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Froedtert South is a leader in cardiovascular care. We provide the latest tests and procedures to diagnose and treat heart and vascular conditions.
Why is the doctor performing this surgery?
To repair a weakened portion of the aorta located in the abdomen. The aorta is the largest artery in the body. It carries oxygen-rich blood from the heart to the rest of the body, including the abdomen. The weakened aorta can balloon out, becoming thin, large, and fragile. This ballooning is called an aneurysm. As it
progresses, there is risk of rupture, with massive internal bleeding.
What is the surgery?
Traditional AAA Repair is an open-abdomen (or open-chest) surgery. The bulging aneurysm part of the aorta is removed, an artificial graft is put in its place, and the remaining aortic end-pieces are reattached to the graft. Alternatively, a less invasive surgery involves placing a stent graft to cover the aneurysm. Blood
flows thru the stent, entirely bypassing the aneurysm, thus preventing rupture, and excludes the aneurysm from the circulation. This less invasive procedure can decrease length of stay and recovery time significantly.
Where is the surgery performed?
In the Operating Room (OR), under general anesthesia.
How long does this surgery take?
AAA Repair usually takes 3-5 hours.
What does "bypass surgery" mean?
Bypass surgery is a surgically constructed new route around an area of blockage or narrowing and can be performed on any artery in the body, but most often is performed on the femoral arteries in the groin, or the popliteal arteries behind the knee. During bypass surgery, a graft vein or artery is taken from a
healthy blood vessel in the body (sometimes an artificial graft is used). The graft is then surgically attached above and below an obstructed or poorly functioning artery. After surgery, the blood will flow thru the graft vessel, avoid or "bypass" the blocked vessel, and provide oxygen and
nutrients necessary for survival to the area of tissue beyond the blockage.
To bypass, or go around, the obstruction caused by an artery filled with a clot or with plaque (atherosclerosis). In the groin and/or legs, decreased blood flow (therefore, decreased oxygen and nutrients) causes painful muscle cramping and spasms, known as claudication. Claudication can progress to constant pain, cold
legs and feet, sores, and even gangrene. If the condition is not treated adequately with medications, exercise, and quitting smoking, surgery is necessary.
Two common vascular bypass surgeries performed include:
Femoral-Popliteal Bypass and Aorto-Bifemoral Bypass each take 2-4 hours.
Bypass surgery can be performed on any artery in the body, but most often involves the coronary arteries (the arteries that supply blood to the heart muscle itself). During bypass surgery, a graft vein or artery is taken from a healthy blood vessel in the body. The graft is then surgically attached above and below an
obstructed or poorly functioning artery. After surgery, the blood will flow thru the graft vessel, avoid or "bypass" the blocked vessel, and provide oxygen and nutrients necessary for survival to the area of tissue beyond the blockage.
To bypass, or go around, the obstruction caused by a coronary (heart) artery filled with a clot or with plaque (atherosclerosis). If the obstruction is not bypassed, the heart muscle beyond the obstruction is denied oxygen and nutrients leading to heart damage (heart attack or chest pain).
There are two types of Coronary Artery Bypass Surgeries (CABGs) routinely performed:
There are four sources used during bypass surgery for the healthy graft blood vessel:
Both On-Pump and Off-Pump/Beating Heart surgeries are performed in the Operating Room (OR), and under general anesthesia.
The length of time surgery takes will vary based on the number of vessels being bypassed, the graft location, On-Pump vs. Off-Pump/Beating Heart procedure, the patient's associated medical problems, etc, but usually an On-Pump or Off-Pump/Beating Heart surgery will take between 3-6 hours.
To remove plaque buildup (atherosclerosis) in the carotid arteries, which supply the brain with vital oxygen and nutrients. Removing this plaque can ultimately prevent a Stroke.
CEA is neck surgery to strip the inner lining of a carotid artery of obstructive plaque. The surgeon first makes an incision in the neck to access the narrowed carotid artery. Then the artery is opened and the plaque is removed. Finally, the artery is sutured back together. Once the plaque is removed, the artery
diameter is wider, and blood can flow to brain tissue freely.
Carotid Endarterectomy usually takes 1-2 hours.
To repair a poorly functioning heart valve. Properly functioning heart valves are essential to direct the flow of the blood thru the heart, and to maintain a normal workload for the heart. The most common heart valve surgically repaired is the mitral valve. The tricuspid and aortic valves may also be repaired.
Valve Repair Surgery is an open-heart procedure to fix a poorly functioning heart valve, often without the need for mechanical or biologic parts. Fused valve leaflets may be separated (called a Commissurotomy); calcium deposits hindering valve function may be removed; pieces of floppy/weak valve leaflets may be
removed (called a resection); and holes or tears in valve leaflets may be patched.
Sometimes a mechanical (synthetic/man-made) ring may be necessary to reshape and tighten the valve opening.
The length of time surgery takes will depend on the valve being repaired, the repair that must be done, the patient's underlying medical condition, etc, but a good estimate is 2-3 hours.
To replace a poorly functioning heart valve. The valve can be narrowed and obstruct blood flow (called stenosis), or it can be floppy/leaky (called insufficiency). Properly functioning heart valves are essential to direct the flow of blood thru the heart, and to maintain a normal workload for the heart.
The most common heart valves surgically replaced are the mitral valve and the aortic valve.
This surgery is an open-heart procedure to remove the poorly functioning (either stenotic or insufficient) valve, and replace it with either a mechanical (synthetic/man-made) or a tissue (biologic/from another organism) valve. The pumping and oxygenation function of the heart is taken over by a heart-lung
machine during the surgery, and medications are given that briefly paralyze the heart (cardioplegia). This way, the heart is completely at rest while the surgeon performs the replacement surgery.
note: Patients receiving a mechanical valve replacement will be required to take a blood-thinning medication called Coumadin (an anticoagulant) daily for life to prevent blood clots from forming on the prosthetic valve.
The surgery length of time will vary based on which valve is replaced, the type of replacement valve, the patient's underlying medical condition, etc, but a good estimate for Valve Replacement Surgery is 3-6 hours.