It is entirely appropriate to ask your surgeon about his or her experience and results with the type of surgery proposed. For instance, all coronary bypass operations done in California must be reported to the state and are published in an annual report. Many hospitals also report their outcomes to the Society of Thoracic Surgeons and know how they compare to other programs in the nation.
It is also important to consider the types of patients who are treated surgically, and to know how you will be cared for after the surgery. Most surgeons should be comfortable discussing these questions with a patient considering heart surgery.
Patients with atrial fibrillation (AF), a condition that causes irregular, rapid heartbeats, over time are at greatly increased risk of stroke. Many AF patients can be managed with medications and anticoagulation, sometimes known as "blood thinning." If medications fail to control the symptoms or are not well tolerated, other options can be considered.
At the UC Irvine Health Cardiovascular Center, these patients are evaluated by cardiologists and surgeons. If a patient is a good candidate for a catheter approach, this may be used effectively. Surgical intervention is more invasive and also more effective. AF patients who require heart surgery for other reasons should have their atrial fibrillation addressed at the same time.
Many patients with coronary artery disease are appropriately managed with medical therapy alone. However, some patients require intervention to decrease the risk of a heart attack, improve symptoms and to live longer. In these cases, all patients should discuss the best form of therapy with their physicians.
Cardiologists can effectively place stents in coronary arteries to improve blood flow to the heart through percutaneous angioplasty (PCI). This is good treatment for certain patients. Yet some patients may face the return of symptoms, long-term medications and additional interventions. PCI has risks as well.
Many studies comparing PCI with coronary bypass surgery (CABG) have shown that over time, patients can do better with surgery, including many diabetics as well as patients with complex blockages, multiple diseased blood vessel disease or already damaged hearts. Patients should fully inform themselves of all options, as well as the long-term risks and benefits of each, before selecting PCI or CABG.
Optimal treatment decisions are best made by a heart team consisting of a cardiologist and surgeon, who work together with a patient to help make the best decisions for interventional care.
Mitral valve repair, when compared with a valve replacement, allows the patient to preserve his or her native valve tissue. In many cases, this affords improved heart function with less risk of infection, blood clots and stroke.
In some situations, it is necessary to replace the native valve with an artificial valve—either a mechanical valve that requires life-long anticoagulation medication or a tissue valve, which may eventually need replacement because they are not as durable as a mechanical valve. Both have a low, but persistent risk of infection, among other possible complications.
At UC Irvine Health, we repair almost all leaking mitral valves requiring surgical intervention.
Recovery time varies from person to person, depending on the procedure performed and overall physical health. At UC Irvine Health, most patients leave the hospital five days after surgery. However, the chest still needs time to heal and patients may find their overall energy level to be below normal for a while.
Patients may need the help of family and friends when they first arrive home but they should be able to return to their usual activities within four to six weeks.
Questions? Please contact our cardiothoracic surgery team at 714-456-3634.