Heart Surgery

If you have been diagnosed with a heart condition, your doctor may recommend heart surgery. Heart surgery is also known as cardiac surgery, and sometimes referred to as cardiothoracic surgery which technically includes the heart and the lungs. Heart surgery is a surgical procedure that is used to treat a variety of heart conditions, such as coronary artery disease, heart valve problems, and congenital heart defects. Some common symptoms of these conditions include chest pain, shortness of breath, palpitations, and fatigue. You may be more likely to have heart surgery if you have a family history of heart disease, or if you have risk factors such as high blood pressure, high cholesterol, or diabetes. There are several different types of heart surgery, including coronary artery bypass grafting, valve replacement or repair, and congenital heart defect repair. 

At Blackrock Health, we have some of Ireland's most respected cardiologists, and cardiac & vascular surgeons on our team. Our three hospitals, the Blackrock, Galway, and Hermitage Clinics, ensure best practice in care. We provide minimally invasive treatments and the latest technology as well as traditional open-heart techniques. Blackrock Health also offers fast access to the five cath labs in our three hospitals. We provide the most accurate diagnostics and effective care plan possible, with the least possible delay. We offer easy access to our teams of consultants and clinical experts and are committed to helping you achieve optimal heart and vascular health.

Blackrock Health's cardiothoracic surgeons offer a huge range of cardiac surgery. We benefit from a depth of experience. Our staff use the newest surgical techniques and technologies alongside traditional methods. Our range includes minimally invasive, percutaneous, and robot-assisted procedures. Our teams are able to perform complex operations on patients with conditions previously deemed inoperable. 

The Blackrock Clinic, in particular, has a long history of pioneering the newest heart treatments and procedures. In 2018, cardiothoracic surgeon Mr Vincent Young performed one of Ireland’s first minimally-invasive heart bypass operations using robotics. The robotic coronary artery bypass graft (CABG) was carried out using Blackrock Clinic's Da Vinci XI surgical system. Patients undergoing this procedure have less pain and quicker recovery, as only small surgical incisions are required. Instead of spending a week in hospital, recovery time is reduced to as little as 48 hours.

Heart surgery performed at our hospitals

There are several types of heart surgery that can be performed, depending on the specific condition being treated. Here are some of the most common types of heart surgery you might require:

Coronary artery bypass grafting (CABG)

Coronary artery bypass grafting (CABG, often pronounced "cabbage") is a surgical procedure used to treat coronary artery disease. This disease causes a build-up of fatty deposits in the arteries that supply blood to the heart muscle. CABG is a common treatment option for people who have severe coronary artery disease. It is used when symptoms have not been adequately managed through medication or lifestyle changes, or when a stent is insufficient.

CABG is performed under general anaesthetic and involves opening the chest through the breast bone to access the heart. Your surgeon creates a new pathway for blood to flow to the heart by using healthy blood vessels from elsewhere in the body. This healthy, or donor, blood vessel may be taken (harvested) from the chest, arm or leg. The healthy blood vessel is prepared for use in the bypass, and a bypass is created by attaching one end of the healthy blood vessel to the aorta. This is the main artery that carries blood from the heart to the rest of the body. The other end is attached to the coronary artery beyond the blockage.

CABG is a major surgical procedure that requires a hospital stay of several days or more and a specialised recovery programme. For many people with severe coronary artery disease, it can be an effective way to improve blood flow to the heart. This reduces symptoms, and lowers the risk of heart attack and other complications.

Heart valve replacement or repair

Heart valve replacement or repair is a surgical procedure performed to treat a heart valve that is not functioning properly. The heart has four valves that regulate blood flow through the heart chambers. If a valve becomes damaged or diseased, it can interfere with normal blood flow. The valve can become too narrow, restricting the amount of blood that flows - called stenosis. It can also become too loose, resulting in a back flow of blood - called regurgitation. This, causes symptoms such as shortness of breath, fatigue, chest pain, and heart palpitations.

Heart valve replacement involves removing the damaged or diseased valve. This is then replaced with an artificial or biological valve. The artificial valve can be made of different materials such as metal, plastic, or ceramic. The biological valve is made from animal tissue such as pig or cow, or from human tissue donated from a deceased person.

