Interventional & Surgical Heart Care in San Antonio
As thousands of patients in San Antonio already know, Southwest General Hospital is one of the community’s most reliable institutions for quality cardiovascular health care and advanced treatment options. Physicians at Southwest General Hospital use cardiac catheterization techniques, minimally invasive surgery, and open heart surgery to treat a wide variety of heart conditions. The following is a non-comprehensive list of procedures that may be available through the cardiologists and cardiovascular/cardiothoracic surgeons at Southwest General Hospital. Click on a procedure to learn more about it.
Abdominal Aortic Aneurysm Repair
Frequently referred to as “AAA repair,” this procedure can be done as an open or endovascular/catheter-based procedure. Open surgery is the most common approach in AAA repair. In an open procedure, an incision is made on the abdomen. The damaged section of the aorta is replaced with an artificial graft, restoring healthy blood flow through the aorta. During endovascular repair, a small catheter is inserted into an artery (typically the femoral artery in the groin). A graft is passed through this catheter, and secured within the aortic wall at the bulging section. Blood passes through this graft, relieving pressure on the aortic wall. Over time, the aneurysm may shrink down around the graft.
Balloon Angioplasty & Stent Placement
Angioplasty is one of the most common “cath lab” procedures. It is used to treat coronary artery disease, peripheral artery disease, and other heart and vascular conditions. In the procedure, a small flexible tube known as a catheter is inserted into an artery in the body. The catheter is maneuvered through the body’s vascular system to the site of the blockage. Once in place, a small balloon is passed through the catheter until it also arrives at the blockage. The balloon is inflated, pressing plaque against the arterial wall. In some cases, a stent may be passed through the catheter and placed within the artery to hold it open.
Cardiac catheterization is a common procedure performed by interventional cardiologists for both diagnostic and treatment purposes. With regards to treatment, cardiac catheterization can be used to perform balloon angioplasty and stent placement (see above), to repair heart defects, valves, and more.
Here’s how a cardiac catheterization procedure works: A small incision is made in the skin above an artery (typically the femoral artery in the groin). A catheter is inserted into the artery, and maneuvered through the vascular system to the region that requires treatment/evaluation. Once the catheter is in place, other instruments and/or substances may be passed through the catheter, as needed. Once the cardiologist’s work is done, the catheter is removed and a bandage covers the insertion site – no sutures necessary. Patients go home the same day in most cases.
Coronary Artery Bypass Graft Surgery
This procedure, also known as “CABG,” is a surgical procedure done to treat coronary artery disease by improving blood flow to the heart. It is the most common type of open heart surgery performed in the U.S.
During a CABG procedure, the cardiothoracic surgeon makes an incision on the center of the chest. An artery or vein from the chest or leg is removed and used as a bypass graft. The artery or vein is used to connect the aorta to the coronary artery, improving blood flow to the heart. There are many different variations of this procedure (including the one described below). If you’re a candidate, talk to your heart care team to learn more about which type of CABG procedure may be right for you.
Minimally Invasive Coronary Artery Bypass (MIDCAB)
MIDCAB is a minimally invasive approach to “bypass surgery,” described above. It is used to achieve the same end as traditional CABG. However, the biggest differences are (1) the chest bone doesn’t have to be cut and (2) a heart-lung machine is not necessary.
In most cases, MIDCAB is used in patients who need a bypass in the front of the heart. In this procedure, small incisions are made on the left side of the chest and directly above the artery that is to be bypassed. An artery from the chest wall is used for the graft (as opposed to the great saphenous vein in the leg).
Heart Valve Replacement
The heart has four valves: the aortic, mitral, pulmonary, and tricuspid valve. These valves may become narrowed or leaky, in which case they may need to be replaced. Depending on the patient and the heart valve, an artificial, human donor, or animal valve may be used in replacement surgery. In many cases, heart valve replacement is an “open heart” procedure. In some cases, valve replacement surgery can be done via catheter. Your cardiothoracic surgeon at Southwest General Hospital can tell you more about heart valve replacement and techniques.
Laser Atherectomy for PAD
Peripheral arterial disease is one of the most widespread diseases in the United States. Laser atherectomy (also known as radiofrequency/laser ablation) is one treatment option for patients at Southwest General Hospital. During this procedure, a catheter is inserted into an artery in the body (typically the femoral artery). The catheter is maneuvered to the site of the blockage. Once in place, a small laser device is inserted through the catheter to the blockage site. Intense, highly concentrated heat is emitted from the tip of the laser, which breaks down arterial plaque. The tiny plaque fragments are safely carried away by the blood stream.
Pacemaker / ICD Implantation
A pacemaker is a device that monitors and controls the heart’s electrical activity. It may be used in patients who have bradycardia (abnormally slow heart rate), atrial fibrillation (irregular fast heart beat), heart block, or some other kind of dysrhythmia. An ICD (implantable cardioverter defibrillator) is a similar device, though it is more often prescribed for patients who are at risk for sudden cardiac arrest.
If your cardiologist has told you that one of these devices could help your heart condition, then you may undergo a brief procedure to have the device inserted just beneath the skin. During the procedure, the device’s lead wires are connected to the heart; the pacemaker is tested to ensure proper function.
Transcatheter ablation is a minimally invasive catheter-based procedure that’s used to treat arrhythmia (irregular heart beat). This type of treatment is typically reserved for patients who are unable to take their arrhythmia medications or cannot take arrhythmic medications because of another health condition.
During the procedure, tiny electrodes are passed through the catheter to stimulate different areas of the heart and record the electrical activity caused by the stimulation. Based on what your physician finds during this probing, another instrument is used to create scar tissue between the damaged tissue and the healthy tissue. This scar tissue interrupts the heart’s faulty electrical signal, thereby eliminating the arrhythmia.
San Antonio Heart Care in Your Neighborhood
For more information about interventional cardiology, cardiothoracic / cardiovascular surgery, and heart care in San Antonio, call Southwest General Hospital at 1-877-215-WELL. Advanced care is here, in your neighborhood!