Heart & Valve Surgeries

Posted: Feb. 1, 2005

Many different kinds of surgery are now performed on the heart or blood vessels. Here are some common surgeries.

Angioplasty and stent procedures
Coronary or balloon angioplasty is often used to open blocked arteries. In this procedure, a catheter (a thin tube) is inserted into a forearm or groin artery and threaded into the narrowed heart artery. The catheter has a tiny balloon at its tip that is repeatedly inflated and deflated to open and stretch the artery, improving blood flow. The tube is removed and often a stent (a small, metal mesh tube) is put in to keep an artery open after an angioplasty. The stent stays permanently in the artery. There are other procedures sometimes used to open the arteries. However, none of these procedures results in a cure for coronary artery disease and there is a chance that the blockage could return.

Coronary artery bypass
This is the most common kind of heart surgery. You may also hear it called coronary artery bypass graft surgery (CABG), coronary artery bypass (CAB), coronary bypass or bypass surgery.

The surgery involves sewing a section of vein from the leg or arteries from the chest or another part of the body to bypass a part of a diseased coronary artery. This creates a new route for blood to flow, so that the heart muscle will get the oxygen-rich blood it needs to work properly.

During bypass surgery, the breastbone (sternum) is divided, the heart is stopped, and blood is sent through a heart-lung machine. Unlike other kinds of heart surgery, the chambers of the heart are not opened during bypass surgery.

When you hear the words single bypass, double bypass, triple bypass, or quadruple bypass, it refers to the number of arteries that are bypassed. The number of bypasses does not necessarily indicate how severe the heart condition is.

Valve repair or replacement
Blood is pumped through your heart in only one direction. Heart valves play key roles in this one-way blood flow, opening and closing with each heartbeat. Pressure changes behind and in front of the valves allow them to open their flap-like "doors" (called cusps or leaflets) at just the right time, then close them tightly to prevent a backflow of blood.

Two of the most common kinds of valve problems that require surgery are:

Stenosis, which means the leaflets do not open wide enough and only a small amount of blood can flow through the valve. Stenosis occurs when the leaflets thicken, stiffen, or fuse together. Surgery is needed to either open the valve that is there or replace it with a new one.

Regurgitation, which is also called insufficiency or incompetence, means that the valve does not close properly and blood leaks backward instead of moving in the proper forward direction. Surgery is needed to either tighten or replace the valve.

Surgical repair of a valve involves the surgeon rebuilding the valve so that it will work properly. Valve replacement means that the valve is replaced with a biological valve (made of animal or human tissue) or a mechanical valve (made from materials such as plastic, carbon or metal).

Source: National Heart, Lung and Blood Institute

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