What cardiac surgery procedures are performed at KRMC?
Kalispell Regional Medical Center's cardiac surgeons are skilled in an extensive range of surgical techniques to help restore and maintain the greatest cardiac health possible:
Coronary artery bypass surgery
Off-pump coronary artery bypass surgery
Apical aortic conduit surgery (for patients who are not candidates for traditional aortic valve surgery)
Valve repair and valve replacement
Complex mitral valve surgery
What is coronary artery bypass surgery?
If you have coronary artery disease, the arteries that supply blood and oxygen to the heart muscle become hardened and narrowed. If lifestyle changes, medicines or interventional procedures such as angioplasty don't help, your doctor may recommend coronary artery bypass surgery.
During the procedure, the cardiovascular surgeon uses a piece of vein to build a new route for blood to flow around the blockage to the heart muscle. The surgeon usually uses a vein from your leg or the internal mammary artery in your chest.
Attaching the vein or artery at the aorta (the main artery at the heart), the surgeon then reroutes the blood supply around the blockage so the heart muscle can start getting blood again. The number of bypasses is determined by the number of blockages where blood has been rerouted, not the number of veins used.
Newer procedures allow off-pump bypasses. These are done without using the traditional heart-lung machine that allows the surgeon to stop the heart from beating while the machine circulates blood through the body. In off-pump procedures, the heart keeps beating while the surgeon stabilizes a particular area of the heart. With that area kept still, the surgeon can bypass the blocked artery in a controlled environment while the rest of the heart keeps pumping.
Off-pump bypass surgery may be ideal for certain patients who are at higher risk for complications. Not all patients are candidates for off-pump bypass surgery. The surgeon determines whether to use the procedure at the time of surgery, when it is possible to examine the heart and arteries closely.
What is apical aortic conduit surgery?
With the enhanced cardiac surgery program at KRMC, patients who once were not candidates for routine aortic valve replacement now have options. Some of those options can be performed in the cardiac catheterization lab, without the need for open-heart surgery.
But for patients whose conditions are best treated surgically, our team of experienced surgeons is skilled at techniques for bypassing – instead of replacing – a diseased aortic valve. This is called apical aortic conduit surgery.
In a normal, healthy heart, blood flows from your left ventricle up through the aortic valve and into the aorta. From there the blood is channeled throughout your body. But if the aortic valve is diseased, blood can't flow properly from your heart into the aorta, and your body is deprived of nourishment from freshly oxygenated blood.
To bypass that diseased valve, the surgeon creates a new hole in the bottom of your heart chamber and attaches a tube – or conduit – to a location on your aorta downstream from the problem valve. That new tube contains a valve that operates in place of your natural aortic valve.
Recovery time for apical aortic conduit surgery is similar to that for other open heart procedures. It offers a good chance for significant relief from your heart symptoms and could prolong your life.
If you have questions about whether this is the right option for you, ask for a consultation with our physicians at Rocky Mountain Heart & Lung.
What is heart valve surgery?
The heart has four valves: tricuspid, pulmonic, mitral and aortic. Each valve has a different role in providing healthy blood circulation to the body. If one valve has reduced function, it can compromise the flow of blood, oxygen and nutrients throughout the body.
Most problems are seen in the mitral and aortic valves. Damage can develop over time, or you can be born with a problem valve.
The most common heart valve problem is mitral valve prolapse. The valve bulges slightly – or prolapses – when it closes, allowing a tiny amount of blood to leak into the heart's upper chamber.
Valves also can develop stenosis, in which scarring or deposits of calcium make the heart muscle work harder to push blood through the constricted opening.
A leaky valve – also called insufficiency – means the valve isn't closing completely, often because it has extra tissue, is loose or shortened, or has a tear. This lets blood leak backward through the valve.
A leaky valve or stenosis usually requires surgery. When valves leak, they often can be repaired instead of replaced.
The heart surgeons at Kalispell Regional Medical Center now use techniques to fix damaged valves using the patient's own valve tissue, markedly reducing complications after surgery. These techniques are sometimes straightforward, but at times they require creativity and a specialized understanding of how the valve should work. Our surgeons have a remarkably successful record of performing very complex repairs.
What if I have more questions?
For more information about cardiovascular care at Kalispell Regional Medical Center, please call Cardiac Surgery at (406) 257-8992.