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Adult Cardiac Surgery
Studies show the quality of a cardiac surgery program often depends on the number of procedures performed, and our program is home to the state's most highly skilled surgeons. Performing leading edge procedures, they are at the forefront of cardiac surgery on a national level.
Minimally Invasive Cardiac Surgery
Constant refinement and research has made open-chest heart surgery, using the heart-lung machine, highly safe and effective. Nevertheless, standard heart surgery typically requires exposure of the heart and its vessels through median sternotomy (splitting the breastbone); considered one of the most invasive and traumatic aspects of open-chest surgery.
In specific cases, minimally invasive open heart surgery techniques allow the surgeon to perform heart surgery through smaller incisions. These techniques can allow for a quicker recovery, meaning shorter hospital stays and a quicker return to the patient's previous lifestyle. In addition, there may be less postoperative pain, decreased need for transfusions and a lower risk of wound infections. The smaller incision also leads to a more acceptable cosmetic result.
At Alaska Regional, minimally invasive cardiac surgery can be used to treat:
- Atrial septal defects (ASDs)
- Mitral valve repair and mitral valve replacement
- Aortic valve replacement
Off Pump / Beating-Heart Surgery
Traditionally, open heart surgery required the heart to be motionless. The heart is stopped using a special chemical solution and then must be started again once procedure is completed. The process of restarting the heart and reintroducing blood to the heart tissue is called reperfusion. Occasionally, heart muscle tissue can be damaged at the cellular level during reperfusion and may lead to complications such as arrhythmias and heart attacks.
Reperfusion injury can be avoided if the heart is kept beating during surgery. Surgeons use a special device to stabilize the part of the heart on which they are operating. The heart continues to beat and circulate blood to heart muscle during the operation. Surgery on a beating-heart helps reduce the risk for complications associated with temporarily stopping the heart during surgery.
Beating-heart surgery is technically demanding, requiring specialized skills and training. At Alaska Regional Hospital, our highly skilled surgeons are able to perform over 40% of all heart surgeries using the beating heart technique.
High Risk and Complex Cardiac Surgery
Heart surgery is of particular concern in high-risk patients, such as the elderly, people who have had several heart surgeries, patients with severe blockages, and those with complex health problems. The heart care team at Alaska Regional has the advanced capabilities to meet the unique needs of this patient population.
Healing the Heart
Our program offers comprehensive, state-of-the-art surgical therapy for adult cardiac diseases of the chest including:
Coronary artery bypass grafting
Complications of myocardial infarction
Aortic valve stenosis, mitral valve stenosis, or tricuspid valve stenosis
Valve insufficiency of the aortic valve, mitral valve or tricuspid valve
Infections of the aortic valve, the mitral valve or the tricuspid valve
Aortic dissections--all types, including thoracic aortic aneurysms
Arrhythmias such as atrial fibrillation
Congenital heart defect repair in adults including ventricular septal defect (VSD) and atrial septal defect (ASD)
Prior to Your Procedure
Our Cardiac Surgery Coordinator is here to ease your way.
Your surgeon’s office will work with you to make the arrangements to have your preoperative workup done a few days before surgery. Whenever possible you will be scheduled with Alaska Regional’s Cardiac Surgery Coordinator. The nurse coordinator will help you navigate the pre-operative process efficiently. You and your family will receive preoperative teaching, a tour of the Critical Care Unit and have the opportunity to have all your questions answered. Knowing what to expect during your hospital stay can reduce the fear of the unknown.
In the days leading up to your surgery:
- Talk to your doctor about what medications you are taking. You may have to stop taking certain medications before your surgery.
- The night before, eat a light meal and do not eat or drink anything after midnight.
- Arrange for a ride to and from the hospital.
- Arrange for help at home after returning from the hospital
An anesthesiologist will see you before surgery to complete their assessment. The preoperative medications ordered by anesthesia will make you groggy while you are prepped for surgery. You will also receive an antibiotic to reduce your risk of infection. Once you are taken to the operating room, you will be put fully sedated using medications given through your IV. After you are asleep, a breathing tube is inserted through your mouth (or nose) and the operation begins.
Open heart surgery procedures vary greatly in duration based on several factors. Your surgeon will provide you and your family with an estimated time for your specific procedure. At your request, our Cardiac Surgery Coordinator will keep your family informed as the procedure progresses and notify them when surgery is completed and you have been transferred to the Critical Care Unit.
The First Day AfterSurgery
- You will be taught deep breathing and coughing exercises. After surgery it may hurt to cough but it is extremely important. When you do not breathe deeply, secretions can build up in your lungs which increase your risk of pneumonia.
- You will be assisted to get up out of bed for the first time.
- You will be helped to change positions in bed frequently to relieve pressure areas
- You will typically start consuming clear liquids and progress to solid foods as tolerated
- Most of your lines will be removed
The Second Day After Surgery
- As your appetite returns, you will eat more solid foods
- If the Foley catheter hasn’t already been removed, it will be
- You will likely be sore and uncomfortable. It is important to let your physician and nurse know so that you can receive pain medication. The more comfortable you are the easier it is to your breathing exercises and to increase your mobility
- You should be up in hall walking 3-4x per day and sitting up in a chair for meals.
- You will usually be transferred to our cardiovascular services unit.
- Phlebitis (blood clots in a vein)
- High or low blood pressure
- Excessive bleeding
- Neurological deficits
- Stroke (rare)
- Kidney dysfunction
- Irregular heart rate
- Death (extremely rare)
Average Hospital Stay
You will probably be ready to leave the hospital five to six days after your surgery. The remainder of your recovery will take you about 6 weeks.
- Schedule follow up visit with heart surgeon for 2 weeks after discharge from hospital
- Schedule visit with family physician, internist or cardiologist for after appointment with surgeon
- Shower daily and gently wash incision site with soap and water. No creams or lotions. No baths for at least two weeks.
- Inspect you incision site daily for any increase in redness, tenderness, swelling or for the presence of pus-like discharge which may indicate infection.
- Unless you are instructed otherwise, you should begin your walking program when you get home. Try to walk 10 minutes in the morning and ten minutes at night, slowly increasing your distance. Get enrolled in a local cardiac rehab program right away. Postpone other physical activities for 6 weeks.
- Typically, you can plan to return to work 6 weeks after surgery, depending on your occupation.
- The breast bone requires approximately 8 weeks to heal.
- Do not lift objects greater than 10 pounds for 6 weeks after surgery.
- Do not drive for 4 weeks. Avoid extended car trips for 6 weeks.
- Talk to your provider for advice on when it is safe to resume sexual activity.
- Walking should be done on a relatively flat surface for the first 6 weeks.
- If angina occurs during physical activity, take your nitroglycerin.
- The body requires more sleep during the healing process. Take brief rest during the day and plan on 8-10 hours of sleep during the first 6 weeks
- Avoid strenuous household activities such as vacuuming, scrubbing floors, gardening, raking and mowing for 6 weeks.
- Avoid any activities that cause incisional discomfort or pain.
Modifying your Risk Factors
- Quit Smoking
- Control high blood pressure
- Control cholesterol and diet
- Control diabetes
- Manage your weight
- Reduce stress
- Increase exercise under physician’s supervision
Caring and Compassionate Expertise
Our dedicated cardiac professionals, exclusive technologies and team approach to heart care assure superior treatment, steady recovery and a healthy return to daily life. If you'd like more information, please call (907) 264-2911.