Cardiothoracic Surgery

Cardiothoracic surgery treats conditions in the heart, lungs, and chest. Our surgeons perform a variety of cardiothoracic surgeries, from minimally invasive to heart transplants.

A few common cardiothoracic surgeries and procedures include:

• Angioplasty. Percutaneous transluminal coronary angioplasty (PTCA, or balloon angioplasty) helps restore a healthy blood flow to the heart by reopening arteries that are narrowed by fatty plaque.
• Stent placement. A stent is a small metal coil or tube that is placed in a narrowed artery to hold it open. To place the stent, your healthcare provider first performs angioplasty or atherectomy to compress or cut away plaque buildup in the artery.
• Ablation. Ablation is a technique typically used to treat abnormal heart rates and rhythms (arrhythmias). It involves ablating (destroying) a very small, targeted area of the heart muscle.
• Pacemakers and implantable cardioverter defibrillators (ICDs). To correct abnormal heart rhythms (arrhythmias) and help your heart beat more efficiently, your doctor may recommend a device implant. The most common device implants are pacemakers and implantable cardioverter defibrillators (ICDs).
• Open heart surgery. Most often, open heart surgeries treat blockages in the coronary arteries or correct problems with the heart valves. Open heart procedures can also repair heart defects and help correct heart rhythm problems.
• Coronary artery bypass grafting (CABG). Coronary artery bypass grafting (CABG, often pronounced “cabbage”) is one of the most commonly performed open heart surgeries. In this procedure, a vein from your leg — or an artery from your chest wall or arm — is used to bypass a coronary artery that is narrowed or blocked by fatty plaque buildup.
• Heart valve repair or replacement. If your heart valves have been damaged or diseased, they may fail to open and close correctly. This puts extra strain on your heart muscle. In this case, your healthcare providers may recommend open heart surgery to repair or replace your heart valve(s).
• Ventricular assist devices. A ventricular assist device is an implantable heart pump that is used to treat heart failure.
• Heart transplant. A heart transplant replaces a severely diseased or malformed heart with a new heart from a human organ donor. This procedure is considered for late-stage heart failure after other attempts have failed.
• Carotid surgery. The name carotid endarterectomy is a mouthful, but it is a relatively simple surgery that removes plaque in one of your carotid arteries (the main arteries in your neck that supply blood to the brain).

Any surgery has risks. Risks and potential complications of cardiothoracic surgeries include:

• Severe reaction to the anesthesia used during surgery
• Bleeding or infection at the surgery site
• Blood clots or bleeding in the brain
• Stroke, seizures, or brain damage (rare)
• Heart attack
• Injury to nerves, esophagus, or trachea (windpipe), which can lead to hoarseness or swallowing difficulty
• Plaque building up in the arteries

Cardiothoracic surgeries can help to open up coronary arteries narrowed by fatty plaque buildup, repair weakened heart muscle or defects, or correct heart rhythm problems.

Your surgical team will follow a plan tailored to your health needs and the type of surgery you’re having. Here are a few elements common to heart surgeries:

• Keeping you asleep and pain-free. An anesthesiologist administers special medication to keep you asleep and free of pain during your surgery.
• Keeping your airways open. An endotracheal tube (ET) is inserted into your throat and windpipe and connected to a breathing machine (ventilator). The ventilator “breathes” for you while you’re asleep. The ET tube may also stay in place for several hours after surgery to ensure that you’re breathing well.
• Reaching your heart. To get to your heart, your surgeon makes an incision (cut) down the middle of your chest and separates your breastbone (sternum). After surgery, your surgeon rejoins your breastbone with wires or heavy sutures, then sews up the incision.
• Keeping your blood circulating. For open heart surgeries, the heart is stopped during surgery and restarted when the procedure is completed. This requires the use of a heart-lung bypass machine (a pump) to take over the work of the heart and lungs during surgery. However, some heart surgeries can now be performed on a beating heart. In such cases, the procedure is performed “off-pump” — without the use of a heart-lung machine.

• You will be taken to an intensive care unit where healthcare providers will check on your blood pressure, breathing, wound, and how alert you are.
• You may have a temporary tube that drains fluid or blood from the incision.
• You will likely stay in the hospital several days.

• Follow your doctor’s advice to manage pain. Your neck may be sore, and it may be hard to swallow. Your doctor will prescribe medicine for pain. Eating softer foods can help.
• Take all medicines as directed by your doctor. This may include an antiplatelet [an-tahy-PLEYT-lit] medicine (that helps prevent blood clots).
• Limit swelling and pain. For the first week, For the first week, keep your head propped up on pillows when you are lying down to limit swelling.
• Don’t drive until your doctor says it’s okay.
• Limit strenuous activity for a few weeks. Don’t lift heavy objects, and don’t do any strenuous exercise until your doctor says it’s okay. You can go back to work and normal activities when your doctor says it’s okay.
• Watch for symptoms. Pay attention to certain changes in how you feel, especially neck swelling or a headache on the side where the procedure was done. Let your doctor know if you notice any of the symptoms listed below.
• If you’ve had a stroke, you’ll have additional treatment such as medicines or stroke rehab. Ask your doctor or nurse for a copy of Intermountain’s guide titled Life after Stroke or TIA to learn more.

• Heart Care Handbook