Heart Surgery

There are many reasons why you may need heart surgery (also called cardiovascular surgery). It can repair heart conditions you’re born with (congenital heart conditions). Or it can treat conditions that developed later in life (acquired).

Heart surgery can repair narrow or blocked arteries (coronary artery disease) so blood can flow better. It can also fix damaged heart valves. And it can treat heart failure, aortic aneurysms and many other conditions. Surgery can also help smooth out abnormal heart rhythms (arrhythmias).

What to expect during your consultation

Preparing for heart surgery can take weeks or even months. You’ll first have what we call a surgical review. This lets us learn more about your condition and why your physician has referred you. You’ll meet with different heart experts who’ll make up your care team, and get a physical exam and blood work. And you’ll have other tests, too.

We use different tests to help us learn more about how your heart looks and works. The results of these tests can guide us in building the best treatment plan (and choosing the right surgery) for you. You may have:

• Cardiac computed tomography scan (cardiac CT).
• Cardiac magnetic resonance imaging (heart MRI).
• Chest X-ray.
• Coronary angiography.
• Echocardiogram (Echo).
• Electrocardiogram (ECG/EKG).
• Exercise stress test.
• Metabolic stress test.
• Nuclear cardiac stress test.
• Cardiac catheterization.
• Coronary calcium scan.
• Pulmonary function tests.

Your care team will use what they learn from testing and the surgical review to decide if you need surgery — and if you do — the kind of surgery you’ll need and when you’ll have it. You may be able to have a minimally invasive or robotically assisted procedure, or you might need open heart surgery.

During your appointment, you’ll also have a chance to spend time getting to know your care team. Feel free to ask as many questions as you want. And share any concerns you may have about moving forward. During your visit, your providers will also ask you to share your story by asking questions like:

• Why did your physician refer you for a surgical review?
• What kind of symptoms are you having?
• How long have you had symptoms?
• Are your symptoms getting worse?
• Have you had any testing yet?
• Do you have other health conditions?
• Does anyone in your family have heart problems?

Meet Our Heart Surgery Team

We believe in personalized care at Cleveland Clinic. That means we build a care team based on your unique needs and diagnosis — combining the experience of providers from different specialties. You’ll mainly work with cardiothoracic surgeons and cardiologists.

These providers work together to make sure you have a care plan that meets your needs. And they’re here to answer any questions you have.

The kind of heart surgery you’ll have depends on your diagnosis. Different heart conditions require different types of surgery. You may need:

Coronary artery surgery

For some cases of coronary artery disease, we can open narrowed or blocked arteries with a minimally invasive coronary angioplasty and stent.

If you have a severe blockage, we may do coronary artery bypass surgery (CABG), commonly called heart bypass surgery. This surgery treats coronary artery disease (CAD).

Surgeons will create a detour around your blocked arteries by taking a healthy blood vessel from your chest wall, arm or leg and connecting (grafting) it to your heart to treat the blocked one. If they do this with more than one blood vessel, it’s called double (2), triple (3) or quadruple (4) bypass surgery.

Often, you’ll be on a heart-lung (cardiopulmonary) bypass machine to help you breathe and keep your heart working during surgery. But other times, your surgeon might decide to do off-pump bypass surgery. This means they’ll operate on your heart without a heart-lung machine. And your heart will beat on its own during surgery.

Heart valve surgery

We often use surgery to repair or replace abnormal or damaged heart valves. The type of heart valve surgery you have depends on what’s causing the problem. You may have:

• Aortic valve surgery, including the aortic root or aorta and transcatheter aortic valve replacement (TAVR).
• Mitral valve repair and replacement, including robotic-assisted and minimally invasive.
• Tricuspid valve surgery.
• Pulmonic valve surgery.
• Bicuspid aortic valve surgery.
• Infective endocarditis surgery.

Aortic surgery

We use aorta surgery for conditions like weakened or bulging aortic walls (aortic aneurysm) and stretching or tearing in it (aortic dissection). You may have aneurysm repair surgery to treat aortic problems in your belly and chest. To make repairs to your aorta, we may do:

• Endovascular surgery.
• Open aneurysm repair surgery.

Heart rhythm surgery

When your heart isn’t beating normally, sometimes surgery can be the best way to get a normal heartbeat (rhythm) — especially if other treatments haven’t worked. For some of these procedures, you may work with an electrophysiologist (cardiologist). These procedures can include:

• MAZE procedure.
• Convergent procedure.
• Catheter ablation.
• Permanent pacemaker.
• Implantable cardioverter defibrillator.

Pericardial surgery

When the double-walled, fluid-filled sac around your heart (pericardium) becomes too stiff, it can affect how your heart pumps blood (constrictive pericarditis). A pericardiectomy removes part or all of your pericardium. Also known as “pericardial stripping,” we do this treatment through open-heart surgery or a thoracotomy.

Hypertrophic cardiomyopathy surgery

A treatment called septal myectomy can help if you have hypertrophic cardiomyopathy. This condition causes your heart muscle to thicken. It usually affects the septum, a muscle dividing the two sides of your heart. We can remove a small part of the septum to improve blood flow in your heart.

Left ventricular assist devices (LVADs)

Having heart failure means your heart may need help pumping blood (mechanical circulatory support). We can implant a left ventricular assist device that pumps blood from the left chamber of your heart (left ventricle) to your aorta. We’ll use a heart-lung bypass machine and a ventilator during this open surgery (sternotomy). Or your surgeon may choose to do a thoracotomy.

Heart transplant surgery

When treatments don’t work, or your heart is too damaged to be repaired (end-stage heart failure), your providers may recommend a heart transplant. We did our first heart transplant in 1964 and have done more than 2,000 since then. If you’re a candidate for one, you’ll go on the waiting list for a donor heart. You may need “bridge treatment” while you wait to help your heart keep working as best it can. You may have a left ventricular assist device or an intra-aortic balloon pump. Or you may receive a total artificial heart, depending on your condition. You may also take medications.

Traveling for Heart Care at Cleveland Clinic

We know that traveling for any kind of healthcare can often be stressful and overwhelming. If you’re coming to us from another city, state or even another country, we’re here to help make things as easy and convenient as possible for you. From knowing where to stay and where to eat to knowing how to get to and from the airport, shop or just find your way around any of our hospitals, we’re here for you.

If you’re an international patient, our experienced and compassionate Global Patient Services (GPS) team will help you navigate Cleveland Clinic. They’ll connect you with the healthcare providers you need, help you make appointments, provide language translation services and coordinate follow-up care when you return home.

Life After Heart Surgery

Recovery time from heart surgery depends on what type of surgery you had and your condition before and after surgery. Some surgeries may take only a week or so to recover from, while others could take eight weeks or more. Once you’ve had heart surgery, it’s important to keep up with your medications, cardiac rehab program and regular follow-up appointments. Doing this helps you have the best possible results during recovery and beyond.

Taking the Next Step

Heart surgery can have a big impact on your life. And you might feel a difference soon after your procedure. But, in the weeks or months leading up to it, it’s OK to feel a little nervous about what to expect. Having heart surgery is a big deal. That’s why our cardiology providers are here to guide you through it all — from preparing for surgery and having the operation to recovering from it. When you come to Cleveland Clinic for heart surgery, you can be sure you have the most experienced and caring team on your side as you move toward a healthier heart.