THE CARDIAC PROCEDURES

These procedures play crucial roles in diagnosing, treating, and managing various cardiac
conditions, contributing to improved heart health and overall well-being.

Angioplasty:

A procedure used to widen narrowed or blocked arteries by inserting a balloon-tipped catheter to inflate
and push aside the plaque.

Purpose: To improve blood flow to the heart muscle.

Coronary Artery Bypass Grafting (CABG):

This is a surgical procedure where a blood vessel graft is used to bypass a blocked coronary artery,
allowing blood to flow around the blockage. It is the most common type of heart surgery — the surgeon
takes a healthy artery or vein from elsewhere in your body and connects it to supply blood past the
blocked coronary artery. The grafted artery or vein bypasses the blocked portion of the coronary artery,
creating a new path for blood to flow to the heart muscle. Often, this is done for more than one
coronary artery during the same surgery. CABG is sometimes referred to as heart bypass or coronary
artery bypass surgery.

Purpose: To restore blood flow to the heart muscle.

Cardiac Catheterization:

A diagnostic procedure involving the insertion of a catheter into the heart chambers or coronary arteries
to measure pressures, take samples, or inject contrast dye for imaging.

Purpose: To assess heart function, identify blockages, or evaluate valve abnormalities.

Pacemaker Implantation:

This is a surgical placement of a small device under the skin, usually in the chest, that helps control
abnormal heart rhythms by sending electrical impulses to the heart.

Purpose: To regulate heart rate and rhythm.

Ablation Therapy:

Involves using heat or cold energy to destroy a scar tissue in the heart that is causing abnormal electrical
signals.

Purpose: To correct arrhythmias or irregular heartbeats.

Heart Valve Repair or Replacement:

Surgical procedure to either repair a damaged heart valve or replace it with a mechanical or biological
valve. Surgeons either repair the valve or replace it with an artificial valve or with a biological valve
made from pig, cow, or human heart tissue. One repair option is to insert a catheter through a large
blood vessel, guide it to the heart, and inflate and deflate a small balloon at the tip of the catheter to
widen a narrow valve.

Purpose: To restore proper blood flow and prevent leakage.

Implantable Cardioverter Defibrillator (ICD) Placement:

This is a device implanted under the skin that monitors heart rhythm and delivers electric shocks to
restore normal rhythm in case of a life-threatening arrhythmia. ICD Medicine is usually the first
treatment option for arrhythmia, a condition in which the heart beats too fast, too slow or with an
irregular rhythm. If medication does not work, a surgeon may implant a pacemaker under the skin of the
chest or abdomen, with wires that connect it to the heart chambers. The device uses electrical pulses to
control the heart rhythm when a sensor detects that it is abnormal. An ICD works similarly, but it sends
an electric shock to restore a normal rhythm when it detects a dangerous arrhythmia.

Purpose: To prevent sudden cardiac death.

Transcatheter Aortic Valve Replacement (TAVR):

Minimally invasive procedure to replace a narrowed aortic valve using a catheter-guided artificial valve.

Purpose: To treat aortic stenosis without open-heart surgery.

Electrophysiology Study (EPS):

Invasive procedure where electrodes are placed inside the heart to study its electrical activity and
identify abnormal rhythms.

Purpose: Diagnose and locate the source of arrhythmias.

Ventricular Assist Device (VAD) Implantation:

Surgically implanted mechanical pump that helps the heart pump blood in cases of severe heart failure.

Purpose: To support heart function and blood circulation.

Cardiopulmonary Bypass (CPB):

A technique used during open-heart surgery where a machine temporarily takes over the heart's
pumping function and oxygenation of blood.
Purpose: To facilitate surgery by maintaining blood circulation and oxygen supply.

Myocardial Biopsy:

Removal of a small piece of heart tissue for examination, typically to diagnose inflammation or infection.

Purpose: To obtain diagnostic information about heart muscle conditions.

Heart Transplantation:

Surgical replacement of a diseased or failing heart with a healthy donor heart.

Purpose: To treat end-stage heart failure when other treatments are not effective.

Maze surgery.

The surgeon creates a pattern of scar tissue within the upper chambers of the heart to redirect electrical
signals along a controlled path to the lower heart chambers. The surgery blocks the stray electrical
signals that cause atrial fibrillation — the most common type of serious arrhythmia.

Transcatheter structural heart surgery.

This involves guiding a long, thin, flexible tube called a catheter to your heart through blood vessels that
can be accessed from the groin, thigh, abdomen, chest, neck, or collarbone. A small incision is necessary.
This type of surgery includes transcatheter aortic valve implantation to replace a faulty aortic valve with
a valve made from animal tissue, MitraClip placement for mitral valve abnormalities, and for
nonvalvular atrial fibrillation patients.

Septal Myectomy:

Surgical removal of part of the septum (wall) between the heart chambers to relieve obstruction in
hypertrophic cardiomyopathy.

Purpose: Improve blood flow and reduce symptoms.

Intra-aortic Balloon Pump (IABP) Insertion:

Insertion of a balloon-tipped catheter into the aorta to provide temporary mechanical circulatory
support.

Purpose: To assist the heart in pumping blood, especially during acute cardiac conditions.

Aneurysm repair.

A weak section of the artery or heart wall is replaced with a patch or graft to repair a balloon-like bulge
in the artery or wall of the heart muscle.

Endocardiography (ultrasound cardiography)

It's used to visualize and assess cardiac function, structure and hemodynamic abnormalities

Transesophageal Endocardiography

An ultrasound transmitter located at the end of a catheter is passed through the oesophagus to the
stomach where flexion of the tip permits imaging of the heart through the stomach wall and the
diaphragm, thus allowing clearer and more accurate diagnostic evaluation. Its more particularly useful in
evaluating vulvar disease

Doppler ultrasound

Can be used to evaluate arterial and peripheral venous patency as well as valvular competency

ECG

The 12 lead ECG is standard for the evaluation of a myocardial ischemia. Electrical activity is generated
by the cells of the heart as ions are exchanged across cells

Phlebography

X ray visualization of the vascular tree after the injection of a contrast medium to detect venous
occlusion

Thread mill stress testing

The patient walks a Thread mill or rides a stationary bicycle until reaching a target heart rate
typicallyv70%-80% of the maximum predicted heart rate. This test has 70%sensitivity and specificity
among the general population

RISKS ASSOCIATED WITH HEART SURGERIES

Most heart surgeries are major surgeries. Although often successful, they do entail risks. The National
Heart, Lung, and Blood Institute identifies some of these risks as:

Bleeding

Infection

Reactions to anesthesia

Damage to tissues in the heart, kidneys, liver, and lungs

Stroke

Death, especially for someone who is already very sick before surgery .

MANAGEMENT OF PAIN
Opioids are used when necessary, but there are many other pain management options, including:

Nerve blocks

Nonsteroidal anti-inflammatory drugs

Acetaminophen

Lidocaine infusion

The risk is higher if you have other diseases or conditions, such as diabetes, peripheral artery disease, or
kidney or lung disease.