International techniques used in heart surgeries

International techniques used in heart surgeries

Under the motto ” medical experts in Turkey”

The Cardiothoracic and vascular center for pediatric and adult in Turkey health care group, offers the best surgical techniques in heart surgery.

The center is distinguished by the best doctors and medical staff expertise in their field, and they have achieved remarkable success in Turkey

Our center in Istanbul, Turkey, provides treatment for all patients, in terms of performing routine examinations or performing heart surgeries.

International techniques used in heart surgeries

All operations related to heart diseases and surgery are carried out in our center using the best modern international techniques and advanced technology, as these operations include:

• Open heart surgeries.
• Robotic heart surgery.
• Minimally invasive heart surgeries.
• Closed cardiac surgeries minimally invasive by catheter.
• Underarm cardiac operations.
• Arterial exchange surgery without heart stopping (the operation is performed without linking to a heart-lung artificial machine).
• Cardiac aortic valve replacement via catheter

What is open heart surgery?

Open heart surgery is a very necessary operation in eliminating the vital problems of blood vessel diseases and blockages that feed the heart. The method of surgery differs from one patient to another. Therefore, the operation is known as open heart surgery. Where the breastbone is cut or opened up to 26-30 cm complete, and blood circulation, lung and heart are connected to an artificial heart device. This technique is considered the most widely used and widespread in the world, in terms of treating coronary artery diseases and the vessels feeding the heart.

Open heart surgery: It is the removal of vessels from another place of the body (the vein of the arms, chest and leg veins), where the removed vessels are cleaned and tied at points,  where there is an imbalance (narrowing or blockage), or the blocked heart vessels are replaced with new vessels as they are treated In this way, it nourishes the heart naturally.

These surgeries are performed by stopping the heart and turning off the lungs. Meanwhile, the body is connected to a system called the heart lung pump and the operation is performed. Heart operations have been safely performed this way for more than 30 years. However, with this method the risk of some complications increases.

In coronary artery disease, narrowing and blockage occurs over time and the blood flow needed by the heart stops. When the condition reaches this position, the heart is not sufficiently nourished and it becomes unable to perform its duties completely. These patients are at great risk of having a heart attack, which leads to death.

Type of anesthesia	General anesthesia
The duration of the operation is	Between 5-7 hours
Duration of stay in hospital	7-10 days
Duration of time to return to work	After two months

 

What are robotic heart surgery procedures?

Robotic surgeries are performed using the Da Vinci robot system, as the endoscopic operations with the Da Vinci robot, they do not need to open the rib cage or cut the breastbone, and do not need to be connected to the lung industrial heart. As a result of this technique, there is no risk of bleeding during the operation, and the patient does not need a blood transfusion, and there is no infection during follow-up in the hospital, where patients can return to their normal life in the shortest time.

The most important robotic surgeries are as follows:

• Heart valve repair.
• Heart bypass surgery (open-heart surgery) transposition of one artery or a maximum of two is performed.
• Heart tumors.
• Repair of the hole in the heart.
• Rhythm disturbance and arrhythmia.
• As a result of childbirth, the hole (ADS) between the heart atria closes.
• Mitral valve repair.
• Transcatheter aortic valve replacement

 

Surgeons control the robots developed for surgery in the processes that involved in robotic heart surgery.

The main difference between robotic surgery and endoscopic surgery is that the surgeon watches from the screen, rotates the robot’s arms, and is controlled remotely.

Robotic surgery was originally designed by the US Space Agency (NASA) in the late 1980’s in response to treating remote wounded soldiers. Then it began to be used in various fields of medicine.

The first clinical results related to robotic heart surgery were obtained in the 1990s and its use increased rapidly after a year 2000.

Minimally invasive heart surgeries

Minimally invasive heart surgery operations (minimally invasive technique), which is a process that is performed by opening small incisions in the chest area using a special endoscopy device .. During the surgery, all tools and surgical supplies are controlled by the surgeon with the use of the endoscopic camera for the purpose of surgery.

