Cardiothoracic Surgery Ask The Expert/FAQs

Other Frequently Asked Questions:

	Q.	How do I know if my hospital is a good place to have heart surgery?
	Q.	Do I need surgery for atrial fibrillation?
	Q.	How do I know if I should have percutaneous angioplasty (PCI) or coronary bypass surgery (CABG)?
	Q.	What are the benefits of having a mitral valve repair rather than a replacement?
	Q.	How long does it take to recover from heart surgery?

Q. How do I know if my hospital is a good place to have heart surgery?

A. This is the age of information, and it is entirely appropriate to ask your surgeon his or her experience and results with the type of surgery proposed. For instance, all coronary bypass operations done in the State of California must be reported to the government and are published in an annual report. Many programs report their outcomes to the national Society of Thoracic Surgeons database and should know how they compare to other programs in the country. It is important to consider the types of patients that are operated at certain hospitals, and to know how you will be cared for after the surgery. Most surgeons would be very comfortable discussing these questions with a patient considering heart surgery.

Q. Do I need surgery for atrial fibrillation?

A. Patients with atrial fibrillation, a condition that causes irregular, rapid heartbeats, can be very symptomatic and over time have an increased risk of stroke. Many patients can be managed with medications and anticoagulation (sometimes known as "blood thinning"). However, if medications fail to control the symptoms, or the medications themselves are not well tolerated, then other options can be considered. At the Cardiovascular Center, these patients are evaluated both by cardiologists and surgeons. If a patient is a good candidate for a percutaneous approach, this can be used effectively. Surgical intervention is more invasive, but is also more effective. Patients who require heart surgery for other reasons should have their atrial fibrillation addressed at the same time.

Q. How do I know if I should have percutaneous angioplasty (PCI) or coronary bypass surgery (CABG)?

A. Many patients with coronary artery disease are appropriately managed with medical therapy alone. However, some patients require intervention in order to decrease the risks of heart attack, improve symptoms, and to live longer. In these cases, all patients should have a discussion regarding the best form of therapy. Cardiologists can now effectively place stents in coronary arteries in order to improve blood flow to the heart. This is good treatment for certain patients. Yet, these patients may still have to consider repeat interventions, return of symptoms, and long term medications that may place them at risk in the future. Plus, these procedures have risks as well. Many long term studies comparing the two procedures (PCI versus CABG) have shown that over time, patients can do better with surgery, including many diabetics, patients with three vessel disease or complicated blockages, and patients who already have damaged hearts. Patients should be fully informed of all the options, as well as the long term risks and benefits of each, before selecting the best option for them.

Q. What are the benefits of having a mitral valve repair rather than a replacement?

A. Mitral valve repair, as compared to a valve replacement, allows the patient to preserve his or her native valve tissue. In many cases, this affords improved heart function with less risk of infection, blood clots and stroke. In some situations, a valve replacement is necessary. The native valve is replaced with an artificial valve, either a mechanical valve that requires life-long anticoagulation medication, or a tissue valve that may require re-replacement in the future because they are not as durable as a mechanical valve. Both have a low, but persistent risk of infection, among other possible complications long term. At UC Irvine, we repair almost all leaking mitral valves that require surgical intervention.

Q. How long does it take to recover from heart surgery?

A. Recovery time varies from person to person, depending on their procedure and overall physical health. At UC Irvine, most patients leave the hospital within 4-5 days of surgery. However, the chest still needs time to heal, and the patients overall energy level may not be normal for awhile. Patients may need the help of family and friends when they first arrive home, but they should be able to return to their usual activities within 4-6 weeks.

Questions? Contact cardiothoracic surgery services at 714.456.3634

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