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Cardiac Surgery - Mississauga Hospital

For people with coronary artery disease, heart valve disease or other cardiac problems, often the best remedy is open-heart surgery. Open-heart surgery involves the use of a heart-lung machine that maintains blood flow for the heart and adds oxygen to the lungs allowing the heart to rest during the operation.

New Heart- Lung Bypass Technology

In March 2004, Mississauga Hospital was the first hospital in Canada to introduce a new state-of-the-art heart-lung bypass machine, which doctors expect will mean far better patient outcomes and reduced stays in hospital. The latest heart-lung machine contains a new mini-pump, which is tiny compared to a conventional cardiopulmonary bypass machine.

Because the mini-pump has less tubing and no reservoir, there is little or no blood dilution, reducing the need for transfusions during and after surgery. Fewer transfusions reduces the stress on a patient's immune and other systems, cuts the risk of infection, and the risk of post-operative complications.

Mississauga Hospital performs almost 1,000 cardiac surgeries annually. About 90% of patients report experiencing major reduction in angina symptoms due to blood rich with oxygen being able to make its way to the heart.

Mississauga Hospital's Cardiac Services perform the following major surgeries:

Coronary Bypass Surgery:
A coronary bypass is needed when an artery in the heart is narrowed or blocked due to coronary artery disease. An artery or vein from another part of the body is grafted to the heart to bypass the narrowed area. To accomplish this the heart must be stopped. A heart-lung machine diverts the blood during the operation and subsequently re-pumps the blood back into the body. Coronary bypass surgery is often used when the patient has several blockages and is not considered a candidate for angioplasty. Coronary artery bypass is one of the most common cardiac surgical procedures.
Heart Valve Surgery:
During heart valve surgery, damaged or scarred heart valves are replaced or repaired allowing the blood to better flow in and out of the heart chambers every time the heart beats. Mechanical or tissue valves (human or pig) can be used when replacement valves are needed. Heart valve repair and replacement is one of the most common cardiac surgical procedures.
Beating Heart Surgery:
Mississauga Hospital Launches Minimally Invasive Heart Surgery. Patients undergoing coronary bypass surgery no longer face long and painful recoveries at Mississauga Hospital due to the introduction of minimally invasive heart surgery. Coronary artery bypass operations involve the surgeon making a cut into the chest and sawing open the breastbone to gain access to the heart. Now, due to innovative technology introduced by Medtronic of Canada Limited and special expertise by Mississauga Hospital's cardiac surgeons, access to the heart is gained through a small cut (6 cm) between the ribs, eliminating the need to split the breastbone. The patient benefits of this new procedure include: much less pain during recovery, less complications from wound healing, less chance of infection, less blood loss due to the breaking of the breastbone, a much faster recovery and no unsightly scars. Patients who undergo minimally invasive cardiac surgery are discharged from hospital within two to three days, a much shorter hospital stay than conventional bypass surgery which requires an average seven day hospital stay. Mississauga Hospital is already a leader in beating heart surgery with about 80% of all coronary bypass operations performed on a beating heart. Mississauga Hospital is now one of only three hospitals in Canada to perform minimally invasive cardiac surgery and one of only a handful in North America. Mississauga Hospital is the only hospital to have all cardiac surgeons performing the procedure. Mississauga Hospital has perfected beating heart surgery, a gentler alternative to conventional bypass surgery where the heart is kept beating throughout the operation," says Dr. Gopal Bhatnagar, Chief, Cardiac Surgery. "Minimally invasive cardiac surgery is a natural evolution to beating heart surgery but requires much more intense training and special expertise by cardiac surgeons." In the minimally invasive cardiac procedure called Multi Vessel Small Thoracotomy (MVST), state-of-the-art devices are inserted through small cuts to help stabilize and position the beating heart. The surgeon, supported by a multi-disciplinary team, grafts an artery or vein harvested from another part of the body, to bypass the narrowed area. Despite the pulsation from the rest of the heart, the surgeon is able to graft directly onto the tiny portion of the heart that has been immobilized.

Beating Heart Surgery

Older patients and patients considered high risk may not even be considered for coronary bypass surgery due to the strain this type of surgery imposes on the body.

Beating Heart Surgery image 
Dr. Gopal Bhatnagar, Mississauga Hospital's Chief of Cardiac Services wears surgical eye loops that allow him to view the artery being grafted three and a half times its normal size. Grace Groetzsch, RNFA, is the registered nurse first assistant during the procedure.
At Mississauga Hospital beating heart surgery is providing a much gentler surgical alternative that is appropriate for many older and sicker patients. Patients that have undergone beating heart surgery experience less serious complications, recuperate faster, and are less likely to suffer an adverse event such as stroke.

 

Mississauga Hospital is one of only three hospitals in the Greater Toronto Area that offer beating heart surgery.

Approximately 70% of all coronary bypass operations performed at Trillium are done using this procedure. That's nearly 600 beating heart surgeries a year, the most of any hospital in Canada.

During this surgery, a stabilization device presses the artery that is to be operated upon, stopping that section of the heart from beating. Despite the pulsation from the rest of the heart, the surgeon is able to graft directly onto the tiny portion of the heart that has been immobilized.

The benefits of beating heart surgery over conventional surgery are numerous and include fewer chest infections, a decrease in bleeding and the need for blood transfusions, and a lower incidence of irregular fast heart beats.

Beating heart surgery also offers patients a shorter hospital stay and a quicker return to normal activities. With conventional bypass surgery there is a 2-3% death rate associated with the operation. This statistic is significantly reduced with beating heart surgery.

Other types of surgeries performed at Mississauga Hospital for adults include:

  • Repair of the atrial septal defect, a hole some people are born with between the upper chambers of the heart
  • Aneurysm of the heart muscle

Heart Surgery Education and Recovery Tips

Heart Surgery Booklet (download) »

Topics covered in this booklet: