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Cardiac Surgery Options

For most types of heart disease, you can successfully manage symptoms with lifestyle changes and medications. You may need heart surgery if a heart condition worsens or you have a severe cardiac event, such as a heart attack.

At the Washington University and Barnes-Jewish Heart & Vascular Center, our cardiac surgeons have expertise in the latest surgical techniques. Our skilled team offers the full spectrum of minimally invasive procedures and traditional open-heart surgery.

Minimally Invasive Heart Procedures

Our heart team offers minimally invasive procedures to treat several types of heart disease. Compared with traditional open-heart surgery, these procedures use smaller incisions and do not require opening the breastbone. Minimally invasive heart procedures can mean less pain, a shorter recovery and a lower risk of complications. 

We use minimally invasive procedures whenever possible, but not everyone is a candidate. Your doctor works with you to decide which approach is right for you. 

Our heart team offers various approaches for minimally invasive heart procedures, including:

  • Thoracoscopic-assisted surgery: The surgeon makes small incisions in the chest, between the ribs, to access your heart. We insert long instruments and a scope (long, thin video camera) through the incisions to perform the treatment.
  • Cardiac catheterization: The doctor makes a small puncture through your skin into an artery, usually in the groin (upper thigh). We insert a catheter (long, thin, flexible tube) and use imaging to guide it to the area of the heart for treatment. We use instruments inserted through the catheter to complete the treatment. We collaborate with our interventional cardiology team for cardiac catheterizations, also called percutaneous coronary interventions (PCI).

Angioplasty and stenting for coronary artery disease

Coronary artery disease is narrowed or blocked heart arteries due to a buildup of cholesterol and other substances (plaque). Angioplasty is a catheter procedure to widen and reopen heart arteries to restore blood flow to heart muscle. In most cases, we place a stent (tiny mesh tube) into the artery to keep it open. Find out more about coronary artery disease treatment.

Aortic procedures and aneurysm repair

The aorta, your largest artery, carries oxygen-rich blood from your heart to your body. The aorta’s thick walls can withstand normal blood pressure, but injuries or certain conditions can create weakened areas known as aneurysms.

Several genetic disorders can affect the thoracic aorta (section of the aorta in the chest). Our cardiologists and surgeons provide coordinated care for people with diseases of the aorta.

Our cardiac surgeons have expertise in several procedures to repair aortic aneurysms and prevent rupture. Find out more about aneurysms and our treatment options for them, including minimally invasive endovascular aortic repair (EVAR).

Minimally invasive direct coronary artery bypass (MIDCAB) graft procedure

Traditional heart bypass surgery uses an open-heart procedure to restore blood flow to the heart muscle. Our cardiac surgeons are experienced in less invasive approaches to access the heart for bypass surgery. 

The surgeon uses a section of healthy blood vessel from elsewhere in your body to bypass (go around) the blocked part of the artery. MIDCAB is an option for people who have blockage in only one artery.

Minimally invasive Cox-Maze procedure for atrial fibrillation

Arrhythmias affect the heart’s electrical system, causing abnormal heartbeats that can be too fast, too slow or irregular. Surgeons at Barnes-Jewish Hospital developed a technique known as the Cox-Maze procedure to treat the most common arrhythmia, atrial fibrillation.

Our cardiac surgeons can perform the Cox-Maze procedure using a minimally invasive approach. Learn more about the technique and other treatments for atrial fibrillation.

Minimally invasive heart valve repair and replacement

The heart has four valves that direct blood from one chamber to the next as your heart pumps. In valvular heart disease, an infection, a heart attack or another heart disease can damage a valve. People can also be born with heart valves that didn’t form properly before birth. 

Our heart team can replace diseased valves using catheter or thoracoscopic-assisted procedures. Learn more about valvular heart disease and our treatment options.

Pacemakers and ICDs for arrhythmia

Our heart surgeons offer other treatments for arrhythmia, depending on the type you have. We use minimally invasive approaches to implant small devices to maintain normal heart rhythms. Our procedures for these devices include:

  • Pacemaker implantation: When it detects an abnormal heart rhythm, the pacemaker sends mild electrical pulses to control it. Through research, our doctors have helped develop leadless pacemakers, tiny devices that we place directly in the heart during a catheter procedure.
  • Implantable cardioverter-defibrillator (ICD) implantation: This device constantly monitors your heart for dangerous arrhythmias. An ICD can send mild electrical pulses to control abnormal heartbeats. It can also send a higher-energy shock for serious, life-threatening heart rhythms. Our team specializes in implanting S-ICDs, or subcutaneous ICDs, which don’t require leads (wires) attached to the heart.
  • Lead extraction: Conventional pacemakers and ICDs deliver electrical pulses and shocks with wires, or leads, attached to the heart. Sometimes, leads stop working properly because of damage, infection or scar tissue, requiring removal. Our heart surgeons are skilled in intricate lead extraction procedures using laser or mechanical instruments. 

