Patient Information - FAQ

• Q. How much time will I spend at the consultation appointment and what will happen at that appointment?
  A. This will be approximately 45 minutes. A doctor will always see you during this time. A nurse and/or a physician’s assistant will also see you. An overview of test results will be discussed. A history and physical will also be obtained. Further testing will be ordered or a recommendation given.
  
  
• Q. How long as the surgeon been in practice?
  A. Please click on the name of each surgeon to see how long they have been in practice, as well as to learn about their background.
  
  
• Q. How long will I be in the hospital?
  A. From 2 to 10 days is normal for heart surgery.
  
  
• Q. How long is surgery?
  A. Surgery takes between 45 minutes for a pacemaker insertion and up to 6 hours for complex open heart surgeries.
  
  
• Q. Will I be taking the same medications before and after surgery?
  A. Not necessarily. Some of the problems from before surgery will have been corrected.
  
  
• Q. Is leg swelling common and what can be done to relieve it?
  A. This is common. Proper leg elevation can help.
  
  
• Q. How will I know if the incision is infected?
  A. You will see increasing redness, drainage and opening of the incision area. Also, some people may experience increasing incisional tenderness.
  
  
• Q. Is it normal to be extremely tired after I return home after surgery? Is it normal to have a poor appetite?
  A. Both of these conditions are normal. However, they will improve with time.
  
  
• Q. When may I return to work following heart surgery?
  A. Depending upon your job duties, there will be lifting restrictions for 6 to 8 weeks following surgery.
  
  
• Q. Will I need 24-hour care when I go home?
  A. Initially someone should be available for up to one week in case you need assistance with daily living activities.
  
  
• Q. If a patient is unable to care for themself after surgery and discharge, what other type of care is available?
  A. A visiting nurse is available if needed.
  
  
• Q. What do you recommend for older patients with activity versus rest after surgery?
  A. There must be a balance between rest and activity based on your energy level. However, activity is very important to rebuild your endurance levels.
  
  
• Q. With valve surgery, will I need to be on Coumadin for the rest of my life?
  A. Most likely this will be the case, but it depends on the particular valve and procedure.
  
  
• Q. After valve surgery, do I need to be medicated before going to the dentist?
  A. Yes, this will be needed.
  
  
• Q. Do you accept Medicare assignment?
  A. Yes, our office accepts Medicare assignment.
  
  
• Q. Do you belong to my HMO?
  A. We belong to many HMO’s. Please click here to see a current list. You may also contact our business office at (414)649-2605 to see about including your plan if necessary.

Coronary Artery Bypass Grafting (CABG)

What is coronary artery bypass grafting?

Coronary arteries are often clogged by the buildup over time of fat, cholesterol and calcium, which can lead to a heart attack. This process is called atherosclerosis. A coronary artery bypass graft operation is sometimes referred to as CABG or “cabbage”. The surgery is done to reroute, or “bypass”, blood around clogged arteries and improve the supply of blood and oxygen to the heart.

How is coronary bypass done?

During bypass surgery, surgeons take a blood vessel from another part of the body to construct a detour around the blocked part of the coronary artery:

• An artery (internal mammary artery) may be detached from the chest wall and one end attached to the coronary artery below the blocked area. Many patients can now have all bypasses performed using only mammary arteries.
• A piece from a superficial vein in your leg (saphenous vein) may be removed and used to graft from the artery that leaves the heart (aorta) to the coronary artery. A minimally invasive technique to remove this vein is now commonly used.

Cardiopulmonary bypass using a heart-lung machine may be used during coronary bypass graft operation. Some patients now qualify for off-pump coronary artery bypass (OPCAB) where the bypasses are done on the beating heart. The way your operation is performed is based on your particular situation.

Heart Valve Surgery

What is heart valve surgery?

Heart valve surgery is performed to replace or repair one or more defective or diseased heart valves. There are four valves: the tricuspid, pulmonary, mitral and aortic. Each valve has a set of flaps (also called leaflets or cusps). When working properly, the heart valves open and close fully. A person can be born with an abnormal heart valve, or a valve can become damaged by things such as infections, rheumatic fever and changes in valve structure in the elderly.

How is valve surgery done?

Valve surgery requires the heart lung machine. During valve surgery, surgeons will either try to repair the existing valve or completely replace the valve with one of two types of valves.

• Mechanical Valves which have excellent durability, but require lifelong blood thinner usage to prevent blood clots from forming.

  Biological Valves which are much less susceptible to blood clots, but also less durable.

The type of valve used is based on your age and medical condition. After surgery, if anticoagulation with the blood thinner Coumadin is necessary, it is started in the hospital for your safety.

People with defective heart valves or artificial valves need to take antibiotics to prevent endocarditis (an infection of the valve) before certain dental or surgical procedures.

Surgical Management of Congestive Heart Failure

What is congestive heart failure?

Congestive heart failure occurs when the heart can no longer meet the body’s need for circulation. A backup of blood in the veins that fill the heart, along with retention of fluids by the kidneys, causes swelling of body tissues. The most common areas of swelling is in the legs and the lungs.

Congestive heart failure can be the end result of:

• Coronary artery disease (heart attacks)
• Diseased heart muscle (cardiomyopathy)
• Abnormal heart rhythms
• Heart valve problems
• Congenital heart disease
• Toxic substances

What treatments are available for congestive heart failure?

• Medications to help blood flow and reduce fluid build up. This is often effective in early stages.
• Heart Transplantation when the heart is irreversibly damaged and medications alone are not effective. It involves removing a diseased heart and replacing it with a healthy human heart. Survival and quality of life are excellent, but there is a shortage of organ donors. Life-long immunosuppression is taken daily to prevent rejection of the new heart.
• Left Ventricular Assist Device is a pump to help the heart pump blood. This device is used to keep a patient alive until a donor heart is found for transplantation.
• Total Artificial Heart is a complete replacement for the heart used when a patient cannot undergo heart transplantation due to age or lack of availability.