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Cardiac Surgery Treatment Approach

The cardiac surgical team at the Barnes-Jewish & Washington University Heart & Vascular Center provides the best and most innovative care to its patients. In addition to the world-renowned cardiac surgeons, a multidisciplinary team of professionals has been assembled to deliver compassionate, high quality service.

This includes a dedicated intensive care unit, inpatient nursing unit, several advanced practice nurses, physician assistants and perfusionists.

The following conditions benefit from the evidence-based treatments practiced by Heart & Vascular Center surgeons.

Heart Attack (Myocardial Infarction)

A myocardial infarction (MI) happens when blood flow to the heart muscle is blocked, and the affected tissue dies. When medicine and lifestyle changes no longer work, a surgical intervention is necessary to help the patient. In an acute situation, angioplasty (stenting) or coronary artery bypass grafting (CABG) may be needed. Our cardiac surgeons are available 24 hours a day, seven days a week, for such emergencies.


Some patients who suffer persistent, debilitating chest pain, called angina, may already have had bypass surgery—perhaps two or three times—and take multiple medications. When patients are unable to perform day-to-day activities because of the pain, transmyocardial laser revascularization (TMLR) may be an option. During this procedure, the surgeons use a laser to stimulate new vessel growth in the heart. This FDA-approved procedure alleviates symptoms immediately in most patients, but it does take three to six months for new vessels to grow.

Aortic Aneurysm

An aortic aneurysm is a ballooning of the wall of the aorta. Heart & Vascular Center cardiac surgeons offer both stent grafts and major aortic surgery. For patients who are eligible, stent grafting offers a minimally invasive approach to major aortic surgery. When major aortic surgery is required, the surgeons at Barnes-Jewish Hospital have the skill and experience to provide better outcomes than the national average.


When the heart does not keep a normal beating rhythm it is called a cardiac arrhythmia. A patient with cardiac arrhythmia will often have difficulty performing everyday tasks because of how uncomfortable the uneven heart rates make them feel. Treatments include:

  • Pacemakers
    These small devices are implanted in the shoulder. Electrodes from the device to the heart regulate the heart, keeping it in rhythm. While most pacemakers are inserted by cardiologists, the Heart & Vascular Center cardiac surgeons are considered experts in pacemakers, as well as difficult electrode removal. When other cardiologists or cardiac surgeons have difficulty implanting or removing a pacemaker, they turn to the experts at Barnes-Jewish Hospital.

  • Automatic internal cardioverter-defibrillator
    The automatic internal cardioverter-defibrillator is a miniature defibrillator implanted in the patient. The device recognizes the types of arrhythmia that may cause sudden death, and then provides an automatic shock to force the heart back into rhythm.

  • Cox-Maze (or Maze) Procedure
    The Cox-Maze procedure was developed at Barnes-Jewish Hospital in St. Louis by James Cox, MD. The Maze procedure cures atrial fibrillation by interrupting the electrical signals that cause the arrhythmia.

Congenital Heart Disease

Many adults with congenital heart disease need surgical repair—either in addition to the surgeries they had as a child, or to repair a defect that has been recently diagnosed. We have experience with all defects from the simplest to the most complex. Surgeons work closely with cardiologists, electrophysiologists, radiologists and anesthesiologists to determine the best treatment for each individual case.

Coronary Artery Bypass

When the arteries of the heart are blocked, surgeons perform a procedure known as coronary artery bypass grafting, or CABG (pronounced “cabbage”). The surgery reroutes or bypasses blood around clogged arteries to improve the supply of blood and oxygen to the heart. The Heart & Vascular Center surgeons offer both an off-pump coronary artery bypass and an endoscopic approach

Valvular Heart Disease

When people are born with or develop defects in the heart valves, blood flow through the heart's four chambers is affected. To keep blood flowing properly through the heart, valve repair or valve replacement can be necessary. Several options are available, including:

  • Ross Procedure, which replaces the aortic valve with the patient's own pulmonic valve.
  • Stentless valves, which more closely mimic the heart’s natural valves than artificial valves do.
  • Valve repair, which allows patients to avoid blood-thinners and the complications of prosthetic valves.
  • Valve replacement, including xenografts, homografts, autografts or artificial valves.
  • Minimally invasive repair, which uses smaller-than-normal incisions resulting in faster recover time.

End-Stage Heart Disease

When any heart disease has progressed to an advanced form, surgery may be a last option. In that case, the following procedures have proven successful.

  • Ventricular assist devices, which partially or totally replaces non-functioning parts of the heart, can provide extra time for patients with end-stage heart disease.
  • Heart transplant. As a regional leader in cardiac transplant, our patient survival rate for heart transplants is above national averages.

To make an appointment with a Washington University heart or vascular specialist at Barnes-Jewish Hospital, call 888.969.4806.