Minimally invasive heart surgeries are:

• Heart valve repair.
• Cardiac arterial switch operation (open heart surgery) is performed by transposing one artery or a maximum of two.
• Heart tumors.
• Repair of the hole in the heart.
• Rhythm arrhythmia disorder.
• As a result of childbirth, the hole (ADS) between the heart atria closes.
• Mitral valve repair.
• Repair or replacement of the aortic valve via catheter

Open heart surgery is performed by connecting the patient to an artificial heart lung machine, where the heart vessels taken from the legs area will be replaced. In minimally invasive heart surgeries, we perform the operation without opening the chest, as the operation is performed through a small incision in the chest.

After minimally invasive cardiac surgeries, patients will move more easily and wounds heal faster after surgery compared to open surgeries.

Patients can return to working and active life early in the postoperative period. However, in order to apply the endoscopic technique, the structure of the chest wall and the anatomy of the heart must be adequate.

What are the advantages of minimally invasive heart surgery?

• The risk of bleeding is low.
• The risk of infection is low.
• The recovery time is much faster.
• The patient cannot see the location of the surgery.
• From an aesthetic and psychological point of view, it will appear as if the patient did not undergo surgery.
• It does not create sexual and social problems.
• After the operation, the patient can lie in the desired position.
• After surgery, the patient should not avoid blows to the chest.
• When discharged from the hospital, he can drive a car and wear a seat belt.
• He can use his arms as if he had never had surgery.
• The patient can lift any weight.

Underarm cardiac operations

Heart surgeries from under the armpit: the operation starts from the right anterolateral chest, where an incision is made about 4-5 cm parallel to the lower breast line under the right armpit, especially from under the armpit without cutting the muscles and rib bones. This technique is used to repair and replace the heart valve without making any incisions anywhere else on the body.

In many cases, the incision size can be reduced further with endoscopic imaging techniques and instruments, as the procedure can be made easier, more comfortable and safer by using the video-assisted laparoscopic surgery technique.

The only difference between open heart surgery and heart surgery under the armpit is the opening or incision mechanism. The internal procedure is the classic heart surgery.

In underarm heart operations, the breastbone incision is not cut or opened. As for open surgery, the chest is fully opened by 26-30 cm.

The right valve is accessed through the ribs by a skin incision 6-8 cm parallel to the breast line under the right armpit. The scar remains under the armpit after the operation. Unless a person raises their arm in front of a mirror, neither he nor others can see the scar.

Underarm cardiac operations include the following:

• Mitral valve repair or replacement surgery
• Aortic valve repair or replacement
• Tricuspid valve repair or replacement
• Double cover repair or replacement process
• Three surgeries cover valve repair or replacement
• Right coronary artery bypass operations
• Atrial septal defect (ASD) surgery
• Mitral valve repair or replacement surgery
• Ventricular septal defect repair surgery
• Oncological heart operations

What are the advantages of minimally invasive heart surgeries, especially with video-endoscopic surgery techniques?

• The risk of bleeding is low.
• The risk of infection is low.
• The patient recovers faster after surgery,
• Shortening the intensive care and hospitalization.
• He does not need a blood transfusion.
• There is less pain after surgery.
• After surgery, he can lie in the position that he wants, and he does not have to lie on his back for a long time like patients who open from the front.
• After the operation, the patient can get out of bed alone, lie down, and cough comfortably, without any help, and there is no risk of opening the breastbone.
• The risk of opening the breastbone, especially in the elderly and with osteoporosis, is absent in this technique as the bone is not cut.
• The wound heals quickly after surgery.
• A hypertrophic scar (keloid), which is more likely to occur in the incisions of the sternum, is almost non-existent.
• The patient is discharged from the hospital early.
• The patient can return to his daily life easier and faster, in addition to the possibility of boarding a plane immediately after the operation.
• The patient can be seated in the driver’s seat shortly after the operation.
• It should not be protected from a blow to the chest.
• He can comfortably use his arms and lift him thickly.
• Since the surgery site is under the armpit, it cannot be seen easily.
• artificial It provides better cosmetic results.