Pacemakers and ICDs treat different types of heart rhythm disorders. Our cardiologists and heart surgeons carefully evaluate you to decide which device may work best for you. Learn more about arrhythmia and heart rhythm disorders

Transmyocardial laser revascularization (TMLR)

Another procedure to treat coronary artery disease is transmyocardial laser revascularization (TMLR). This procedure improves blood flow to the heart by creating tiny channels, or holes, in small areas of heart muscle. 

Our skilled heart team offers minimally invasive TMLR, accessing the heart using a catheter-based procedure. We equip the catheter with a laser to complete the procedure.

Repair for congenital heart conditions

Congenital heart disease refers to defects in the heart’s structure that develop before birth. Many people with congenital heart disease receive treatment during childhood to repair a defect. Others might experience mild or no symptoms, so the condition can go unnoticed until adulthood.

Our heart team has experience treating all types of congenital heart disease — even the most rare and complex. We offer procedures to repair recently diagnosed defects or those that need additional treatment after childhood surgeries. Learn more about adult congenital heart disease and our treatment options.

Transcatheter alcohol septal ablation

Hypertrophic cardiomyopathy (HCM) is a structural heart disease that causes thickening of the heart muscle. With HCM, thickened heart muscle can become stiff, forcing the heart to work harder to pump enough blood to the body.

Our heart team performs transcatheter alcohol septal ablation to remove part of the thickened heart tissue. We use a catheter procedure to deliver a small amount of alcohol to destroy the targeted tissue. 

The Hypertrophic Cardiomyopathy Association has named us as one of only about 40 centers of excellence nationwide. Read more about our care for people with hypertrophic cardiomyopathy.

Open-Heart Surgery Procedures

Traditional, open-heart surgery provides the best approach for many people who need treatment for certain complex heart conditions. Our world-renowned cardiac surgeons have advanced training and expertise in the latest techniques to treat all types of heart disease.

After open-heart surgery, you may have a longer hospital stay. Your care team helps you prepare for heart surgery and supports you during your recovery. Learn more about the cardiac surgery patient journey.

Aortic procedures and aneurysm repair

Open repair is the standard procedure to treat an aortic aneurysm. Our cardiothoracic surgeons have experience in procedures that replace the weakened area of the aorta with a graft. The graft is a tube usually made of synthetic material. In many cases, we use novel minimally invasive stent-graft options to treat aneurysms without having to open the chest.

Coronary artery bypass graft surgery (CABG)

In open-heart procedures for coronary artery disease, our heart surgeons create new routes to supply blood to the heart muscle. We take a section of healthy blood vessel from elsewhere in your body and attach (graft) one end above and the other below the artery blockage. The newly attached vessel bypasses (goes around) the blocked part of the artery.

During CABG, we use a heart-lung machine to circulate blood through the body while your heart is stopped. Our skilled surgeons also offer off-pump CABG surgery for many people. We use special equipment to stabilize the area being operated on.

Cox-Maze procedure for atrial fibrillation

The traditional Cox-Maze procedure uses an open-heart approach to access the heart and treat atrial fibrillation.

Open-heart surgery for heart failure

If heart failure becomes severe, you may need surgery to help maintain your health. Our skilled cardiac surgeons offer:

•    left ventricular assist devices (LVADs), mechanical devices that help the heart pump better
•    heart transplant to replace a diseased heart with a donor heart 

Learn more about all of your options for heart failure treatment.

Open heart valve repair and replacement

Our cardiac surgeons are experienced in open-heart procedures to repair and replace heart valves. In both open and minimally invasive valve procedures, we can:

•    repair valves that leak, to help them close tightly
•    widen valves that are stiff, to help them open wider
•    replace valves that cannot be repaired using synthetic or biological valves (made from human or animal tissue)

Learn more about heart valve repair and replacement at Barnes-Jewish Hospital.

Open surgery to treat congenital heart disease

Depending on the heart condition you have, an open-heart procedure may be the best option to treat it. Our cardiac surgeons have experience in techniques to repair structural heart defects and relieve your symptoms.

Pulmonary thromboendarterectomy

Pulmonary hypertension is high blood pressure in lung arteries. This condition can result from chronic pulmonary embolism, or frequent blood clots in lung arteries. 

If medications aren’t enough to manage the blood clots, our cardiac surgeons can remove them. Pulmonary thromboendarterectomy (PTE) is an intricate, open-heart surgery to remove blood clots from lung arteries. Learn more about pulmonary embolism treatment.

Septal myectomy

To treat cardiomyopathy, the surgeon performs open-heart surgery to remove the thickened areas of heart muscle. Septal myectomy is a complex procedure, and our cardiac surgeons have the skill and experience to provide excellent results.

Cardiac Surgery Research and Clinical Trials

Through groundbreaking research, our cardiac surgeons help develop the latest standards of care for heart diseases of all kinds. As our patient, you may be eligible to participate in our clinical trials. These research studies offer access to promising new treatments before they’re available to the public. Learn more about our innovation.

Contact Us

To make an appointment with a Washington University heart specialist at Barnes-Jewish Hospital, call 888-230-8832.