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Home - System of Care - Surgical Services - Cardiac Surgery

Cardiac Surgery

When patients need cardiac services, they trust St. Joseph's. Since St. Joseph's performed the first open heart surgery in Central New York in1958, and was only the third center in the United States to perform angioplasty, it has continued to lead the way in the prevention, detection and treatment of heart disease.

These successful outcomes are the result of talent and experience. St. Joseph's physicians, nurses and cardiac technicians consistently care for more patients than any other provider in Central New York.

Each year at St. Joseph's:

  • Our cardiac surgeons perform approximately 800 open heart procedures, including 450 coronary artery bypass grafts and 350 valve replacements.
  • Interventional cardiologists perform more than 4,500 cardiac catheterizations and nearly 2,000 percutaneous coronary interventions annually.
  • Electrophysiologists conduct more than 300 electrophysiology case studies, including three-dimensional mappings.
  • Electrophysiologists and surgeons implant approximately 675 cardiac defibrillators and pacemakers.

Our care is recognized by HealthGrades, Excellus and the Society of Cardiovascular Patient Care. For a complete list of our awards and distinctions, click here.

To learn more about our cardiac center of excellence, visit our Cardiac Services page.

Conditions & Relevant Terms

Aneurysm
A bulging, weakened area in the wall of a blood vessel resulting in an abnormal widening or ballooning greater than 50 percent of the vessel's normal diameter.

Angioplasty
Widening of the narrowed or obstructed blood vessel.

Angina
Chest pain or discomfort that can occur if an area of your heart muscle doesn’t get enough oxygen-rich blood.

Aorta
The largest artery in the body.

Arrhythmia
A problem with the rate or rhythm of one’s heartbeat.

Artery
A blood vessel that carries blood from the heart to tissues and organs in the body.

Atherosclerotic Narrowings
A thickening of the artery wall as a result of the accumulation of fatty materials such as cholesterol.

Cardiac Defibrillators
A small, implantable device that is similar to a pacemaker, but slightly larger. Unlike a pacemaker, a defibrillator can deliver two levels of electrical energy: a low energy shock that can convert a beating heart that is in an abnormal rhythm back to a normal heartbeat, and a high energy shock that is delivered only if the arrhythmia is so severe that the heart is only quivering instead of beating.

Cardiopulmonary Bypass Machine
Also referred to as a heart-lung machine, the bypass machine is used in heart surgery when it is necessary to pump blood because the heart is stopped and kept still.

Endoscope
A thin surgical tube with a light and camera on the end.

Pacemaker
A small device that is implanted under the skin (most often in the shoulder area just under the collarbone), which sends electrical signals to start or regulate a slow heartbeat.

Stenotic
The narrowing of an artery.

Valvular Insufficiency
Regurgitation or “flow back” of blood from one ventricle to another in the heart.

Valvular Stenosis
The stiffening of a vein.

Vein
A blood vessel that carries blood to the heart from tissues and organs in the body.

Ventricle
A fluid-filled cavity in the heart or brain.

Procedures

Aortic Coarctation Repair
Aortic coarctation is a condition existing at birth where the aorta, the largest artery in the body, narrows in the area where the ductus arteriosus – the blood vessel connecting the pulmonary artery to the aortic arch –inserts. Treatment is conservative if asymptomatic, but may require surgical removal of the narrow segment where the artery and blood vessel meet if there is high blood pressure. In some cases angioplasty, or widening of the narrowed or obstructed blood vessel, can be performed to dilate the narrowed artery. If the coarctation is left untreated, high blood pressure may become permanent due to irreversible changes in some organs.

Atrial Septal Defect Repairs 
An atrial septal defect is a heart defect existing at birth where there is an opening in the atrial septum – the dividing wall between the two upper chambers of the heart known as the right and left atria. Treatment options include surgical repair or device closure. Additionally, some seek treatment through medical management or infection control.

Coronary Artery Bypass Grafting (CABG)
Coronary artery bypass grafting (CABG), also called heart bypass or bypass surgery, is a surgical procedure performed to relieve angina (chest pain or discomfort that can occur if an area of your heart muscle doesn’t get enough oxygen-rich blood) and reduce the risk of death from coronary artery disease. Arteries or veins from elsewhere in the patient's body are grafted – moved from one part of the body to another – to the coronary arteries to bypass atherosclerotic narrowings (thickening of the artery wall as a result of the accumulation of fatty materials such as cholesterol) and improve the blood supply to the heart muscle. This surgery is usually performed with the heart stopped, necessitating the usage of cardiopulmonary bypass; techniques are available to perform CABG on a beating heart, so-called "off-pump" surgery. There are also many minimally invasive CABG procedures available today.

