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Cardiovascular Surgery

Cardiovascular diseases include the most common disease, coronary artery disease, which refers to the narrowing or complete blockage of the heart arteries we call coronary arteries. All modern medical treatment methods, endovascular interventions, and surgical procedures are safely performed in our hospital with Adult Cardiovascular Surgery.

Coronary Bypass Surgery: The arteries that supply blood to the heart are called coronary arteries. Serious narrowing and blockages in these arteries around the heart lead to heart attack (myocardial infarction) and heart failure. Coronary artery disease, which develops due to high cholesterol levels and intense smoking in individuals with a family history of coronary artery disease, impairs the patient’s quality of life.

In coronary surgery, which constitutes a large part of heart surgeries, the aim is to bypass the blocked section of the artery (by creating a bypass) to restore blood flow to the unreceived areas of the heart. As blood flow is restored to the heart, angina due to ischemia disappears, the risk of heart attack decreases, and deterioration in cardiac contraction function is prevented.

Grafts are usually prepared using mammary arteries (LIMA – RIMA) located in the chest wall, radial artery, and saphenous veins harvested from the leg. After bypass surgery using the LIMA (internal mammary artery), the open rates of the artery remain above 90% even after 10 years. During surgeries, a heart-lung machine (cardiopulmonary bypass) may be used, or in appropriate cases, bypass can be performed on a beating heart. Fast-track anesthesia methods and minimal invasive cardiac surgery procedures are applied to ensure rapid patient recovery, which is the main goal of modern cardiac surgery. When preparing bypass grafts, veins taken from the arm and leg can be harvested using endoscopic methods, limiting surgical incisions to 1-2 cm in many patients. Most patients recover to a level where they can be discharged within 4-5 days. Patients return to their normal lives shortly thereafter and achieve a higher quality of life.

Heart Valve Surgery: Heart valves are located between the ventricles and atria of the heart, and between the ventricles and the main arteries leaving the heart. The mitral, aortic, tricuspid, and pulmonary valves have important functions for the normal functioning of the heart. When there are severe narrowings or insufficiencies in these valves, the diseased heart valve needs to be repaired or replaced in cases where repair is not feasible.

In our clinic, repair methods aimed at preserving the existing heart valve are primarily applied. Most heart valve surgeries can be performed with a small incision made through thoracotomy or underarm. Minimal invasive surgical techniques are applied in appropriate cases. Patients recover rapidly and return to normal life very quickly after this procedure.

Closure of ASD (Atrial Septal Defect): ASD (Atrial Septal Defect) means a congenital hole (congenital) in the membrane (septum) between the atria (atriums) of the heart. When this hole is small, it can only be repaired with stitches. In the presence of a large defect, it can be closed with a patch prepared from the pericardium, the layer surrounding the heart. These surgeries are mostly performed in our clinic with minimal invasive methods (mini-thoracotomy, mini-sternotomy incisions). Patients are discharged with very small incisions and can return to their normal lives shortly thereafter.

Heart Tumor (Myxoma) Surgeries: More than half of benign heart tumors are myxomas. Cardiac myxomas are frequently located in the left atrium. They are less commonly located in the right atrium (atrium). The tumor can be associated with heart valves or the cardiac conduction system. Surgery should be performed as soon as the diagnosis is made due to the risk of thromboembolism (clotting). The aim of surgery is to remove the tumor from the heart valves and conduction system while preserving them. Minimal invasive techniques are used for this surgical procedure.

Surgeries of Arm and Leg Arteries (Peripheral Vascular Surgery): Peripheral vascular surgery involves surgical procedures on arteries that carry blood to an extremity.

Peripheral vascular surgery is generally performed in cases of artery blockages, artery injuries, and artery dilations (aneurysms). It is performed using small incisions, using veins taken from the patient or synthetic veins. Surgical intervention aims to restore normal blood flow to the area supplied by the artery. Pain in the more blood-supplied tissue decreases, wounds heal more quickly, and as a result, the risk of serious infection and limb loss decreases. When performed for dilated arteries, it prevents the risk of rupture of the artery and damage to surrounding tissues. In cases of artery injury, the goal is to restore normal blood flow.

Carotid Artery Surgeries: Carotid artery blockages have serious consequences, and they are the main cause of the development of stroke (SVO) known as cerebrovascular accidents. Narrowing in the carotid arteries and rupture of atherosclerotic plaques can cause detached pieces (cerebral emboli), leading to mild stroke that can progress within hours, temporary visual impairments, and other symptoms. Failure to treat the narrowing can lead to a high risk of severe stroke (paralysis). The treatment of these blockages can be performed under general anesthesia or local anesthesia (where the patient is awake) with a small incision made in the neck area to clean the atheroma (calcified tissue narrowing the artery) causing the narrowing and to repair the artery.

Aortic Aneurysm (Bulging) Surgery: Enlarged sections of the abdominal, thoracic, or thoracoabdominal aorta are surgically replaced using a synthetic vascular graft. In recent years, these procedures are mostly performed through groin angiography (endovascular route) and repaired without the need for open surgery. Patients who are not suitable for this method undergo surgical intervention for aneurysm repair. The goal is to prevent fatal complications that may occur as a result of the rupture of the diseased arterial segment by replacing it with an artificial artery.

Endovascular Aortic Surgery (EVAR-TEVAR) and Percutaneous Endovascular Treatments: Peripheral endovascular interventions involve percutaneous (through the skin) catheter-based interventions to treat blockages or injuries in the main arteries carrying blood to an extremity or organ.

In many cases of arterial blockages, blockages are eliminated by balloon or stent application through groin angiography without the need for surgery. Endovascular treatments are performed under general or regional anesthesia. Through the artery in the groin or arm, a large incision is made without making a large incision, and a strong synthetic tube or several stent-like synthetic grafts are placed in the ballooned or aneurysmal portion of the artery. By performing interventions on the artery, blood flow to the area supplied by the artery is increased. Wounds heal faster in tissues with increased blood supply, reducing the risk of serious infection and limb loss. The aim is to prevent functional loss of the poorly nourished organ. In endovascular surgeries performed for aneurysms (EVAR-TEVAR), small incisions made through the groin are used to open the artery, and a graft prepared based on previous measurements is placed inside the artery. Compared to open surgery, endovascular surgeries aim to treat abnormally structured and dilated arteries without major surgical trauma. The main advantages of these procedures are their minimally invasive nature, shorter hospital stay, and faster recovery time.

Venous Surgery: Peripheral venous interventions are aimed at eliminating varicose veins and venous insufficiencies in the lower extremities that disrupt venous blood flow.

In recent years, the most effective method in the treatment of varicose veins is endovenous laser treatment. In this treatment, a small catheter is inserted into the vein and laser energy is applied to close the varicose vein. Sclerotherapy is used for the treatment of small varicose veins and spider veins. For venous insufficiency, the main treatment is surgical intervention to prevent blood from flowing back to the legs. The purpose of these interventions is to prevent complications such as leg swelling, pain, and ulcers due to blood pooling in the legs.

Our clinic performs minimally invasive treatments for these diseases to ensure rapid patient recovery, which is the main goal of modern cardiac surgery. Patients recover rapidly and return to normal life very quickly after these procedures.

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