Category Archives: Surgical Solutions

Coronary Bypass

What is coronary artery bypass surgery?

Coronary artery bypass graft surgery is open-heart surgery in which vessels (veins or arteries) taken from another part of the body are used to supply blood to coronary arteries that are not receiving enough blood. The arteries or veins used in the surgery can be easily removed from the areas where they were located and do not interfere with blood flow in their former location.

Examples of grafts from the arteries include the internal thoracic artery (internal mammary artery), which runs down the inside of the chest wall, and the great saphenous vein, which runs down the inside of the leg just under the skin from the ankle to the groin. Sometimes vein grafts can also be prepared from the back of the leg or arm if necessary. The radial artery from the forearm and the gastric artery from the abdomen can be used as arterial grafts.

During surgery, arterial and vein grafts are connected directly to the coronary vessels that run on the surface of the heart. Thus, the grafts act like a bridge and provide blood flow beyond the stenosis.

Coronary artery bypass surgery is usually performed using a heart-lung machine. This machine oxygenates the blood and supplies the body with a certain pressure that allows the heart to stop. This is how coronary artery bypass surgery is performed.

What does coronary artery bypass surgery provide?

Coronary artery bypass grafting surgery increases decreased blood flow to the myocardium. This greater blood flow relieves chest pain (angina). It also reduces fatigue and the need to take several medications, making patients feel better. As a result, patients’ quality of life increases. Bypass surgery in people with severe coronary artery disease prolongs the patient’s life.

Robotic Surgery

Robotic surgery is considered the highest level of technology that cardiac surgery has reached.
Robotic surgeries are performed through much smaller incisions, without stopping the heart, and offer a great advantage to patients both cosmetically and during recovery. Since there is no bone or muscle incision and the wound is very small, patients can get up much faster after surgery, pain in the postoperative period is minimized, and problems related to the wound are largely avoided.

In robotic surgeries, the surgeon sits at the main console (master unit) with a three-dimensional imaging system remote from the patient, whereas the arms of the robot in the chest (slave unit) simultaneously follow the surgeon’s hand movements to perform the surgical procedure. A second surgeon at the patient’s head performs the exchange of surgical instruments at the robotic arms and other procedures. In the da Vinci robotic system, the surgical instruments can perform all the movements of a human wrist can in the thorax.

What is Robotic Surgery?

Robotic surgeries are performed through much smaller incisions, without stopping the heart, and offer a great advantage to patients both cosmetically and during recovery. Since there is no bone or muscle incision and the wound is very small, patients can get up much faster after surgery, pain in the postoperative period is minimized, and problems related to the wound are largely avoided.

How is Robotic Surgery Performed?

In robotic surgeries, the surgeon sits at the main console (master unit) with a three-dimensional imaging system remote from the patient, whereas the arms of the robot in the chest (slave unit) simultaneously follow the surgeon’s hand movements to perform the surgical procedure. A second surgeon at the patient’s head performs the exchange of surgical instruments at the robotic arms and other procedures. In the da Vinci robotic system, the surgical instruments can perform all the movements of a human wrist can in the thorax.

For whom can robotic surgery be used?

• Robotic surgery is mainly used in coronary bypass surgery, mitral valve repair, and arrhythmia surgery.
• However, robotic surgery cannot be used in every patient.
• With current techniques, robotic surgery is not preferred for bypass surgery on more than two arteries.

Minimally Invasive Surgery

In the last decade, there have been rapid developments in cardiac surgery. Due to on these developments, the results of surgeries are getting better and better, and it is possible to reach a wider mass of patients.

A patient undergoing open heart surgery stays in the hospital for an average of 8-10 days and then spends about a month in recovery, resulting in a significant loss of manpower. With new developments, ideas have emerged that this procedure can be performed without losing blood, through smaller holes and without stopping the heart.

Initially, bypass operations on the working heart began to be successfully performed without stopping the heart. Later, it was found that this operation could be performed through a much smaller incision, and this was called “pericardial window surgery.” In the following years, cardiac valve surgeries were also performed using this method, i.e., through a small hole.

The most obvious advantages of this method are that the patient feels less pain and can get up faster. A patient who stays in the hospital for ten days on average in the case of normal open-heart surgery, can be discharged within 4-5 days with this method and return to work in a short time.

Valve Surgeries

In surgical procedures on cardiac valves, a distinction is made between valve repair and valve replacement. The chance of repairing the valve is higher in patients whose valvular cardiac disease has not progressed and who consulted the physician early. Otherwise, valve replacement with a new valve is the most favorable option. Your doctor will provide you with detailed information and guidance in this regard.

There are two types of valves used when they need to be replaced: the biological valve and the mechanical valve. The biggest advantage of the biological valves is that they do not require blood thinners. However, their average lifespan is limited to 7-10 years. Mechanical valves, on the other hand, have a very long-life span. Yet, because they are made of metal, patients must take blood thinners for the rest of their lives to prevent clots from forming on the valves.

Many factors should be considered when choosing the most appropriate valve for you: Your age, the type of valve disease, whether you can take blood thinners for life, and whether you want to have a child.

Arrhythmia Surgery / Atrial Fibrillation

Surgical treatment of atrial fibrillation (AF) can be divided into two groups. The first group of patients are those who have another disease that causes AF and requires surgical treatment. In this group of patients, “ablation” surgery to treat AF can be performed along with heart surgery for their current problem (coronary bypass surgery, valve disease surgery). The success rate of this type of surgery to turn it to sinus rhythm is about 85% for 2 years.

The second group of patients are those who have only AF without another heart disease. In this group of patients, “ablation” surgery with smaller surgical incisions (using minimally invasive methods) can be performed to bring it into sinus rhythm and treat AF. In our clinic, this type of ablation surgery can be performed in these patients with surgical incisions of about 3 centimeters under the right and left breast, which is performed in only a few centers in the world.

Thus, atrial fibrillation is a cardiac arrhythmia with life-threatening complications that occurs in association with various cardiac diseases or sometimes alone and affects the quality of life. Although medications and angiographic treatments are available, success rates are not very high. Atrial fibrillation is a condition that can be treated surgically, either in conjunction with various cardiac disorders or alone. This type of cardiac surgery has been successfully performed at our hospital for the past five years.