Conditions & Services
Below are some of the advanced procedures performed by UC Irvine Healthcare’s cardiothoracic surgeons:
• Coronary bypass grafting (bypass surgery - CABG)
This surgical procedure relieves angina and reduces the risk of death from coronary artery disease. Arteries or veins from elsewhere in the patient’s body are grafted to the coronary arteries to bypass atherosclerotic narrowings and improve blood supply to the heart muscle. This procedure can be lifesaving in those patients who, by virtue of evidence-based research, are not good candidates for percutaneous catheter techniques or continued medical therapy. At UC Irvine, surgeons may also perform minimally invasive and “off pump” procedures without the use of a heart-lung machine. Our team has long adhered to the principles published in the “Appropriateness Criteria for Revascularization” by the American College of Cardiology and American Heart Association.
• Cardiac valve repair and replacement
Surgeons at UC Irvine are highly skilled in techniques used to repair cardiac valves that are partially blocked or leaking. While preserving native valve tissue is always the first choice, valves that are too badly damaged to repair are replaced using mechanical or tissue prostheses (including the implantation of human donor tissue). Nationwide, the use of valve repair for mitral valve disorders is still less than 50 percent for appropriate candidates, while the success rate at UC Irvine is more than 90 percent.
• Minimally invasive aortic and mitral valve repair and replacement
Surgical treatment for mitral valve disease includes either repairing the patient’s diseased valve or replacing it with a metal, mechanical valve or an animal tissue valve. Historically, these procedures have required open-heart surgery resulting in a major incision in the chest. Now, surgeons at UC Irvine Healthcare are performing minimally invasive aortic and mitral valve repair and replacement procedures through two- to three-inch incisions. Such procedures are technically more demanding than an open-heart repair, but they offer tremendous benefits, including lower risk of infection, faster recovery times and less blood loss.
• Surgical ventricular restoration for congestive heart failure (Dor procedure)
When a heart attack occurs in the left ventricle (the chamber of the heart that pumps blood to the body), a scar may form, making the rest of the heart work harder to pump blood throughout the body. Over time, the left ventricle becomes larger than normal and pumps less effectively. This leads to heart failure and severe limitation of a patient’s activity level. In the ventricular restoration or Dor procedure, the surgeon excludes the scarred, dead area of heart tissue from the circulation and reshapes the ventricle to a more normal shape – improving heart function. This is often done in conjunction with coronary bypass surgery and/or valve repair.
• Surgical treatment of thoracic and thoracoabdominal aortic aneurysms and dissection
The aorta is the largest blood vessel in the body, most of which is located in the chest. Weakening of the wall can cause an aneurysm (dilatation) which is prone to rupture, or lead to a separation of the wall known as an aortic dissection. Either can be a life-threatening emergency. Once an aneurysm or dissection is identified by a chest X-ray, echocardiogram, computed tomography, or magnetic resonance imaging scan, surgeons develop a repair strategy. These complex operations help ensure the safe distribution of blood to the rest of the body. The procedure repairs weakened or ruptured arteries or damaged section of aorta with a graft of special surgical woven material. Most of these require an open surgical procedure, however, at UC Irvine many of these procedures can be performed using endovascular techniques without surgical incisions. At UC Irvine’s Cardiovascular Center, cardiac and vascular surgeons work together to achieve excellent results with all types of diseases of the aorta.
• Installation of the TandemHeart™ percutaneous assist device
Ventricular assist devices are used as a bridge to transplantation or to recovery in some cases. TandemHeart is a temporary device that maintains the patient’s circulation either before or after surgery, and can also be used in patients undergoing high-risk percutaneous coronary artery interventions. This small, semi-portable device can be placed percutaneously through the groin, or at the time of open heart surgery as necessary. The fully implantable devices are in their early stages of development, but reliable external pumps are a promising treatment for heart patients by temporarily supplementing heart function and are often lifesaving.
• Esophageal and pulmonary resection
Both the esophagus and lungs are vital organs that can be affected by either benign or malignant diseases (cancer). In some cases, surgical removal of lung tissue or the esophagus is necessary for treatment. Many of these operations can now be performed without creating large and painful surgical incisions. UC Irvine surgeons use innovative surgical techniques to tailor the operation according to the patient’s needs. Minimally invasive surgery has become standard therapy in certain cases to remove cancerous tissue from the lungs.
• Minimally invasive radiofrequency ablation surgery for atrial fibrillation
Atrial fibrillation is a common but abnormal heart rhythm that can lead to rapid, irregular heartbeats. These heartbeats can cause discomfort, dizziness, and shortness of breath. Left untreated, patients are at increased risk for stroke. While some patients can be treated with medications or percutaneous procedures, others are resistant to these interventions. UC Irvine surgeons use radiofrequency waves (modified electrical energy) to create precise scar lines on the surface of the heart without opening the chest. The scars block the erratic electrical impulses (cause of irregular heartbeat) and restore a normal electrical pathway through the heart to correct atrial fibrillation.
• Evaluation and treatment of mediastinal tumors
Mediastinal tumors are abnormal tissue growths in the part of the chest cavity between the two lungs. These tumors can be benign or malignant (cancer) and occur across all age groups. Surgical treatment may include thoracotomy, a procedure performed through an incision in the chest, and minimally invasive approaches, including thoracoscopy and mediastinoscopy.
Our cardiothoracic team carefully addresses the concerns of patients and their families, educating them on what to expect both before and after surgery.
