Leading the nation in healing hearts: The evolution of heart surgery

Heart Health

by Gonzalo Gonzalez-Stawinski, MD

Feb 10, 2017

Sternotomies — the medical term for splitting open the chest to reach the heart — get the headlines. Transplants, bypasses and other open-heart surgeries are amazing, dramatic and lifesaving, the stuff of riveting documentaries and poignant narratives. By many measures, including transplants, Baylor Scott & White Health is one of the nation’s leaders in healing hearts.

But so much of our cardiac work nowadays is far less invasive and just as effective. The new, exciting wave in heart surgery is treating the same diseases we used to treat with sternotomies using catheter technology. That means threading a catheter containing tiny lights, cameras and tools through the groin all the way to the heart, and replacing or repairing heart valves from the inside.

The goal of the first catheter procedures was to prove the process was safe. Once studies were able to demonstrate the obvious benefits, the U.S. Food and Drug Administration, which oversees public health, approved catheter technologies for high-risk patients. As of the last four or five years, if you did not qualify as a candidate for conventional open-heart surgery, it no longer means you have to die from valvular heart disease.

Now we’re in the midst of studies to approve these types of catheter devices in patients with medium or lower risk. The minimally invasive approaches have obvious benefits. In a typical open-heart surgery case, the patient would remain in the hospital three to five days, whereas the patient who has a catheter procedure can usually go home in less than 24 hours. That means quicker recovery time, quicker return to work, less rehab and better quality of life.

And that’s the history of medicine. We have gone from very large clunky devices and very complicated procedures down to ever-smaller devices and less-invasive procedures. Automatic defibrillators used to be the size of shopping carts. Now they’re the size of a wafer and can be implanted easily. That’s a natural evolution of what medicine does.

So our work at Baylor University Medical Center at Dallas is a combination of conventional surgery and the new innovative technologies. People get excited about heart transplants and VADs (Ventricular Assist Devices, or mechanical pumps implanted in patients suffering heart failure), and we do about 100 a year. But that’s only a tenth of our total patient volume. We can treat a lot of diseases that come to us without having to do a transplant.

Every patient is evaluated by a multidisciplinary group of specialists, almost like a Supreme Court of physicians sharing their opinions about how best to best manage this patient.

What’s unique to Baylor Scott & White Heart and Vascular Services is a tailored approach to care. It’s a collaborative effort of cardiology and heart surgery. Every patient is evaluated by a multidisciplinary group of specialists, almost like a Supreme Court of physicians sharing their opinions about how best to best manage this patient. And we can reach out to doctors within our health care system, not necessarily within our own hospital, for advice and assistance.

It’s an exciting field, and it’s an exciting time for Baylor Scott & White.

About the Author

Gonzalo Gonzalez-Stawinski, MD, is chief of cardiac surgery and heart transplantation at Baylor University Medical Center at Dallas. Follow him on Twitter@HRTTRNSPLNTMD.

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