|
Cardiac Surgery General Information |
When you
have no health insurance coverage and cardiac surgery is your best option, you
will, of course, want the finest care possible at an affordable price. You want
a world class surgeon backed by a team of highly skilled professionals, and you
want a medical center that is recognized for excellence in cardiac care. Our
Comprehensive Cardiovascular Centers offer all this and more. We offer the best
surgical and medical care in an exceedingly supportive and caring environment.
We do everything possible to accommodate your family and loved ones as well. We
also make arrangements for families with special needs. Our patient
representative will be happy to assist you in any way possible.
 Coronary artery bypass surgery
Valve replacement surgery
Aortic Homograft
Aneurysm Repair
Stent Graft
Off pump "beating heart" surgery
Minimally invasive surgery
Advanced Cardio-vascular Technologi
Surgeons at
our Comprehensive Cardiovascular Centers are highly experienced and skilled in
all aspects of adult and adolescent cardiac surgery. There is special emphasis
placed on the performance of "beating heart" procedures and the use of minimally
invasive techniques, which may lessen the discomfort after cardiac surgery and
frequently shorten the hospital stay.
Heart
and Blood Vessel Basics
Your heart is a hollow organ in the center of your chest. Although you may feel your heart beat when you place your hand over it, your heart is not right under your skin. Instead, your heart is behind your breastbone, inside your ribcage, and between your lungs. Your heart is part of the circulatory system, which also includes your blood vessels and lungs. An average adult heart is about the shape and size of a closed fist. Like a valentine heart, yours is slightly pointed at the lower end. The pointed end is called the apex.
Although your heart is hollow, it isn't empty. In an average adult, about 5 quarts (4.7 liters) of blood flow through the heart each minute. The main job of your heart is to pump that blood, which is full of oxygen and nutrients, through your entire body. Your organs (like your brain, kidneys, and liver) will stop working if they don't get oxygen and nutrients from blood. Your heart's walls are made mostly of strong muscle, called the myocardium. The myocardium is the strongest, hardest-working muscle in your body. It continuously pumps your blood through 60,000 miles (96,560 kilometers) of blood vessels for a lifetime, without rest!
Heart
Chambers
The
hollow center of your heart is divided into four sections, called chambers. Each chamber is like a
separate room, with doors that let blood in and out.
Where Blood Flows In — The
Atria
The two
upper chambers in your heart are called the atria. The atria are the receiving
chambers of your heart. When blood flows into your heart from the body or lungs,
it always flows into either the right or left atrium—never anywhere else. (One
upper chamber is called an atrium.
Both upper chambers together are called the atria.)
Where Blood Is Pumped Out —
The Ventricles
The two
lower chambers in your heart are called ventricles. The ventricles are the pumping chambers of your heart.
When blood leaves your heart, it is always pumped out from the ventricles—never
from anywhere else. The ventricles are very strong because they have to pump
hard enough to push blood through your lungs and entire body.
Your Heart's
Right and Left Sides
Sometimes
the right and left sides of your heart are called your right heart and left heart. The right atrium and
right ventricle are, of course, on the right side of your heart (the same side
as your right arm), and the left atrium and left ventricle are on the left side
of your heart. However, when you look at a picture of the heart, the right heart
is on your left. A wall, called the septum,
separates the left and right sides of your heart. Blood that hasn't yet been to
the lungs (blood with no oxygen) stays on the right side of the septum. Blood
returning from the lungs (blood with oxygen) stays on the left side of the
septum.
Heart
Valves
When you
listen to your heartbeat through a stethoscope ("lubb-dubb lubb-dubb"), you hear
the sound of your heart valves closing. Although your heart has four valves, the
valves open and close two at a time. That's why you hear only two thumps (one "lubb-dubb")
per heartbeat, rather than four. Your heart valves keep blood flowing in one
direction through your heart, just like the one-way valves in your home's
plumbing. They open to let blood flow through, and then close to prevent blood
from flowing back the way it came. When a valve closes, flaps of tissue on the
valve close tightly together to create a seal. These flaps of tissue are called leaflets
Your heart
has four valves. Blood flows through each valve one time on its way through your
heart. The four valves can be grouped by their job:
Atrioventricular — Atrioventricular valves control blood flow between your heart's upper and lower chambers (Figure 2). The valve between the right atrium and the right ventricle is called the tricuspid valve. The valve between the left atrium and the left ventricle is called the mitral valve.
Semilunar — Semilunar valves control blood flow out of your heart. Blood flows out of the right ventricle to the lungs through the pulmonary valve. Blood flows out of the left ventricle to your body through the aortic valve.
Blood Flow Through Your Heart and Lungs
All of the
parts of your heart, like the chambers and valves, work together to ensure that
blood always flows on the same path on its way through your heart and lungs. You
can read about the steps below.
