Cardiovascular and Thoracic
Community Memorial Hospital
Cardiovascular and Thoracic Surgery
The cardiovascular and thoracic surgeons at CMH are specially trained to perform operations on the heart and blood vessels of the body and related areas in the chest. Examples of these surgeries and treatments include:
- Permanent pacemaker insertion and follow-up care;
- Coronary artery (bypass) surgery;
- Surgical treatment of valvular heart disease;
- Surgical treatment of artery problems for lower extremity occlusion, and aortic aneurysm;
- Surgical treatment of carotid artery problems;
- Surgical treatment of lung and esophagus problems; and
- Microvascular surgery for diabetic leg ulcers.
- An established Stable Team of Cardiac Surgeons
- Specialized Surgical Team of Anesthesiologists and O.R. Nurses
- Available When You Need Them, 24 Hours a Day, 365 Days a Year
- Working Together With Your Cardiologist, Family Doctor and Other Specialists in an Integrated Multidisciplinary Setting.
A Great Place to be When Your Heart Needs Help
CMH is the starting point in one's journey back to heart health. The hospital and staff have a special dedication to the total care of patients requiring cardiac operations.
Our cardiac surgeons perform hundreds of open-heart operations each year, with unsurpassed results and patient satisfaction. The surgeon functions as captain of a large experienced and dedicated team. A team that will work with the patient to recover from the operation and embark on a course of improved heart health.
We Can Help Your Heart Recover
A heart operation can mark a turning point in one's life. It can be the point in which he or she takes control of their health, improve the quality of their life, thereby extending their life by many years.
Our patients range in age from their 20s into their 90s, with the majority in their 60s and 70s. Age and other health problems are factors in the risk associated with heart surgery—and will obviously influence the recovery period and potential for future levels of activity—but the overwhelming majority of patients recover and return to active and fulfilling lifestyles. Our surgical outcomes are continuously tracked and analyzed. CMH is unique among the hospitals and programs in Ventura County, as it has participated since the outset in both the Society of Thoracic Surgeons and the statewide cardiac surgical databases.
At CMH, our patients are cared for by people who are specialists in the field of cardiac care, from the surgeons who repair the heart, to the anesthesiologists who provide comfort and pain control during and after the operation, to the nurses who care for patients in the Operating Room, Cardiac Care Units and Telemetry units, to the dieticians, physical therapists, social workers and other professionals who work with patients toward their recovery.
Entering a hospital for heart surgery is obviously a stressful time, but when the heart needs help, CMH is the place to be.
Coronary Artery Disease
High blood pressure, high cholesterol, smoking and other risk factors can cause a build-up of plaque along the walls of the arteries that carry oxygen-rich blood to the patient's heart muscle. That build-up narrows the pathways in the arteries and the blood flow to the heart muscle can be reduced, causing this muscle to become starved for oxygen and other nutrients. In severe cases, plaque or blood clots can completely block an artery, causing a myocardial infarction or “heart attack,” with damage to the affected area of heart muscle.
Coronary Bypass Surgery
Coronary artery bypass is an operation through which blood flow is rerouted through bypass grafts to supply needed blood flow to the heart muscle. This restored blood flow decreases the risk of future heart damage and can improve the function of heart muscle that is impaired by critically diminished blood flow.
Coronary Artery Bypass Grafting Surgery
CMH surgeons employ the latest scientifically validated and most effective techniques. Using sections of arteries from the chest wall or forearms or sections of one of the many veins in the legs, blood is rerouted through these grafts to the heart muscle that needs it.
This operation can sometimes be performed using a relatively new technique through which your heart continues to work and pump blood, while the bypasses are being performed.
At other times, the bypasses are best performed with the heart still and resting. A specialist called a Perfusionist is an integral part of the operating team. The Perfusionist controls and monitors the Heart Lung Bypass machine, which temporarily replaces the blood pumping function of the heart and the gas exchange function of the lungs.
Heart Valve Disease
Heart valves can become stiff due to age, unusual anatomy, or scarred from infection. These valves become “too tight” and do not open as easily as they should, causing the heart to work harder to push blood through the smaller opening and decreasing the blood flow to the body. In other cases, age, infection, abnormal anatomy or a combination of these factors can cause a valve to have significant leakage. When a valve doesn't close snugly, it lets blood leak backward into a chamber. The heart then has to work harder to push the same blood through the valve again, causing enlargement and damage to the heart muscle as well as decreased blood flow to the body.
