"Minutes equal muscle."
You can't choose the timing of a heart attack and timing is a critical issue in treatment. With a top-notch cardiac surgery program right here in Indian River County, patients receive treatment immediately and are saved from suffering avoidable heart muscle damage. Fast treatment is important to saving lives.
In addition to excellent cardiac surgeons, IRMC also boasts state-of-the-art facilities, equipment, and advanced diagnostic testing procedures.
Essential elements include advanced cardiovascular surgery equipment and a wireless communication and patient monitoring system.
Angioplasty is a procedure used to open narrowed or blocked coronary arteries.
- A flexible tube, catheter, is threaded from the leg into the area of the coronary artery where there is a blockage; X-rays are used to help guide this process
- A dye is injected into the blocked area and pictures taken
- Once the catheter is positioned in the blocked area, and the obstruction confirmed, a balloon is inflated at the end of the catheter
- This inflation gently pushes the plaque and opens up the blocked artery to allow blood to flow through the area
Angioplasty does not always unblock arteries permanently. The artery may close up again, possibly due to blood clots. Anti-clotting medication may be prescribed. Surgery may still be required at a later date.
Coronary Artery Stents
Sometimes a stent will be inserted into the artery during angioplasty. A stent is a small, slotted, metal tube that is mounted on a balloon catheter. It is placed into the artery following an angioplasty and positioned at the site of the blockage. The stent acts as a 'scaffold' to help hold open the artery. It improves blood flow and relieves symptoms caused by the blockage.
A stent is a permanent implant that remains in the artery. Over time cells will form a natural cover that holds the stent in place.
Atrial Septal Defect (ASD) Surgery
Ventricular Septal Defect (VSD) Surgery
These defects are caused by a hole in the wall between chambers of the heart. The two upper chambers of the heart, called the right and left atrium, are separated by a 'wall' called the atrial septum. Sometimes there is a hole in the septum called an atrial septal defect (ASD). Holes may be large or small, single or multiple, and the heart may otherwise be normal.
Ventricular septal defect is similar to ASD except a hole appears in the wall between the two lower chambers of the heart, the ventricles.
In the normal heart, blood flow is completely separated in each side of the heart. When there is a hole in the septum, blood from the left side flows through into the right side, causing the right side to work harder. It also causes the lungs to receive more blood than normal causing heart failure.
Sometimes the opposite happens and blood flows from right to left. This is caused by abnormally high pressure in the right side of the heart. It may cause cyanosis, a bluish discoloration of the skin, or a stroke.
Another complication from an ASD is an abnormal heart rhythm. This is caused by the right atrium enlarging and stretching. Usually the abnormal rhythm stops after surgery.
Some defects close on their own, but most need to be closed by surgery.
- Blood is routed through a heart-lung machine
- The defects are surgically repaired, with a patch material needed for larger holes.
Coronary Artery Bypass Graft (CABG)
About 500,000 Americans have heart bypass surgery each year. A Coronary Artery Bypass Graft (CABG) is referred to as 'cabbage.' This type of surgery is done when a coronary artery blockage prevents adequate blood flow to the heart muscle. Veins or arteries are connected above and below the blocked vessels providing another pathway for oxygen rich blood to flow to your heart muscle.
- Blood is routed through a heart-lung machine
- An artery or vein from the leg, arm or chest is used to bypass the blockage in the coronary artery
- The surgery usually takes three to six hours
Bypass surgery will not make an old heart attack scar go away. It will not cure coronary artery disease because the disease is a progressive process. It will restore adequate blood flow to the heart where the bypass has been placed.
Off Pump Coronary Heart Bypass
This type of surgery is much like the traditional surgery, but without the need for a heart lung machine. This is possible because medications and a stabilizer are used to slow the heart rate. Recovery is the same except the hospital stay may be a day shorter.
Heart Valve Surgery
Heart valve surgery is also considered a form of open heart surgery. Heart valves allow blood to sufficiently move through your heart.
A heart valve may not open or close properly because of a birth defect, or if it has been thickened or damaged by rheumatic fever, infection, calcium deposits or even aging. An abnormal valve or heart vessel can become too narrow or begin to leak. This narrowing is called stenosis. A valve that cannot close completely is called insufficient or regurgitating. Heart valve surgery repairs or replaces diseased or damaged heart valves.
- The blood will be routed through a heart-lung machine
- A commissurotomy (a surgical procedure to loosen the stenotic valve) is performed, increasing the size of the valve's opening
- If repair is possible, the tissue and or edges of the valve(s) will be reshaped
- The valve is replaced by sewing a prosthetic valve into the heart
- There are two types of valves *
- Tissue (bioprosthetic) from a specially treated animal or human tissue
- Mechanical, ('St. Jude' valve) made from plastic or metal
- Surgery usually takes three or more hours
(* The type of prosthetic valve is determined by the extent of heart disease or other diseases, lifestyle, activity levels and tolerance to anticoagulant therapy. Mechanical valves usually require anticoagulant medication to prevent blood clotting near the valve.)
A unique risk after surgery of the heart valves is bacterial endocarditis, an infection of the heart valves. It occurs when bacteria enter the blood during dental work, surgery, medical procedures or an infection. Oral infections are common sources of bacterial endocarditis. Antibiotics are often needed before and after certain procedures as prophylactic treatment (preventative). Tell all physicians and dentists if you have heart valve abnormalities. Good dental care is important to decrease your risk of heart valve damage due to infection.