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beating heart surgery

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beating heart surgery

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Beating heart or “off pump” coronary artery surgery is the latest revolution in the management coronary disease. It is being embraced world-wide by increasing numbers of surgeons. Many of the advantages are subtle but reduced mortality, stroke, and bleeding as well as earlier discharge are well-established benefits. A cardiac stabiliser is mandatory for this surgery, most are single use only and very expensive, this one is multiple use and is saving many healthcare dollars.

Beating-heart surgery is a way to perform surgery without stopping the heart. 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.

Surgery on a stopped heart is common, and some heart procedures can only be performed on a motionless heart. Physicians use a special solution called cardioplegia to stop the heart.

If the heart is stopped for surgery, the surgeon must restart it and reintroduce blood into the tissue. This is called reperfusion. Reperfusion can cause impairment of heart function. Sometimes, heart muscle tissue can be damaged at the cellular level during reperfusion, a phenomenon known as reperfusion injury. In some people, reperfusion injury can lead to complications such as arrhythmias and heart attacks. Reperfusion injury is especially a 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.

Reperfusion injury can be avoided if the heart is kept beating during surgery.

At the University of Chicago Medical Center, our cardiac surgeons opt to perform beating-heart surgery whenever possible. More than 90 percent of coronary artery bypass surgeries performed here are done on a beating heart.

While not all procedures can be performed on a beating heart, our surgeons have developed many techniques that make beating-heart surgery an option for even complex procedures on the inside of the heart–including valve repair. In fact, our surgeons were among the first in the world to perform beating-heart mitral valve surgery. The University of Chicago Medical Center is one of the only hospitals in the nation where beating-heart surgery is being performed to treat valve disease.

Some of the procedures performed on a beating heart include:

Coronary artery bypass graft surgery (including ThoraCAB, a minimally invasive option performed without cutting the breastbone, as well as open-chest, beating-heart bypass)

Surgery for atrial fibrillation

Treatment of some congenital heart defects, such as closure of atrial septal defect

Valve repair (mitral, pulmonary, or tricuspid)

Valve replacement (mitral or tricuspid)

Ventricular reconstruction

Conventional On Pump Coronary Artery Bypass Surgery

More than 70%² of all bypass surgeries are performed on a stopped heart. Unlike beating heart surgery, during conventional on pump heart bypass, medication is used to stop your heart.

A heart-lung machine takes over the function of your heart and lungs during the surgery.The heart-lung machine is also called a cardiopulmonary bypass machine. It has a pump to function as the heart and a membrane oxygenator to function as the lungs.

Heart-Lung Machine

This mechanical “heart and lungs” keeps oxygen rich blood circulating throughout your body. The heart-lung machine collects the blood. Carbon dioxide and other waste products are removed. The oxygenator adds oxygen, and the oxygenator’s heat exchanger warms (or cools) the blood. The blood is gently circulated back through the body. This process is called perfusion. The person who operates the heart-lung machine is the perfusionist.

Stopping Your Heart

Your heart will usually be stopped for about 30-90 minutes of the 3-6 hour surgery. The heart-lung machine makes it possible for the surgeon to work on a still heart. This technique has been used for many years with excellent results. Once the surgery is over, the surgeon and perfusionist restart your heart.

Medtronic Perfusion Systems

Medtronic creates the dependable perfusion systems that make on pump surgery possible. We are committed to providing doctors, hospitals, and patients with reliable, technically advanced equipment.

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100 Life Saving Health Food Tips

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100 Life Saving Health Food Tips

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Health food is a term that has been used in the United States since the 1920s and refers to specific foods claimed to be especially beneficial to health.

In contrast to a regular healthy diet, proponents of health foods claim that particular foods have specific favorable effects on health. Examples of health foods include alfalfa sprouts, wheat germ and yogurt. Natural foods and organic food are related categories. Health foods are sold in health food stores or in the health/organic section of supermarkets.

The term is often used for foods that are low in fat and/or sugar, since overconsumption of fatty and sugary foods is seen as contributing to the obesity epidemic.

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Brain Tumor Surgery

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Brain Tumor Surgery

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A brain tumor is an abnormal growth of cells within the brain or inside the skull, which can be cancerous or non-cancerous (benign).

It is defined as any intracranial tumor created by abnormal and uncontrolled cell division, normally either in the brain itself (neurons, glial cells (astrocytes, oligodendrocytes, ependymal cells), lymphatic tissue, blood vessels), in the cranial nerves (myelin-producing Schwann cells), in the brain envelopes (meninges), skull, pituitary and pineal gland, or spread from cancers primarily located in other organs (metastatic tumors).

Primary (true) brain tumors are commonly located in the posterior cranial fossa in children and in the anterior two-thirds of the cerebral hemispheres in adults, although they can affect any part of the brain.

Signs and symptoms

Symptoms of brain tumors may depend on two factors: tumor size (volume) and tumor location. The time point of symptom onset in the course of disease correlates in many cases with the nature of the tumor (“benign”, i.e. slow-growing/late symptom onset, or malignant, fast growing/early symptom onset) is a frequent reason for seeking medical attention in brain tumor cases.

Large tumors or tumors with extensive perifocal swelling edema inevitably lead to elevated intracranial pressure (intracranial hypertension), which translates clinically into headaches, vomiting (sometimes without nausea), altered state of consciousness (somnolence, coma), dilatation of the pupil on the side of the lesion (anisocoria), papilledema (prominent optic disc at the funduscopic examination). However, even small tumors obstructing the passage of cerebrospinal fluid (CSF) may cause early signs of increased intracranial pressure. Increased intracranial pressure may result in herniation (i.e. displacement) of certain parts of the brain, such as the cerebellar tonsils or the temporal uncus, resulting in lethal brainstem compression. In young children, elevated intracranial pressure may cause an increase in the diameter of the skull and bulging of the fontanelles.

A bilateral temporal visual field defect (bitemporal hemianopia—due to compression of the optic chiasm), often associated with endocrine disfunction—either hypopituitarism or hyperproduction of pituitary hormones and hyperprolactinemia is suggestive of a pituitary tumor.

Treatment and prognosis

Many meningiomas, with the exception of some tumors located at the skull base, can be successfully removed surgically. In more difficult cases, stereotactic radiosurgery, such as Gamma knife, Cyberknife or Novalis Tx radiosurgery, remains a viable option^.

Most pituitary adenomas can be removed surgically, often using a minimally invasive approach through the nasal cavity and skull base (trans-nasal, trans-sphenoidal approach). Large pituitary adenomas require a craniotomy (opening of the skull) for their removal. Radiotherapy, including stereotactic approaches, is reserved for the inoperable cases.

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