The coronary arteries carry blood to the heart; the heart then pumps the oxygen-rich blood to the rest of the body. When a blockage in the coronary arteries prevents blood from reaching the heart, part of the heart muscle is damaged, causing a heart attack (myocardial infarction). Surgical heart procedures restore the flow of blood to the heart (revascularization). The descriptions below will help you better understand the different types of heart surgery. For information on preventing heart disease and adopting a heart-healthier lifestyle, go to LaurusHealth.com.

Balloon Angioplasty - Percutaneous Transluminal Coronary Angioplasty
Depending on how much the artery is blocked, cardiologists may use balloon angioplasty to clear the blockage. Angioplasty is performed in the catheterization lab using fiberoptic scopes to guide the surgeon to the blocked site. A small surgical balloon is inflated at the site, enlarging the blocked area of the artery. To keep the artery open, the surgeon implants a hollow, metal mesh stent in the artery.

Bypass Surgery - Coronary Artery Bypass Grafting
Patients who have more extensive heart disease (blockages in multiple arteries) will need bypass surgery. During bypass surgery, the surgeon removes a vein from the leg or an artery from either the chest wall or arm and uses it to bypass, or go around, the blocked coronary artery. Bypass surgery involves splitting the breastbone and placing the patient on the heart-lung machine, stopping the heart in order to perform the surgery. The heart-lung machine continues to supply blood to the patient’s body during surgery.

The operative risks of bypass surgery are low and the overall results are excellent. Most patients return home within 5 to 6 days after surgery and return to work in 5 to 6 weeks. The progression of heart disease can be delayed by making lifestyle changes. Talk to your physician about what you can do to keep your heart healthier.

Off-Pump Coronary Artery Bypass Surgery
Some patients benefit by having their bypass surgery performed without using the heart-lung machine. Patients who have other medical problems or who have limited blockage and easy-to-access revascularization sites are candidates for off-pump bypass surgery. The surgical incision — the splitting of the chest along the breastbone — is the same in either traditional or off-pump coronary artery bypass surgery.

Minimally Invasive Surgery
Minimally invasive surgery for coronary artery bypass grafting or valvular surgery also may require using the heart-lung machine. Small incisions, called keyhole incisions, are made on either side of the breastbone to allow the surgeon to perform the surgery on the heart. Minimally invasive surgery using this approach is also referred to as heart port-access or keyhole surgery.

Transmyocardial Revascularization (TMR)
Patients who have severe coronary artery disease who normally would not be candidates for traditional or off-pump coronary bypass surgery may benefit from transmyocardial revascularization. During this procedure, a laser is used to stimulate growth of arteries to improve blood flow to the heart muscle (myocardium). Memorial Hospital of South Bend is the regional referral center for TMR procedures.

Valve Surgery
Although most heart surgery involves improving blood flow to the heart, there are a number of people who, for a number of reasons, need to have their heart valves repaired or replaced. Valve replacement with either a mechanical valve or a bioprosthetic valve has been performed since the early 1960s with relatively low risk. During the past several years, techniques for repairing valves have been developed and perfected. Talk to your surgeon to determine what is right for you. Not all valves can be repaired.