Heart Surgery

Valvular Heart Surgery

Valvular stenosis or leakage will lead to progressive heart damage. If the valvular disease is severe, early intervention is needed in order to prevent permanent muscle damage. Timing of surgery is often the most important aspect in managing valvular heart patients.

Treatment options include:

• Valve repair
• Valve replacement
• Percutaneous valve intervention

Aortic Aneurysm Surgery

Aneurysm dilatation of the aorta will lead to fatal outcome once it ruptures. Size of the aneurysm is the most important risk factor for aneurysmal rupture.

Early intervention and elective operation will help to prevent this dreadful outcome.

Thoracic and Abdominal Aneurysm Repair Surgery

What is the Problem and why I need this kind of surgery?

If the size of the thoracic aneurysm is greater than 6 cm, surgery will need to be considered. As for abdominal aortic aneurysm early repair is indicated if the aneurysm is greater than 4.5 cm in size.

After the surgery, what improvements do I have?

Benefit of elective repair is to save life by preventing sudden aneurysm rupture. Once the aneurysm ruptures, it is often fatal.

New treatment option in aneurysm includes:

• Endovascular stenting

Coronary Artery Bypass Surgery

Bypass surgery may be performed in the following groups of patients:

1. Patients whose angina has not been controlled with medications,
2. Patients who are not good candidates for balloon angioplasty and
3. Patients whose coronary arteries have re-narrowed after angioplasty.
4. In patient with left main stenosis, evidence has shown that the patient's life expectancy will be improved, regardless of whether there are symptoms present.

• Debilitating angina that failed to be controlled by medication (heart arteries are narrowed so that too little blood reaches the heart muscle) and often several coronary arteries are blocked at the same time.
• Multiple diseased coronary arteries and the heart's main pump (left ventricle) is functioning poorly.
• Left main coronary artery, which serves the left ventricle, is severely narrowed or blocked.
• Coronary artery blockage that's not suitable for balloon angioplasty or the artery has re-narrowed after angioplasty.

• Prolonged survival
• Relief of symptoms such as chest pain or shortness of breath
• Improve exercise tolerance
• Reduce the need for angina medications
• Prevention of fatal heart attacks

Peripheral Anterior Bypass Surgery

Blockages in the blood vessels in the lower limbs will lead to pain on walking and poor wound healing.  When the blockages are greater than 70%, patients usually will start to have symptoms. Progressive worsening of symptoms despite of adequate medication is an indication for surgery.

Treatment options:

• Peripheral artery bypass such as aorto-femoral, femoro-popliteal or popliteal tibial bypass grafting.
• Endovascular dilatation and stenting

Arterio-venous Fistula

What is the problem and why I do need this kind of surgery?

Vascular access is needed for hemodialysis in patients with end stage kidney failure. An arterio- venous fistula can be created in the forearm for such purpose.

Varicose Vein Surgery

What is the problem and why I need this kind of surgery?

Varicose veins are dilated, tortuous vein present usually in the lower limbs. Although the pathophysiology is multi-factorial, in primary varicose veins the main abnormality is valvular dysfunction. This may occur in the deep, perforating or superficial long and short saphenous veins.

Long standing disease can lead to venous hypertension, hyperpigmentary skin changes and stasis ulcer. Clear indications for surgery are signs of chronic venous insufficiency, superficial thrombophlebitis and bleeding.

Treatment options include:

• Surgery- Ligation and stripping, ligation of perforators
• Endovenous Laser Treatment
• Injection sclerotherapy

After the surgery, what improvements do I have?