Heart Disease Treatments
Cardiac Surgery Services within North Shore-LIJ performs some of the most progressive and effective types of heart disease treatments on congenital heart disease, mitral valve prolapse, arterial blockage and other heart diseases.
Our patients are cared for by our multi-disciplinary team of experts in our advanced state-of-the-art Heart disease treatment facilities. As a result of our patient-focused philosophy, each patient will meet with their surgeon and will be provided with information pertaining to the treatment of their heart disease and what to expect after surgery. Our staff is on call 24/7 to help with any issue you may have. Every patient will have a slightly different experience, depending on the nature of their heart surgery. However, it is important for all patients to know that our main goal is to provide them with the best healthcare possible.
Minimally Invasive Heart Surgery
The Department of Cardiovascular and Thoracic Surgery at North Shore-LIJ offers a wide variety of minimally invasive surgical procedures. Where appropriate, these procedures offer an alternative to some of the more traditional open surgical approaches. These advanced surgical procedures are performed through small incisions between the ribs, sometimes using specialized surgical instruments. The breast bone does not need to be opened, as is done in open-heart surgery. Benefits to patients include: faster recovery, earlier return to normal activities, decreased risk of infection and cosmetic advantages.
Robotic Heart Surgery
The Minimally Invasive and Robotic Heart Valve Surgery Center at North Shore- LIJ Health System is the first center on Long Island to use the Da Vinci® surgical robotic system to perform minimally invasive heart operations. The robotic system includes small instruments, which are inserted between the patient’s ribs without splitting any bones. These miniature instruments translate the surgeon’s hand motion from a console in the operating room. This technology has enabled some cardiac procedures to be performed less invasively without sternotomy (cutting through the sternum, or breast bone).
Minimally Invasive Valve Repair
Our Center offers patients with mitral valve disease a less invasive operation where indicated. The operation is performed through a small, three-inch incision between the ribs on the right side of the chest. For patients who require aortic valve replacements and are considered good candidates, minimally invasive techniques are also available which include either a partial sternotomy or a minimally invasive incision between the ribs, again avoiding splitting of the breastbone. Potential benefits of minimally invasive valve surgery include:
- Off-Pump Coronary Artery Bypass Surgery (OPCAB)
In off-pump coronary artery bypass, using a specialized stabilizing device, we have the ability to perform the bypass grafts while the heart is still beating and without the need for the heart-lung machine. This technique is particularly advantageous for patients who have excess calcium in the aorta, patients at risk for stroke and those who have advanced kidney disease.
- Minimally Invasive Closure of Atrial Septal Defect
Atrial septal defect repair can be performed through a minimally invasive approach. The defect can be either primarily repaired or patched with autologous or bovine pericardium through a minimally invasive incision.
Cutting-Edge Treatment for Aortic Valve Disease
Transcatheter Aortic Valve Replacement Surgery
When the aortic valve of the heart becomes narrower than normal and impedes the flow of blood, the condition is known as aortic valve stenosis, or aortic stenosis, and can cause life-threatening impairment of heart function. In cases of severe aortic valve stenosis, the valve must be replaced which has traditionally required open-chest surgery. Unfortunately, the surgery is often considered too risky for many patients, especially older ones.
Inconceivable just a decade ago, transcatheter aortic valve replacement is a minimally invasive treatment alternative to traditional open-chest surgery. This breakthrough procedure provides a potential lifeline for the highest risk patients with severe aortic valve stenosis and can result in both longer life and better quality of life.
During the transcatheter aortic valve replacement procedure, the cardiac surgeon inserts a replacement aortic valve in the area of the patient's own aortic valve through a small puncture in the femoral artery of the leg or through a small incision in the side of the chest. The procedure is performed in a hybrid operating room/catheterization lab where combined angiographic, interventional and complete open heart surgical procedures can be performed in a single space.
Treatment for Coronary Artery Disease
The Department of Cardiovascular and Thoracic Surgery at North Shore-LIJ Health System successfully performs hundreds of CABG surgeries annually, often for patients who have been considered to be too high-risk elsewhere. Our surgeons offer the full complement of surgical options for the treatment of CAD, including traditional CABG, arterial bypass grafting, endoscopic vessel harvest from the leg and arm, and minimally invasive and off-pump procedures where appropriate.