Arterial switch surgery without stopping the heart (The operation is performed without connection to a heart-lung machine)

Open heart surgery is a procedure performed by stopping the heart and connecting the heart-lung to an artificial device. The function of this device is that it continues the blood circulation of the body in order to deliver oxygen to all the organs of the body, and it also supplies oxygen to the blood, and then it is pumped back into the patient’s body through the artificial heart-lung machine, in the meantime the surgeon performs heart surgery.

Arterial exchange surgeries without cardiac arrest (the operation is performed without linking to a heart-lung artificial device), are surgeries that are performed without any pump (heart-lung machine) and without stopping the heart, as it has become common among surgeons today.

The use of the heart-lung machine during heart artery replacement surgery is minimally invasive.

The advantage of bypass surgery without cardiac arrest is that the heart-lung pump is not used. Technically, bypassing the stopped heart is the easiest method.

Working heart bypass is performed with the help of special stabilizers. Where the area in which the vein is located is repaired and heart bypass surgery is performed. This technique is performed by an experienced team with high success rates.

The bypass method without stopping the heart has been put on the agenda as this method preformed for patients at risk of developing weak cardiac strength. Successful results were obtained in those patients who had a high risk of heart surgery.

Heart bypass surgery is a procedure that requires special rules for both anesthetists and surgeons, as it is applied by teams with experience in this field, and it has very high success rates.

 

What are the advantages of bypass in a working heart?

• The risk of embolism is lower in these surgeries because the heart does not stop and the aortic vessels are not manipulated.
• The vital organs such as the brain, lung and kidneys are less affected by the operation.
• Bleeding problems are less common in these patients.
• Patients can recover faster and stay less in the hospital.

Repair or replacement of the aortic valve via catheter (TAVI)

Heart aortic valve ligation is performed using the catheter method without open heart surgery. As the biological heart valves that are used during this procedure and which are still used in valve replacement surgeries around the world and in our country.

Through the catheter, this biological valve is placed in the stent sheath and when the stent is opened, it is securely attached and positioned in the area where the valve is attached to.

The aortic valve can be repaired or replaced via catheter, using two different techniques. In the first technique, the valve is developed from the groin to the heart with the help of a catheter, as in the case of angiography applications where the stent mechanism is opened.

If there is a blockage in the groin area or in the abdominal area it is used to access the heart, where the other technique is applied. In this technique, a small 4-5 cm incision is made in the anterior chest wall, the heart tip is accessed, and an advanced catheter cap is inserted into the heart.

In both methods, there is no need for cardiac arrest and open surgery. Where the operation can be performed under local anesthesia without the need for the patient to sleep.

Patients are transferred to their rooms after the catheter procedure and at the same time, the patient is given blood thinning medication and followed up in the hospital for 4-5 days under the patient’s normal conditions. He is discharged after this time.

The patient will be referred to the hospital after a few days of having a rest and doing their normal life.

The catheter method is primarily recommended for patients with very high risk of open surgery and valve insertion.

In addition, this method can be applied in patients with any disability in open surgery.

Patients with severely impaired lung, liver, or kidneys, or patients who have previously undergone open heart surgery, are particularly at higher risk of open surgery.

The catheter method is known to be effective in extending life and improving the clinical condition of patients, especially for whom open surgery is not suitable.

The Center for Adult and Child Cardiovascular Diseases and Surgery in Istanbul has a global infrastructure in accordance with international standards, and we have the ability to diagnose and treat heart diseases, as well as protect heart health, as all facilities are provided, to ensure the diagnosis and treatment of all types of heart diseases, starting from newborns to the elderly.

Early detection of cardiovascular and arterial disease saves your life and can also reduce the risk of heart attack and permanent weakness of the heart muscle.

The Cardiovascular Surgery Center of Turkey Health Care Group provides you with all the services that the patient wishes, including inspection, psychological comfort, and follow-up before and after the operation

Turkey Healthcare Group also provides comprehensive check-ups for cardiovascular diseases, which aim to quickly discover the disease and treat it before it is too late.

 

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