Operating With A Sense Of Urgency
This column is the second in a series aimed at raising awareness on heart health during February, which is National Heart Month.
I want to help you have a change of heart.
As a cardiothoracic surgeon, I operate on the heart, lungs and related areas of the chest, to help restore function and quality of life to people who are often seriously – even critically – ill. We use the term “heartbroken” in matters of love. That happens with your physical health too, when your heart is in need of repair.
The good news is that modern medicine and surgical techniques offer you better outcomes than ever before.
Health Is The Heart Of The Matter
At the same time your heart is keeping you going, it’s also watching out for itself. The main line for blood out of the heart to the body is the aorta. Branching directly off it are the left and right coronary arteries, which feed right back and provide the constant supply of blood the heart needs to do its job.
As my colleague Dr. Lior Shamai said in last week’s column, when that flow becomes obstructed it can cause problems. In the most severe cases, the result is a heart attack, which can be life-changing and even deadly. To prevent that, sometimes it’s necessary to surgically restore the flow of blood. That’s what I do when I perform a coronary artery bypass graft.
Think of the blood vessels that cover your heart like roads. When you are driving and find your route is blocked, what do you do? You take a detour and go around. Heart bypass uses the same principle, using a surgically created “detour” to restore blood flow.
In 1960, the first coronary artery bypass graft (we call them CABG – pronounced “cabbage” – or just bypass, for short) was performed. Since then, bypass surgery has advanced by leaps and bounds, becoming one of the safest and most common heart surgeries available.
Cut Less, Heal More
One of the biggest changes to bypass surgery is the technique. It used to be far more common to perform bypass surgery by doing a large incision in the patient’s chest and then directly accessing the heart. It’s an effective method, and we still use it. But modern medicine is always looking for ways to get the better outcomes with less-invasive methods.
Today, that means we try to do bypass surgeries through smaller incisions, and even with the use of technology that almost seems futuristic. Using open surgical methods, we make a larger incision and have to “crack” the patient’s breastbone to access the heart. Minimally invasive and robotic methods try to go in between the ribs, which is much gentler on the patient, leading to an easier recovery. Open surgery typically has a recovery time measured in weeks. Minimally invasive and robotic methods cut that down to days.
We also have options when it comes to the way we operate on the heart itself. During bypass surgery, we can use a heart/lung machine to take over and keep blood flowing while we keep the heart still for the surgery. We can also do the surgery while the heart keeps doing its job, which we call a “warm heart” technique. Each of these methods has advantages, depending on the patient’s needs.
We also have seen improvements in the types of anesthesia used for these surgeries. In years past, our medicine options sometimes had negative side effects on the heart. Today, those drugs have been replaced with others that do the same job even better, and with fewer risks and side effects.
Back To Life
Why do we do bypass surgery? Because we want to help you return to being happy and healthy and living the life that you want. To make that a reality, we work with patients after their surgery to help get up and about much sooner, offering the services of facilities like the Healthpark, Heart and Lung Rehabilitation, and more.
In years past, we thought patients who underwent bypass needed to rest. Today, we know that patients benefit from being active sooner because it lowers their risk of complications such as blood clots. Patients also benefit because physical activity promotes heart health, even after a bypass surgery.
One of the most important factors in a patient’s recovery is the support they have along the way. That’s why keeping patients close to home throughout their treatment, near their family, friends and loved ones, is so important. I’m also especially proud of the fact that Owensboro Health has cardiac outcomes that meet or exceed the national averages, which means you don’t have to travel to get excellent heart care.
If you have questions about your heart health and the options available to you, it’s important to talk to a doctor sooner rather than later. We want to give you every advantage possible as we try to get you back to living your life.
Dr. Doug Adams is a board certified cardiothoracic surgeon with Owensboro Health’s One Health medical group. For more information or to request an appointment wtih Dr. Adams, call 844-44-MY-ONE (844-446-9663).
This article originally appeared February 11, 2016 in the Owensboro Messenger-Inquirer.