Coronary Artery Bypass Grafting (CABG) Treatment
Surgeons use healthy arteries and veins taken from other parts of the body to bypass blocked arteries. CABG reduces the risk of heart attack and also relieves chest pain. The coronary artery bypass grafting (CABG) treatment improves the blood flow to the heart. It is performed on people with severe Coronary Heart Diseases (CAD).
Treatment for Congenital Heart Disease
This non-invasive procedure performed by a cardiologist, involves passing a thin flexible tube (catheter) into the right or left side of the heart, usually from the groin or the arm. It is usually done to get information about the heart or its blood vessels, to provide treatment in certain types of heart conditions or to determine the need for heart surgery.
Minimally Invasive Heart Surgery
This acquired or congenital heart disease treatment uses alternative approaches to optimize wound healing and reduce length of stay.
Treatment for Heart Valve Disease
Heart Valve Repair or Replacement
The valve repair or replacement surgery is used to repair the flaps/leaflets if they do not open-up wide enough. Due to this sufficient blood does not flow through the valve into the artery. If the leaflets do not close tightly, blood can leak back into the chambers.
Transcatheter Aortic Valve Replacement (TAVR)
Treatment for Mitral Valve Prolapse
Valve Repair or Replacement
This treatment repairs the valve flaps, also known as leaflets, if they do not open-up wide enough. Due to this condition, sufficient blood does not flow through the valve into the artery. If the leaflets do not close tightly, blood can leak back into the chambers. Mitral valve prolapse surgery treatment is performed to correct the problem. Additionally, our Center offers patients with mitral valve disease a less invasive operation where indicated. The operation is performed through a small, three-inch incision between the ribs on the right side of the chest.
Treatment for Thoracic Aortic Aneurysm
Decision making and treatment for patients with early aneurysms is complex, due to the array of potential operative and non-operative treatment options. With the development of a computer-based aortic registry on both campuses within one department, at North Shore-LIJ Health System, we are able to enlist patients for long-term longitudinal follow-up of their aortic pathology. The benefit of being in an aortic registry is the ability to determine subtle enlargement or disease progression. Even patients who have had successful surgery demand continued follow-up through an aortic registry.
Conventional surgery has long been the gold standard of treatment for thoracic aortic aneurysms. Unfortunately, these operations are often exceedingly difficult for patients and have many risks, including paralysis in up to eight percent of cases. In 2005, an innovative, minimally invasive treatment option called TEVAR received FDA approval and gave new hope to patients and their doctors.
Thoracic Endovascular Aortic Repair (TEVAR)
TEVAR is ground-breaking treatment for thoracic aortic aneurysms, dissections and traumatic injuries to the thoracic aorta received FDA approval. The procedure involves placing a catheter-based endograft into the area of the diseased or damaged aorta. An endograft is a fabric covered metallic stent that is placed inside an aneurysm to prevent rupture. Precise placement of the stent is guided by the use of fluoroscopic imaging and angiography. The benefits of TEVAR include lower risk of operative mortality, shorter recovery time and shorter hospital stays.
Treatment for Pulmonary Embolism
A pulmonary embolism (PE) is an obstruction caused by a blood clot (thrombus) in the pulmonary artery that has traveled through the bloodstream (usually from a vein in the legs) A blood clot in the deep veins of the legs or elsewhere in the body is called a deep venous thrombosis (DVT). Our cardiovascular and thoracic surgeons are experienced in a variety of medical and surgical treatments for pulmonary embolism, including:
- Anticoagulation drugs (blood thinners)
- Anticoagulation combined with thrombolytics (drugs that dissolve a clot and reopen an artery or vein)
- Filter placement – A filter is placed in the inferior vena cava, a blood vessel in the abdomen, that is designed to catch and stop blood clots from causing pulmonary embolism
- Surgical embolectomy – removes the blood clot from the pulmonary artery
- Thromboendarterectomy – a surgical procedure for chronic thromboembolic pulmonary hypertension (pulmonary hypertension induced by recurrent pulmonary obstructions)
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