Cardiovascular Surgery of the Heart and Blood Vessels

Overview

You may need to undergo cardiovascular surgery so your surgeon can:

• Open up narrowed or blocked arteries
• Repair a congenital (present at birth) heart condition
• Repair or replace damaged heart valves
• Treat atrial fibrillation (AFib), or irregular heartbeat
• Treat or prevent a blood clot
• Treat or prevent a heart attack
• Treat heart failure

Candidates for cardiovascular surgery

Many different conditions may require heart surgery treatment. They include:

• Blocked arteries
• Blood clot
• Heart attack
• Heart failure
• Heart valve conditions
• Stroke

Your doctor may also recommend cardiovascular surgery for people at high risk for developing the above conditions.

Types of cardiovascular surgery

Heart surgeons perform a full range of advanced surgeries, including minimally invasive robotic-assisted surgery, open surgery and off-pump (beating heart) surgery. When minimally invasive approaches aren’t  possible, cardiovascular surgeons can perform the most advanced open surgeries, including

• Aortic surgery - Uses minimally invasive approaches to treat conditions that affect the aorta. These can include aortic valve problems, aneurysms and hardening of the arteries. 
• Heart bypass surgery (CABG) - One of the most common types of procedures to help manage blockage of blood to the heart muscle. Surgeons take arteries or veins from other parts of the body to reroute the blood around the clogged artery. This helps restore blood flow to your heart. 
• Heart failure surgery - Can help restore blood flow to the heart and is also used to implant heart devices such as biventricular pacemakers and percutaneous left ventricular assist device (L-VAD).
• Heart rhythm surgery - Uses surgical techniques to treat heart arrhythmias and can include implanted devices and Maze surgery.
• Hybrid surgery - Uses minimally invasive and traditional surgery approaches in a single procedure. There are several different types of hybrid surgery, including ablation (ex-maze procedure), and hybrid revascularization. 
• Minimally invasive surgery - Uses tiny instruments and advanced imaging to perform surgery through small incisions rather than the larger incision used during open surgery. The approach often results in less pain and a quicker recovery. There are several different minimally invasive approaches surgeons use, including aortic valve surgery, atrial fibrillation surgery and mitral valve surgery. 
• Open-heart surgery - Uses a large incision (cut) in your chest to treat conditions affecting your heart muscle, valves or arteries. Open heart surgeries may involve the use of a heart-lung machine, used to take over the pumping of your heart. Off-pump surgery (beating-heart) is a technique where the surgeon performs surgery without stopping and restarting the heart.
• Valve and structural heart surgery - Uses leading-edge techniques such as robotic-assisted approaches to treat problems with heart valves or structural heart problems. These can include mitral valve repair (MitraClip) and transcatheter aortic valve replacement (TAVR).

Expectations from cardiovascular surgery

Most types of cardiovascular surgery are performed in an operating room or lab at a hospital. You will be under general anesthesia (fully asleep) for these procedures. In many cases, surgeons can use minimally invasive techniques to perform cardiovascular surgery. With minimally invasive surgery, you will generally have smaller incisions (cuts) and a shorter downtime following surgery.

Recovery from cardiovascular surgery

You will spend several hours in a post-surgical recovery area for close monitoring while the effects of anesthesia wear off. Depending on the type of surgery you undergo, you may spend some time in the intensive care unit (ICU) or you may go directly to a hospital room recovery room. Your recovery time will vary based on the type of surgery you undergo and your exact situation. Your surgical team will provide details on when you can resume your normal activities, including returning to work or school.

When to seek care

If you think you may need to undergo cardiovascular surgery, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a cardiologist for more specialized treatment.