Heart Surgeries

Recently Answered

• QWhy is heart bypass surgery a good choice for people with diabetes?

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  A The Society of Thoracic Surgeons answered

  People with diabetes mellitus who undergo heart bypass surgery for multiple blocked arteries have a significantly better five-year survival rate than diabetic patients who undergo angioplasty with drug-eluting stents (DES), according to a study published in The Annals of Thoracic Surgery.

  Study researcher Rephael Mohr, MD, of Israel's Tel Aviv Sourasky Medical Center, explained that coronary arterial blood vessels in diabetic patients are smaller, which increases the risk of new blockages of the blood vessels after treatment with stents.

  The study is the first comparative effectiveness demonstration of coronary artery bypass grafting (CABG) surgery using both internal thoracic arteries versus percutaneous coronary intervention (PCI) with DES in patients with diabetes.

  Rephael Mohr, MD, Yaron Moshkovitz, MD, and colleagues reviewed 5-year outcomes for 226 patients who underwent bilateral internal thoracic artery (BITA) grafting with outcomes for 271 patients who underwent PCI with DES. They found that BITA patients had a 13 percent greater survival rate, as well as a lower risk for non-fatal heart attacks, recurrent chest pain, and future re-interventions. Additionally, they found that the more stents that were used, the greater the risk of a major cardiovascular event.

  “The long-term benefit of BITA bypass graft surgery is probably related to the protection provided by CABG conduits that bypass the blockages and protect against future blockages,” said Dr. Mohr. “Protection from recurrent coronary events due to disease progression cannot be achieved by the stents placed in the coronary arteries during heart catheterization.”

• QWill TAVR become more widespread in the future?

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  A Dr. Vamsee Mohan M. Yaganti, MD , Interventional Cardiology, answered on behalf of St. Mark's Hospital

  

  Watch the video to learn more about TAVR and hear from Vamsee Yaganti, MD, from Heart Center at St. Mark's, and his prediction if the procedure will become more widespread in the future.
• QWhat can hospitals do to improve coronary artery bypass grafting outcomes?

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  A The Society of Thoracic Surgeons answered

  Hospitals can improve coronary artery bypass grafting (CABG) outcomes through designated leadership of a coronary surgery program, standardization of all aspects of coronary care, and rigorous quality review. With a more focused surgeon, team and program—specialized coronary teams to improve all aspects of care—more people undergoing CABG could survive.

• QHow can specialized CABG programs affect overall operation times?

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  A The Society of Thoracic Surgeons answered

  A specialized coronary artery bypass grafting (CABG) surgery program can decrease overall operation time by 48 minutes from incision to closure, according to researchers at the University of Maryland Medical Center (UMMC). In the UMMC specialized CABG surgery program, surgical approach and operative techniques were standardized, resulting in decreased operation time.

• QDoes a specialized approach to CABG improve mortality rates?

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  A The Society of Thoracic Surgeons answered

  A specialized approach to coronary artery bypass grafting (CABG) has been shown to improve mortality rates. Researchers at the University of Maryland Medical Center reviewed survival data for people who had CABG under a specialized CABG surgery program compared to people who underwent CABG during an earlier period when a general approach was used. The research showed that mortality decreased from 2.67 percent to 1.48 percent after just three years of the more specialized coronary surgery program. As a result, it is estimated that specialization in CABG surgery prevented five deaths during that time period.

• QWhy should I find a specialized team for my CABG surgery?

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  A The Society of Thoracic Surgeons answered

  You should find a specialized team for your coronary artery bypass grafting (CABG) surgery because a surgeon dedicated to coronary bypass and working with a specialized team may have better outcomes. While all cardiac surgeons can perform a bypass operation, people who undergo CABG—the most common heart surgery performed—may live longer and experience fewer complications when under the care of a highly focused surgical team that uses simplified and standardized approaches. Researchers have found many operative factors and clinical outcomes to be significantly improved, demonstrating the effects of team and program specialization.

• QCan I have bypass surgery if I have a stent?

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  A Dr. Michael J. Wahl, MD , Thoracic Surgery (Cardiothoracic Vascular), answered on behalf of Regional Medical Center Bayonet Point

  

  In this video, Michael Wahl, MD from Regional Medical Center Bayonet Point, describes why people with stents may eventually need to have bypass surgery.
• QHow is a vein or artery used in coronary bypass surgery?

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  A Dr. Michael J. Wahl, MD , Thoracic Surgery (Cardiothoracic Vascular), answered on behalf of Regional Medical Center Bayonet Point

  

  Veins were used more often in early coronary bypass surgeries, but arteries are preferred as they can last a patient's entire life. Learn more about the procedure in this video with Michael Wahl, MD from Regional Medical Center Bayonet Point.
• QWhat determines if someone needs coronary bypass surgery?

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  A Dr. Michael J. Wahl, MD , Thoracic Surgery (Cardiothoracic Vascular), answered on behalf of Regional Medical Center Bayonet Point

  

  In this video, Michael Wahl, MD from Regional Medical Center Bayonet Point, describes that reasons can be emergency or elective when it comes to needing coronary bypass surgery.
• QWhat kinds of valves are used for aortic valve replacement?

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  A The Society of Thoracic Surgeons answered

  Current aortic valve replacement options are limited to those made solely from manufactured products (mechanical valves) or animal tissue (bioprosthetic valves). Mechanical heart valves tend to last longer than bioprosthetic valves, but they carry a greater long-term risk for blood clots that may lead to stroke and arterial thrombosis (clotting in the arteries), as well as bleeding from anticoagulant medications designed to prevent thrombosis. Bioprosthetic valve replacements, on the other hand, are prone to limited durability, which means people may need a reoperation usually 10 to 15 years after implantation.

  Traditionally, tissue-engineered valves are built on a scaffold that will degrade once the tissue is more mature. Once the scaffold has degraded, however, the valve leaflets often shrink, which can cause leaks and result in valve failure.

  Although potentially only available for use in humans in 2025, hybrid tissue-engineered valves may expand options for people requiring heart valve surgery. This novel technology creates patient-specific valves that won’t degrade over time.

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