Cardiac surgery unit does 4 high-tech CABGs
Cardiac surgery unit does 4 high-tech CABGs
7% of all Cleveland Clinic’s cardio cuts are mini
Cleveland Clinic, one of the highest volume cardiac surgery centers in the nation, now offers four different minimally invasive procedures on beating and stopped hearts. (See the chart listing the procedures, p. 123.) In 1996, 7% of heart surgeries at Cleveland Clinic were via three-inch incisions, and that number will increase by year’s end. "The genie is out of the bottle, and it will never go back in," comments Delos Cosgrove, MD, chairman of thoracic and cardiovascular surgery at the facility. (For details of Cleveland Clinic’s national ranking, see p. 126.)
Cleveland surgeons employ two devices for beating heart bypass procedures Medtronic’s "Octopus" and CardioThoracic Systems’ "MIDCAB." Each device holds a small area of the beating heart motionless, so the surgeon can place sutures with precision. MIDCAB stabilizes the area with pressure on either side of the artery to be bypassed. Octopus uses small suction cups to lift and immobilize a portion of the heart.
The stilled heart
Minimally invasive surgery on a non-beating heart is considered by most to be an easier, safer procedure than on the beating heart. Two or more grafts can be accomplished, and the heart can be manipulated and operated on from behind. Cleveland Clinic surgeons use Heartport’s Port-Access for those procedures.
The fourth technique employed at Cleveland Clinic is one developed by Cosgrove, who has performed nearly 300 mitral and aortic heart valve repairs or replacements since January 1996. Nearly half of the 115 patients having the Cosgrove technique during the first half of 1996 were discharged within four days. The surgeon makes one three-inch incision horizontal for aortic valve surgery and vertical for the mitral valve through which he connects the patient to the heart-lung machine while he performs the surgery.
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