this reduces blood supply to the heart. Reduced blood supply to the heart may cause chest pain, difficulty breathing, and heart attack. Extreme cases can cause a full cardiac arrest where the heart can actually stop beating.

Most times a cardiologist can open the blockages using angioplasty which is a small balloon that presses the blockage open. Severe cases of blocked arteries, especially with multiple blockages, a Coronary Artery Bypass Grafting surgery, or CABG, is the best option to improve blood supply.

A CABG is an open heart operation. The surgeon takes healthy vessels and bypasses the blockages on the heart. The vessels used can be from the chest wall or leg. One or more arteries may need to be bypassed.

The operation is done by a heart surgeon and a highly skilled heart surgery team.

Sometimes patients may need to have a special machine circulate blood during the operation. The machine allows the heart surgeon to bypass the blocked arteries.

Surgery can last from 2 to 6 hours depending on the number of bypasses needed. After surgery a course of care is followed so that the patient can return safely to activity.

Valve Repair or Replacement Surgery

The heart has four valves which are like doors. They open and close to let blood in and out of the chambers of the heart with each heart beat, keeping the blood flowing in one direction. The MITRAL VALVE and the AORTIC VALVE (the valves on the left side of the heart) are under greater pressure than those on the right side and are more frequently damaged. Heart valves may not work properly for the following reasons:

Patients often had rheumatic fever when they were young and as they get older they begin to have problems with their valves, specifically the MITRAL VALVE. Rheumatic fever cause the leaflets (the door like part of the valve) to thicken.

Infections that are left untreated can cause damage to the leaflets (the door like part of the valve) by making them thick. It is important to seek early treatment of infections to prevent damage to heart valves.

Drug use can cause the heart to work harder, which increases the heart rate and blood pressure. It may also cause an inflammation to the heart valves and the lining of the heart damaging the structure and allowing bacteria to grow.

During development heart valves may not form correctly.

When heart valves do not open enough to let blood out it is referred to as a stenosis (a narrowing). Valves that do not close properly allow blood to leak between chambers.

Either way, the heart has to work harder to move blood around the body. The extra work makes the heart weaker and not stronger. Over time the extra work can lead to a condition called Heart Failure, the heart can not longer pump blood efficiently or can also lead to pulmonary hypertension where blood pressure in the lungs becomes elevated and can cause difficulty with breathing.

• Pain in the chest.
• Shortness of breath or dizziness during activity.
• Swelling in the hands or feet. (This is also a sign of heart failure)

Heart Valve Surgery is an open heart operation in which the surgeon may repair a diseased valve using a special ring to tighten up the area around the valve to help the valve close. The surgeon may find that the valve is too damaged to repair in this case, they have to remove the diseased valve and replace it with an artificial valve. The artificial valve can be either mechanical where the parts are made of synthetic material, or they may come from a pig's heart. The choice of which valve to use is discussed with the patient and depends on the age of the patient, other medical conditions, and the patient's occupation/activities.