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August 21, 2012 > Advanced Cardiac Surgery in Your Neighborhood

Advanced Cardiac Surgery in Your Neighborhood

In the last 15 years, studies reported by the Centers for Disease Control indicate that the percentage of Americans with cardiovascular problems is declining. Yet, heart disease remains the No. 1 killer in the U.S.

Every year, thousands of people in this country undergo surgery to treat problems associated with heart disease. In Alameda County, according to the 2010 Community Needs Assessment, more than 40,000 people were hospitalized for coronary heart disease between 2006 and 2008, the most recent local statistics available. Many of these patients went into the hospital to undergo cardiac surgery.

For the past 17 years, Washington Hospital's Cardiothoracic Surgery Department has provided this community with innovative, state-of-the-art surgical care for adults with heart problems. One of the Department's greatest strengths is its multidisciplinary, comprehensive approach to care, which brings together physicians specializing in cardiac surgery and a range of other accomplished healthcare professionals to provide the treatment and support needed to achieve the best patient outcomes.

Before having cardiac surgery at Washington Hospital, patients meet with their surgeon, anesthesiologist, members of the Hospital staff who provide care and support before surgery, and a nurse from the Cardiac Rehabilitation Department. After all the critical information is gathered, a plan is developed to meet the patient's individual needs before, during and after surgery.

Advanced procedures performed at Washington Hospital include Coronary Artery Bypass Grafting (CABG) and heart valve surgery.

CABG procedures are intended to improve blood flow to the heart when there is a significant blockage of one or more coronary arteries. These blood vessels are critically important because they carry oxygen-rich blood to the heart muscle. A severe blockage causes muscle damage and may lead to a potentially fatal heart attack. This surgery creates a blood vessel graft, providing a path around the blockage and restoring blood to the heart.

CABG procedures have traditionally been done by placing the patient on a heart-lung machine, which does the work of the heart and lungs during surgery. With this on-pump approach, the patient's heart is stopped and a heart-lung machine supplies the blood with oxygen, pumping it back through the patient's body.

Now, surgeons at Washington Hospital also perform the innovative off-pump-or "beating heart"- procedure. In this case, the heart-lung machine is not used and the heart is not stopped while the surgeon performs the procedure.

With off-pump CABG surgery, the patient receives medication to slow down the heart rate. The surgeon uses special tools that stabilize one part of the heart to provide the best access to the blocked arteries. Meanwhile, the rest of the heart pumps oxygen-rich blood to the patient's body.

"We focus on doing the off-pump procedure because it can offer some distinct advantages to the patient, such as fewer blood transfusions. The on-pump approach can be associated with longer hospitalizations and less satisfactory outcomes. Off-pump procedures also decrease the risk of stroke after surgery," reported Jon-Cecil Walkes, M.D., a board certified cardiovascular surgeon on the medical staff at Washington Hospital. Dr. Walkes practices with the Washington Township Medical Foundation.

Dr. Walkes and other cardiac surgeons at Washington Hospital also perform different types of heart valve surgery, ranging from the traditional sternotomy to an innovative, minimally invasive approach. With traditional heart valve surgery, the surgeon makes an incision in the center of the chest and divides the breastbone to gain access to the heart and surrounding structures. It usually takes patients about six to eight weeks to fully recover from this procedure.

With select patients, the surgeon can use a minimally invasive approach to repair or replace the heart valve through a small incision in the right side of the chest. Patients typically require fewer blood transfusions and the recovery time, including hospitalization, is shorter. This procedure can be used to repair an aortic valve or mitral valve. In some cases, it can also be used to treat heart tumors.

"With mitral valve surgery, many hospitals do mainly valve replacements but, at Washington Hospital, 90 percent of the mitral valve procedures we do are valve repairs," explained Dr. Walkes. "This avoids many unnecessary replacements, which are riskier and require more complicated post-surgical care."

For further information about cardiothoracic surgery at Washington Hospital, go online to the Hospital's Web site at www.whhs.com/openheart. To learn more about Dr. Walkes and other physicians with Washington Township Medical Foundation, go to www.mywtmf.com.

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