Click here to listen to a podcast on CABG. 

Coronary Artery Bypass Surgery
Coronary artery bypass surgery is also referred to as coronary artery bypass grafting (CABG). Please see CABG for further information.

Click here to view a video about coronary artery bypass surgery.

Descending Thoracic Aneurysm Repair
A thoracic aortic aneurysm is a bulging, weakened area in the wall of the aorta (the largest artery in the body), resulting in an abnormal widening or ballooning greater than 50 percent of the vessel's normal diameter. The thoracic aorta is located in the chest area and descending indicates it goes downward through the chest. The descending thoracic aorta is the most common location of a thoracic aneurysm.

Repair of a descending thoracic aortic aneurysm is typically surgical. An open repair is made with a large incision, extending from the back under the shoulder blade around the side of the rib cage to just under the breast (thoracotomy). Less invasive options, such as endovascular aneurysm repair (EVAR), which includes the insertion of a stent-graft through a catheter in the groin, may also be an option.

Implantable Cardioverter Defibrillator Insertion/Revision
An implantable cardioverter defibrillator (ICD) insertion is the implantation of an electronic device just below the collarbone used to help regulate electrical problems with the heart. An ICD may be inserted in survivors of sudden cardiac arrest, syncope (fainting) due to ventricular arrhythmia, or some inherited heart conditions.

Minimally Invasive Coronary Artery Bypass Grafting
Many methods of minimally invasive coronary artery bypass grafting (CABG) also referred to as bypass surgery, have been developed today. Off-pump coronary artery bypass (OPCAB) is a technique of performing bypass surgery without the use of cardiopulmonary bypass (the heart-lung machine). Further refinements to OPCAB have resulted in minimally invasive direct coronary artery bypass surgery (MIDCAB), a technique of performing bypass surgery through a mini-thoracotomy (a 2-to-3 inch incision between the ribs), instead of through a traditional median sternotomy (dividing the breastbone). Advances in robotic procedures are also increasingly being used.

Two other surgical improvements for persons undergoing CABG are endoscopic vein harvesting and endoscopic radial artery harvesting, instead of traditional open approaches that involve making long surgical incisions. In both of these procedures surgeons use an endoscope (thin surgical tube with a light and camera on the end) to locate blood vessels that will be used for bypassing the blocked coronary arteries. Veins are generally harvested from the inner thigh and calf areas of the legs, while the radial artery is harvested from the wrist.

Minimally Invasive Mitral and Aortic Valve Replacement and Repair
Minimally-invasive procedures in which the incision is much smaller than a traditional open-heart valve replacement, often mean less pain after surgery and shorter hospital stays. Valvuloplasty, where a catheter is advanced from a blood vessel in the groin through the aorta into the heart to repair or replace the valve, is another method that may be used to treat valve stenosis (stiffening of valves) in some cases.

For more information on traditional valve replacements, click here.

Mitral and Aortic Valve Replacement and Repair
The mitral valve is located between the left atrium and the left ventricle of the heart and the aortic valve is located between the left ventricle and the aorta. When these heart valves require replacement or repair surgery is a treatment option for valvular heart disease. When heart valves become damaged or diseased, they may not function properly. Conditions which may cause heart valve dysfunction are valvular stenosis (stiffening) and valvular insufficiency (regurgitation).

Traditionally, repair or replacement of heart valves has involved open-heart surgery, which means that the chest is opened in the operating room and the heart stopped for a time so that the surgeon may repair or replace the valve(s). In order to open the chest, the breastbone, or sternum, is cut in half and spread apart. Once the heart is exposed, large tubes are inserted into the heart so that the blood can be pumped through the body during the surgery by a cardiopulmonary bypass machine (heart-lung machine). The bypass machine is necessary to pump blood because the heart is stopped and kept still while the surgeon performs the valve repair or replacement procedure.

Newer, less invasive techniques have been developed to replace or repair heart valves. Minimally-invasive procedures in which the incision is much smaller often mean less pain postoperatively and shorter hospital stays. Valvuloplasty is another method that may be used to treat valve stenosis (stiffening of veins) in some cases.

Off-Pump Bypass Surgery
Off-pump coronary artery bypass or "beating heart" surgery is a form of coronary artery bypass graft (CABG) surgery performed without cardiopulmonary bypass (heart-lung machine) as a treatment for coronary heart disease. During most bypass surgeries, the heart is stopped and a heart-lung machine takes over the work of the heart and lungs. When a cardiac surgeon chooses to perform the CABG procedure off-pump, also known as off-pump coronary artery bypass (OPCAB), the heart is still beating while the graft attachments are made to bypass a blockage.

