Cardiovascular Surgery

Heart procedures are some of the most commonly practiced medical procedures in the world, requiring an extraordinary level of precision, professionalism, and cutting-edge technology. Around the world, more patients are seeking advanced heart care in centers that blend innovation with accessibility. Among them, Biruni Hospital stands out for its surgical precision and its patient-focused philosophy, rooted in clinical excellence.

What is cardiovascular surgery?

Cardiovascular surgery includes a wide range of medical procedures on the heart and blood vessels. These procedures are performed to treat diseases that threaten the heart’s function or blood circulation.

Key aspects of cardiovascular surgery:

• Restore or improve heart and vessel function
  
• Bypass surgery, valve repair/replacement, aneurysm repair, congenital defect correction, heart transplant
  
• Open-heart, minimally invasive, robotic-assisted, catheter-based
  
• Coronary artery disease, valve disorders, congenital heart defects, heart failure, arrhythmias
  
• Surgeon, cardiologist, anesthesiologist, perfusionist, nurses
  
• Hospital stay and rehab vary by procedure; most patients require follow-up and lifestyle adjustments
  

Key Types of Cardiovascular Surgery

Cardiovascular surgery includes specialized operations to treat heart and blood vessel diseases. Each procedure targets a specific issue and is performed with techniques adapted to the patient’s needs. Below are the main types of cardiovascular surgeries performed at Biruni Hospital.

1. Coronary Artery Bypass Grafting (CABG)

 CABG restores blood flow to the heart by bypassing blocked coronary arteries. The surgeon uses a healthy blood vessel, often taken from the leg, arm, or chest, to create a new route for blood to reach the heart muscle.

Procedure at Biruni Hospital

• Performed under general anesthesia.
• The chest is opened through a sternotomy.
• A healthy vessel is harvested from another part of the body.
• The heart is either temporarily stopped and connected to a heart-lung machine or operated on while beating using stabilization techniques.
• The graft is sewn into place to bypass the blockage.
• The chest is closed after ensuring proper blood flow.

Who It’s For:

• Patients with severe coronary artery disease (CAD).
• People experiencing angina (chest pain) unrelieved by medication.
• Individuals at high risk of heart attack due to blocked arteries.

2. Heart Valve Repair or Replacement

This surgery treats defects in one of the heart’s four valves (aortic, mitral, tricuspid, or pulmonary). When possible, the valve is repaired; otherwise, it is replaced with a mechanical or biological valve.

Procedure at Biruni Hospital:

• Comprehensive diagnostic imaging (echocardiography, MRI, or CT) before surgery.
• Performed under general anesthesia.
• Damaged valves may be reshaped, patched, or completely replaced.
• If replacement is necessary, the new valve is sewn into position.
• Heart function is tested before the chest is closed.
  

Who It’s For

• Patients with valve stenosis (narrowing) or regurgitation (leakage).
• Individuals with congenital valve malformations.
• Those with valve damage from infection (endocarditis) or rheumatic fever.

3. Aortic Aneurysm Repair

 This procedure repairs dangerous bulges in the aorta that could rupture. It may be done with open surgery or endovascular stent grafting.

Procedure at Biruni Hospital:

• Preoperative imaging with a CT scan or MRI to define the aneurysm’s size and location.
• Performed under general or regional anesthesia.
• Open repair: the damaged section of the aorta is replaced with a synthetic graft.
• Endovascular repair: a stent graft is inserted via catheter through the groin to reinforce the aortic wall.
• Blood flow is restored, and the artery is stabilized.

Who It’s For:

• Patients with thoracic or abdominal aortic aneurysms larger than 5 cm or showing rapid growth.
• Individuals with aneurysms are at high risk of rupture.
• Those with connective tissue disorders such as Marfan syndrome affecting the aorta.

4. Congenital Heart Defect Surgery

Surgery to correct structural heart problems present at birth, such as holes in the heart wall (septal defects),abnormal valve shapes, or incorrectly connected blood vessels.

Procedure at Biruni Hospital:

• Diagnosis through fetal echocardiography, newborn screening, or adult imaging.
• The surgical approach depends on the defect: patching holes, redirecting vessels, or repairing valves.
• Most cases require open-heart surgery using a heart-lung machine.
• Some defects can be corrected with catheter-based techniques.
• Postoperative monitoring in the pediatric cardiac intensive care unit for oxygen levels, heart rhythm, and growth.

Who It’s For:

• Newborns, children, or adults with uncorrected congenital heart defects.
• Patients with defects affecting blood circulation or oxygen delivery.
• Individuals with heart malformations causing fatigue, poor growth, or cyanosis (bluish skin).

Getting ready for heart surgery

Preparing for heart surgery is a crucial part of ensuring a smooth and successful procedure. This stage involves both physical assessments and lifestyle adjustments that help minimize risks and improve surgical outcomes. By following your doctor’s instructions closely and understanding what to expect, you’ll feel more confident and supported throughout the process.

Pre-surgery testing

Before anything else, your medical team will likely schedule several tests. These include:

• Blood work: This helps assess your blood count, kidney and liver function, clotting ability, and infection markers. It ensures you're physically prepared to undergo surgery and anesthesia.
• Chest X-ray: A chest X-ray provides a clear view of your lungs and heart size. It helps detect any hidden lung issues or infections that may complicate the surgery or recovery.
  
• ECG (Electrocardiogram): This test records the electrical activity of your heart to check for irregular rhythms, previous undetected heart attacks, or other cardiac abnormalities that could affect the surgery.
  
• CT Scan (Computed Tomography): A CT scan offers detailed images of your heart and blood vessels, allowing your medical team to locate blockages, assess the structure of the heart, and plan the most precise surgical approach.

Meeting with your doctor

Prior to undergoing the procedure, you’ll have a detailed meeting and conversation with your doctor. This is your chance to ask them all the questions you want to ask about the procedure.

Medications and lifestyle changes

Your doctor may instruct you to stop taking certain medications, especially blood thinners like aspirin. You will also have to quit smoking and drinking alcohol before undergoing the procedure.

Fasting before the surgery 

The night before your operation, your doctor will likely instruct you not to eat or drink anything after a certain time. Typically, fasting lasts at least six hours.

Post-operative recovery after cardiovascular surgery

The recovery journey after cardiovascular surgery is just as important as the procedure itself. This phase requires careful monitoring, gradual physical rehabilitation, and emotional support to ensure the best possible outcome. Understanding what to expect during both the short- and long-term stages of healing can help patients and families feel more prepared, confident, and engaged in the recovery process.

The short-term healing

During the first days after the procedure, the patient may experience:

• Some mild fatigue, limited mobility, and soreness, especially around the sternum or incision site
  
• Swelling in the legs or chest due to fluid retention (this is normal and easily treatable using the right medication)
  
• Emotional changes such as anxiety, mood swings, or mild depression; In such cases, seeking emotional support is recommended
  

The long-term healing

As physical recovery progresses, the long-term healing period starts to focus more on full healing and improving your quality of life.

The key aspects of this healing period include

• Continued healthy eating, regular low-intensity exercise, weight control, and stress reduction
  
• When experiencing fear about the healing process, body image concerns, or depression, counseling or support groups may be needed; remember that mental health is as important as physical health
  
• To evaluate the heart’s response under exertion, the doctor will perform periodic stress tests, echocardiograms, or Holter monitoring
  
• For those with hypertension, diabetes, or hyperlipidemia, Long-term control is essential
  

A new lease on life

Cardiovascular surgery is a complex and transformative journey, offering patients a second chance at a healthier, more fulfilling life. From the initial preparation to the postoperative recovery, each step is essential to ensuring success.