Expert Cardiac Treatments & Interventions
LRMC’s heart care team can treat the most minor to the most complex cardiac condition using the latest in technology. We've perfected the most complicated of cardiothoracic procedures. 

Angioplasty is a procedure to remove the blocked artery and restore blood flow to the heart. If you suspected a heart attack and went to the emergency room right away, chances are you received the first-line treatment: percutaneous (below the skin) coronary intervention or angioplasty. It’s likely you will be placed on a lifetime regimen of medication after having a heart attack. There are many categories of medications.  

Open heart surgery can take many forms, from heart valve repair or replacement to coronary bypass surgery, which creates a detour or "bypass" around the blocked part of a coronary artery to restore the blood supply to the heart muscle. When one or more of the coronary arteries becomes partially or totally blocked, the heart does not get enough blood. This is called ischemic heart disease or coronary artery disease (CAD).

OVERVIEW OF THE PROCEDURE:
Heart bypass surgery creates a detour or "bypass" around the blocked part of a coronary artery to restore the blood supply to the heart muscle. The surgery is commonly called Coronary Artery Bypass Graft, or CABG (pronounced "cabbage"). You will receive anesthesia and be completely free from pain. Then the heart surgeon makes a surgical cut in the middle of the chest and separates the breastbone. Through this cut, the surgeon can see the heart and aorta (the main blood vessel leading from the heart to the rest of the body). After surgery, the breastbone will be rejoined with wire and the opening will be sewn closed.

Artery and vein grafts are used when there are healthy arteries and veins that can be taken from other areas of the body and grafted to the heart during coronary bypass surgery.  

If the saphenous vein in the leg is to be used for the bypass, an incision is made in the leg and the vein is removed. The vein is located on the inside of the leg. It runs from the ankle to the groin. The saphenous vein normally does only about 10% of the work of circulating blood from the leg back to the heart. Therefore, it can be taken out without harming you or or the leg.

The internal mammary artery (IMA) can also be used as the graft. This has the advantage of staying open for many more years than the vein grafts, but there are some situations in which it cannot be used. The left IMA, or LIMA, is an artery that runs next to the sternum on the inside of the chest wall. It can be disconnected from the chest wall without affecting the blood supply to the chest. It is commonly connected to the artery on the heart that supplies most of the muscle.

Other arteries are also now being used in bypass surgery. The most common of these is the radial artery. This is one of the two arteries that supply the hand with blood. It can usually be removed from the arm without affecting the blood supply to the hand.

In the traditional surgery, you are connected to the heart-lung machine, or bypass pump. This machine adds oxygen to the blood and circulates blood during the surgery. This is necessary because the heart muscle must be stopped before the graft can be done. One end of the graft is stitched to an opening below the blockage in the coronary artery. If the grafted vessel is the saphenous vein or the radial artery, its other end is stitched to an opening made in the aorta. If the grafted vessel is the mammary artery, its other end is already connected to the aorta. The entire surgery can take 4-6 hours. After the surgery, you will be taken to the Intensive Care Unit. For a few days after the surgery, you will be connected to monitors and tubes.

Other surgical techniques for this procedure are being used more frequently. One popular method is to avoid the use of the heart-lung machine. This is called off-pump coronary artery bypass or OPCAB. This operation allows the bypass to be created while the heart is still beating. The advantage is that use of the heart-lung machine can lead to some loss of memory and mental clarity. With OPCAB, that risk is reduced because the heart isn't stopped, and oxygen isn't added to the blood outside the body.

Cardiac rhythm studies and ablation (EP) refers to the detection of heart rate rhythm disturbances and the use of advanced electrical systems, such as the implantation of pacemakers and defibrillators, to help treat and/or destroy the cause of the disturbance.  

Therapeutic hypothermia cools the body to about 91 degrees and can be used following cardiac arrest to stabilize an unconscious patient's heart and help to minimize brain-cell death and other organ demise that could lead to permanent neurological damage. Sometimes cooling begins in the ambulance, but more often it's initiated in the emergency room.