Pacemaker Insertion/Revision
A pacemaker insertion is the implantation of a small electronic device in the chest (just below the collarbone) to help regulate electrical problems with the heart. A pacemaker may be inserted in order to provide stimulation for a faster heart rate when the heart is beating too slowly, and when other treatment methods, such as medication, have not improved the heart rate.

Percutaneous Coronary Interventions
Percutaneous coronary intervention (PCI),also referred to as percutaneous transluminal coronary angioplasty (PTCA), coronary angioplasty or simply angioplasty, is one therapeutic procedure used to treat the stenotic (narrowed) coronary arteries of the heart found in coronary heart disease. It is performed to open blocked coronary arteries and to restore blood flow to the heart tissue without open-heart surgery. A special catheter (long hollow tube) is inserted into the coronary artery to be treated. This catheter has a tiny balloon at its tip. The balloon is inflated once the catheter has been placed into the narrowed area of the coronary artery. The inflation of the balloon compresses the fatty tissue in the artery and makes a larger opening inside the artery for improved blood flow.

For an animation of PTCA, click here.

Pericardectomy
Pericardiectomy is the surgical removal of part or most of the pericardium, the thin sac (membrane) that surrounds the heart. This operation is most commonly done to relieve constrictive pericarditis, or to remove a pericardium that is calcified and fibrous.

Radiofrequency Ablation
Also known as a catheter ablation or cardiac ablation, radiofrequency ablation is a treatment for heart arrhythmia – a problem with the rate or rhythm of one’s heartbeat. The procedure guides a catheter into the heart to destroy small areas of heart tissue with electrodes that emit radio energy that may be causing the abnormal heartbeat

Transcatheter Aortic Valve Replacement (TAVR)
The transcatheter aortic valve replacement (TAVR) procedure is an alternative to open heart valve replacement surgery. For those with aortic valve stenosis – when the aortic valve tightens or narrows, preventing blood from flowing through normally – but are too sick or weak for traditional surgery, TAVR can be an option. The less invasive procedure is done by squeezing the valve into a balloon and inserting it with a catheter, which is sent to the heart for implantation. This insertion is typically done through the groin or a small incision in the chest over the heart. Once the valve is in the right place, the balloon is inflated and the valve precisely positioned.

Tricuspid Valve Replacement and Repair
The tricuspid valve is located between the right atrium and the right ventricle in the heart. When heart valves become damaged or diseased, they may not function properly. Conditions which may cause heart valve dysfunction are valvular stenosis (stiffening) and valvular insufficiency (regurgitation). Heart valve replacement or repair  surgery is a treatment option for these valvular heart diseases.

Traditionally, repair or replacement of heart valves has involved open-heart surgery, which means that the chest is opened in the operating room and the heart stopped for a time so that the surgeon may repair or replace the valve(s). In order to open the chest, the breastbone, or sternum, is cut in half and spread apart. Once the heart is exposed, large tubes are inserted into the heart so that the blood can be pumped through the body during the surgery by a cardiopulmonary bypass machine (heart-lung machine). The bypass machine is necessary to pump blood because the heart is stopped and kept still while the surgeon performs the valve repair or replacement procedure.

Newer, less invasive techniques have been developed to replace or repair heart valves. Minimally-invasive procedures in which the incision is much smaller often mean less pain after surgery and shorter hospital stays. Valvuloplasty is another method that may be used to treat valve stenosis in some cases.

Ventricular Aneurysmectomy
A ventricular aneurysmectomy is a surgical procedure performed to repair an aneurysm (a bulging, weakened area in the wall of a blood vessel resulting in an abnormal widening or ballooning greater than 50 percent of the vessel's normal diameter) in the ventricle (a fluid filled cavity in the heart). Ventricular aneurysms are one of the many complications that may occur after a heart attack. They usually arise from a patch of weakened tissue in a ventricular wall, which swells into a bubble filled with blood. This, in turn, may block the passageways leading out of the heart, leading to severely constricted blood flow to the body.

Ventricular Septal Defect Repairs 
A ventricular septal defect is a heart defect existing at birth where there is an opening in the ventricular septum – the dividing wall between the two lower chambers of the heart known as the right and left ventricles. Treatment options include surgical repair or interventional cardiac catheterization. Additionally, some seek treatment through medical management, nutrition or infection control.

Resources

Do you know the signs and symptoms of a heart attack?
Heart Attack Warning Signs
Women and Heart Attacks