Heart valve repair is a procedure to mend a damaged or malfunctioning valve without replacing it. Repair techniques can include:

• trimming or reshaping the valve flaps, 
• tightening the ring of tissue that supports the valve, or 
• repairing the strings that anchor the valve flaps to the heart muscle.

Both heart valve replacement and repair are performed under general anaesthetic. They both require a hospital stay of several days to a week. For many people with heart valve disease, these procedures can greatly improve their quality of life. They can reduce the risk of serious complications such as heart failure or stroke.

Aortic Aneurysm repair

This aorta is the main artery that carries blood from the heart to the rest of the body. Aortic surgery involves repairing or removing a weakened section of the aorta. 

An aortic aneurysm is a condition in which the walls of the aorta, the largest blood vessel in the body, weaken and bulge outward. This can be a life-threatening condition if the aneurysm ruptures, leading to massive internal bleeding. Therefore, repair of an aortic aneurysm is often necessary to prevent this dangerous complication.

The aorta can develop an aneurysm in two places. If it occurs in the chest it is called a thoracic aortic aneurysm. If it happens in the abdomen, it is called an abdominal aortic aneurysm, or triple A. Thoracic aneurysms are usually  treated by a cardiothoracic surgeon, and abdominal aneurysms by a vascular surgeon.  

There are two main approaches for repairing an aortic aneurysm: 

• Open surgery 

Open surgery involves making an incision in the abdomen or chest and replacing the damaged portion of the aorta with a synthetic graft. This is a major surgical procedure that typically requires a hospital stay of several days or even weeks.

• Endovascular aneurysm repair 

Endovascular aneurysm repair (EVAR), is a less invasive alternative to open surgery. During this procedure, a catheter is inserted into a blood vessel in the groin and guided up to the site of the aneurysm. A stent graft, which is a small metal mesh tube covered in fabric, is then placed inside the aneurysm to reinforce the weakened walls of the aorta.

Endovascular repair has a shorter hospital stay, less pain and discomfort, and a lower risk of complications than open surgery. However, not all patients are suited to endovascular repair, and open surgery may be necessary in some cases.

The decision of which approach to use will depend on a variety of factors, including the size and location of the aneurysm, and your overall health. [LINK to EVAR Vascular page]

Congenital heart defect repair

This surgery involves repairing structural defects in the heart that are present from birth. Congenital heart defects are sometimes diagnosed as an infant, but occasionally do not become evident, or produce symptoms, until many years later. In Blackrock Health, our surgeons treat adults with congenital heart problems. These can include holes in the heart or abnormal blood vessels.

The repair of congenital heart defects can involve surgical or non-surgical procedures, depending on the type and severity of the defect.

Non-surgical procedures, such as cardiac catheterisation, may be used to treat some types of defects. During this procedure, a thin, flexible tube called a catheter is inserted through a blood vessel in the groin and guided to the heart. Once the catheter reaches the affected area of the heart, a small device or material can be placed to close the hole or repair the defect.

Surgical procedures are often required to repair more complex congenital heart defects. The type of surgery depends on the specific defect. It may involve;

• Open-heart surgery, in which the chest is opened and the heart is exposed, or 
• Minimally invasive procedures, which involve smaller incisions and the use of specialised instruments.

After surgery, patients may require follow-up care and monitoring to ensure that the defect has been fully repaired and the heart is functioning properly.

Multi-disciplinary Care Team

As well as your surgeon, anaesthetist, and clinical nurse specialists, your cardiothoracic care team includes cardiothoracic physiotherapists. These chartered physiotherapy specialists work closely with you before and after surgery. 

Before surgery, they will talk to you about your procedure and your recovery. They will assess your requirements and instruct you on the techniques and exercises you require. These may be for breathing, coughing, chest wound support etc. They will demonstrate mobility techniques. 

You will see them often following your surgery. This will reduce as your mobility improves. Prior to discharge, they will equip you for continuing your own physiotherapy programme at home.

Your cardiothoracic team works closely with colleagues in our cardiology, vascular and respiratory departments. Holistic, multi-disciplinary patient care helps towards a speedy and smooth recovery.