STEP 1. Blood returns to your heart from your body and lungs.
SeOxygen-poor blood from your body flows into your right atrium.
At the same time, oxygen-rich blood from your lungs flows into your left atrium.
STEP 2. Blood flows from the upper to the lower chambers.
Blood flows from your right atrium into your right ventricle.
At the same time, blood flows from your left atrium into your left ventricle.
STEP 2. Blood is pumped back out to your lungs and body.
Your right ventricle pumps blood out of your heart to your lungs, where the blood's oxygen supply is replenished.
At the same time, your left ventricle pumps blood — once again full of oxygen — out of your heart to your body.
Blood flows through each chamber one time on its way through your heart — first through the right side of your heart and then through the left. Blood doesn't flow by itself — your heart's chambers work hard to keep blood moving. The chambers relax and expand to let blood flow into them. Then they tighten and pull inward (contract) to help push blood out. You might hear your nurse talk about your diastolic pressure or systolic pressure when you get your blood pressure checked. When a chamber is relaxed, or expanded, it is in diastole. When a chamber is contracted, or small, it is in systole.
Your Heart's Electrical System
The electrical system in your heart controls the speed of your heartbeat. The system includes a network of electrical pathways, similar to the electrical wiring in your home. The pathways carry electrical signals through your heart. The movement of the signals is what makes your heart beat. When working properly, your heart's electrical system automatically responds to your body's changing need for oxygen. It speeds up your heart rate as you climb stairs, for example, and slows it down when you sleep. When your heart rate speeds up, it means your heart pumps faster and your body gets more oxygen-rich blood. Your heart's electrical system is also called the cardiac conduction system.
Your heart's electrical system includes three important parts:
S-A node (sinoatrial node)
A-V node (atrioventricular node)
His-Purkinje system
The S-A Node: Your Heart's Natural Pacemaker
The S-A node is a bundle of specialized cells in your right atrium. The S-A node cells are special because they create the electricity that makes your heart beat. The S-A node normally produces 60-100 electrical signals per minute — this is your heart rate, or pulse. The S-A node is called the "natural pacemaker" of your heart because it controls your heart rate.
The A-V Node: Your Heart's Electrical Bridge
The A-V node is a bundle of specialized cells between your heart's upper and lower chambers (between the atria and ventricles). The A-V node cells are special because they allow electricity to pass through them. Except in rare conditions, no other cells between the atria and ventricles allow this. So, the A-V node is the "electrical bridge" between the atria and ventricles. Some types of slow heart rhythms are caused by problems in the A-V node.
The His-Purkinje System
The His-Purkinje system is in your heart's ventricles. Electricity travels through the His-Purkinje system to make your ventricles contract. The parts of the His-Purkinje system include:
His Bundle (the start of the system)
Right bundle branch
Left bundle branch
Purkinje fibers (the end of the system)
Electrical Signals and Blood Flow
Electrical signals created by the S-A node follow a natural electrical pathway through your heart walls. The movement of the electrical signals causes your heart's chambers to contract and relax. When a signal passes through a chamber wall, the chamber contracts. When the signal has moved out of the wall, the chamber relaxes. In a healthy heart, the chambers contract and relax in a coordinated way, or in rhythm.
When your heart beats in rhythm at a normal rate, it's called sinus rhythm. A problem in your heart's electrical system can disrupt your heart's normal rhythm. Any kind of abnormal rhythm or heart rate is called an arrhythmia. It's normal and healthy for your heartbeat to speed up or slow down during the day as your activity level changes. But it's not normal for your heart to beat out of rhythm. When your heart beats out of rhythm, it may not deliver enough blood to your body.
The Path of an Electrical
SignalYou can read about the path of an electrical signal below.
STEP 1. The S-A node (natural pacemaker) creates an electrical signal.
STEP 2. The electrical signal follows natural electrical pathways through both atria.
The movement of electricity causes the atria to contract, which helps push blood
into the ventricles.
STEP 3. The electrical signal reaches the A-V node (electrical bridge). There, the
signal pauses to give the ventricles time to fill with blood.
STEP 4.The electrical signal spreads through the His-Purkinje system. The movement of
electricity causes the ventricles to contract and push blood out to your lungs
and body.
Recording Electrical
Activity in Your Heart — The Electrocardiogram (ECG)
If your
doctor suspects a problem in your heart's electrical system, he or she may
schedule you for an electrocardiogram (ECG). An ECG is a recording of the
electrical activity in your heart. You've probably seen an ECG on television or
when visiting someone in the hospital. The ECG monitor is usually next to the
patient's bed. It shows what looks like an electric current on its monitor, and
it makes a "blip, blip, blip" sound.
Parts of an ECG
The hills
and valleys on an ECG recording are called waves. Each wave tells your doctor a
story about how your heart is working:
|
|
