Into the Heart Maze
The Bypassing Open-Heart Surgery Story
Those with severe blockage in the arteries of the heart often need a type of open-heart surgery called coronary artery bypass grafting (CABG). During the operation, a surgeon reroutes blood flow to the heart by connecting a healthy vessel to the diseased one, which diverts the blood around the clot. At CHRISTUS St. Frances Cabrini Hospital, Chance DeWitt, M.D., FACS, cardiothoracic surgeon at Louisiana Cardiovascular & Thoracic Institute LLC, offers a next-level version of CABG that patients once had to travel out of state to have: robotic CABG using the da Vinci® Surgical System.
Patients may be eligible for robotic CABG if they have blockages in the left anterior descending (LAD) artery — sometimes called the “widow-maker” artery — and have not had surgery on the left side of their chest before. During the procedure, Dr. DeWitt controls da Vinci’s arms from a console. “I make a three- to five-inch incision beneath the patient’s left breast and bypass the blockages in the LAD using the left internal mammary artery,” Dr. DeWitt says. “Patients usually need minimal recovery time. Typically, once the skin heals after a week or two, they are free to do all activities.” After a two- to five-day hospital stay, patients complete two months of cardiac rehabilitation to help the heart rebuild its strength.
Into the Mini-Maze
Treatment for atrial fibrillation, the most common form of irregular heartbeat, has come a long way, from medication to open surgery to, most recently, an ablation procedure that requires just a few small incisions in the chest. Gary Jones, M.D., FACS, cardiothoracic surgeon at Louisiana Cardiovascular & Thoracic Institute LLC, began performing this procedure — called mini-maze — at CHRISTUS Cabrini in 2016.
“Mini-maze is for patients with stand alone atrial fibrillation [those who don’t have other heart problems and don’t need bypass surgery],”Dr. Jones says. “Prior to the procedure, an electrophysiologist maps the patient’s heart to find the sources of the arrhythmia. During minimaze, I use probes to treat those areas of the heart and, hopefully, stop the abnormal beat.” Dr. Jones also closes the left atrial appendage, a sac in the heart’s left chamber where blood can accumulate and clot, potentially leading to a stroke. Mini-maze patients usually stay in the hospital for two to three days and then complete one to two weeks of cardiac rehabilitation after they return home.