Heart Valve Surgery
The surgeons at CMH replace or repair diseased valves, correcting the problem and helping to restore the heart's ability to pump blood efficiently. During valve repair surgery, surgeons reshape the valve to remove extra tissue when necessary or tighten the valve so it will close securely. In cases where the valves are not reparable, the valve is replaced with an artificial valve that is either mechanical or made of natural tissue.
Recovery and Rehabilitation
Patients will awaken after surgery in the Cardiac Care Unit (CCU) with a specialized CCU nurse at their bedside. They will have a breathing tube in place, chest tubes to drain fluid that may build up in the operative area, and many monitoring devices attached to constantly monitor their condition and vital signs.
The breathing tube is not painful, but is uncomfortable and a protocol is in place to remove it at the patient's bedside as soon as it is safe, often within the first several hours after the operation. The other tubes and lines are removed as recovery progresses, usually within the next 24-48 hours while the patient is in the CCU.
We use a combination of pain medications to help ensure our patients are able to rest and recover as quickly as possible, and though there is usually some discomfort, it is rarely severe and some patients report little or no significant pain in the recovery period.
The day following the operation, most patients are up in a chair. But the recovery period can be quite variable, depending on the patient's other medical problems and condition prior to the heart operation. The average hospital stay is 5-6 days, but this too is variable and is individualized to the needs of each patient.
Whether the hospital stay is short and uneventful or if complications ensue, all the resources needed will be dedicated to helping the patient toward complete recovery.
Heading for Home
Before returning home, patients are instructed regarding recommended diet and activity levels. Most patients are encouraged to start walking daily as soon as they return home, gradually increasing the duration of these walks. Patients should refrain from heavy lifting, pushing or pulling for six weeks while the sternum heals to its full strength. Returning to work can often occur in 3-4 weeks, if this entails no lifting or physical exertion. Gradually, you can begin to build strength and endurance.
Regaining an Active Life
When patients arrive home from CMH, they will have a second chance to be good to their heart. They will be provided with the tools and information needed to take advantage of this chance and should focus on the positive strides that have been made with the help of the team of professionals at CMH. Recommendations for initial activity level will be individualized. Patients are often instructed to start taking short walks as soon as they go home. They will be walking a few minutes once or twice a day and will begin building up distance and time, so that by the time six weeks have passed since the operation, they are walking at least 30 minutes a day. This improves the way their body works, as well as the patient's outlook on life and has shown to be essential for maintaining a healthy heart.
After recovery, a more vigorous exercise regimen may be recommended and a cardiac rehabilitation program at CMH is often available to patients, to provide them with a structured approach, to what hopefully becomes a lifetime health maintenance endeavor. A heart-healthy diet and close follow-ups with their cardiologist and/or primary care doctor, who will monitor their blood pressure and cholesterol profile, and prescribe and monitor medications as needed, are also important components of supporting and maintaining the repaired heart.
The prospect of open-heart surgery may seem overwhelming, but the team at CMH works with patients to help make this an opportunity for them to regain a more heart-healthy life.
It is normal to be concerned when facing the prospect of open-heart surgery, but our team of specialized medical professionals guide our patients through this process and help give them the opportunity for a longer, healthier life.
nursing care was phenomenal. Excellent, just excellent. I wouldn't
trade Dr. Tedesco and the team at Community Memorial Hospital for the
world, I can't say enough about them.”
Hank Owens underwent quadruple bypass surgery and was back on the golf course two months later.
- An anesthesiologist: specializing in cardiac surgeries.
- A Perfusionist: expert in the use of the heart lung bypass machine.
- Two scrub nurses, working in concert with the patient's surgeon to expeditiously complete the repair of the heart.
- A circulating nurse (an RN specially trained for operating room, cardiac needs) and anesthesia technicians who work to assure that all needed supplies are available, while performing important support tasks.
The treatment of vascular disease has undergone remarkable changes. Modern techniques, including minimally-invasive, catheter-based procedures, are often the initial treatment of choice. Aortic aneurysms, carotid disease, venous disease, and varicose veins are just some of the conditions that can be treated with just needle puncture.