Cardiovascular Surgery

Cardiovascular Surgery

The importance of coronary heart diseases in human life is better understood day by day.
Our hospital has all kinds of infrastructure in order to perform all kinds of surgical interventions in heart diseases, which are among the leading causes of death.
Our academic staff, who are experts in Cardiology and Cardiovascular Surgery, successfully perform infant heart surgeries, all kinds of heart valve and bypass operations, as well as surgical treatments of various vascular diseases.

Coronary Artery Disease

What is coronary artery disease?

Coronary arteries are the arteries that carry oxygen and nutrients to the heart muscle. Age and certain risk factors cause these soft and flexible arteries to gradually harden. These stiffnesses (atheroma plaques) grow into the arteries and slow down the blood flow in the coronary arteries over time. Sometimes they also cause clot formation. As a result, they can completely block the blood flow and cause sudden blockage of the artery.

Symptoms of coronary artery disease

When the coronary arteries narrow, the blood supply to the heart muscle is reduced. This is characterised by tightness in the chest, a burning pressure sensation and pain, usually radiating into the left arm and jaw. Conditions that increase the heart’s need for blood, such as exercise and stress, can initiate these complaints and they usually pass when rested. This condition is called “Angina Pectoris”
If the coronary artery is suddenly blocked, the heart muscle is permanently damaged. When this is accompanied by prolonged chest pain, it is called a “myocardial infarction” (heart attack).

How is coronary narrowing treated?

Plaques that cause narrowing of the coronary arteries are usually located in a limited area of the artery. Beyond the narrowed area, the vessel diameter is normal. If the problem is limited to one or two vessels, the existing stenosis can be opened by a kind of dilatation procedure without the need for surgery. This procedure is called balloon angioplasty (PTCA). This procedure is performed by cardiologists using angiographic x-ray devices. If the balloon is not sufficient, stents with or without medication are placed to optimise the blood flow.
If the coronary artery disease involves several vessels and is complicated, coronary artery bypass surgery is required. In this operation, new vessels from the leg or another suitable location are added to the narrowed or non-functioning vessels. The heart muscles, which are starved for fresh blood and oxygen, can then breathe a sigh of relief. By-pass operations are performed by cardiovascular surgeons.

Heart Valve Diseases

There are exactly 4 valves in our heart, which works 24 hours a day without a break. Various problems may occur in these valves at any time of life. These causes can be congenital or hereditary. The most commonly affected valves are the aortic and mitral valves. If the valve is narrowed, the blood flow through it decreases, or if there is insufficiency, the blood escapes backwards. Stenosis or insufficiency can occur individually or both can occur together.

Since these disorders in the valves increase the load on the heart, they may cause irreversible disorders in the heart if they last for a long time. Experienced cardiac surgeons can repair the damaged valve in situ, or in some cases, they can replace the damaged valve with artificial valves from outside. These artificial valves may be made of metal or soft material. It should be kept in mind that patients who have undergone valve surgery should be followed up for many years.

Vascular Diseases

Aneurysms: Aneurysmal vascular diseases, which are ballooning of large vessels, are a major threat to life. The aneurysm may be located at the exit of the heart or in the abdominal cavity. If the aneurysm is more than 4 cm in size, an operation is decided immediately.

Carotid artery occlusion: When there is stenosis in the neck vessels, there are some problems in the nutrition of the brain. This condition can be in various degrees. In mild stenosis, there is a feeling of sticking in the tongue, numbness in the hand, dizziness, while in more advanced cases, paralysis and even death may occur. Atherosclerotic plaques that cause blockage in the vein are removed by interventional methods and serious improvements occur in the problems.

Atherosclerotic occlusion of the leg veins: Atherosclerosis can affect the leg arteries as well as the coronary arteries. In this case, while there are complaints such as pain and difficulty in walking at the beginning, walking is gradually restricted. If the walking distance falls below 50 metres, an operation is required. “Peripheral by-pass”. It should be kept in mind that if the operation is not performed in time, various problems may occur up to gangrene in the foot.

Rhythm Disorders (Atrial Fibrillation)

During a heartbeat, the atria contract and fill the relaxed ventricles (ventricles) with blood. Half a second later, the ventricles contract and release the blood into the body circulation. For effective blood circulation, a regular heart rate (RHYTHM) of between 60 and 100 beats per minute must be maintained when the body is at rest. The rhythm is regulated by the electrical system of the heart. Each heartbeat normally originates from a group of specialised cells called sinus nodes. This sinus node is located in the upper right atrium of the heart. The heartbeat is maintained by electrical impulses emanating from this node. This is why the normal heart rhythm is called “sinus rhythm”. When the heart does not work in its natural rhythm, it is called “arrhythmia”.

Arrhythmias originate either from the ventricles (ventricular) or the atria (atrial). Tachycardia (more than 100 beats per minute) is a fast heartbeat, bradycardia (less than 60 beats per minute) is a slow heartbeat. Not every tachycardia or bradycardia means there is a disease.

“Atrial fibrillation” is the rapid and irregular beating of the atria and is the most common arrhythmia. Atrial fibrillation (AF) completely disrupts the electrical function of the atria. It is a very risky condition when the atria start to beat so fast that they reach 300 to 400 beats per minute. This is called “fibrillation”.

Structural heart diseases such as rheumatic heart disease, hypertension and heart failure are important risk factors leading to atrial fibrillation. This can lead to disorders in the heart muscle or thrombosis (embolism).

There are 3 different treatment options to correct fibrillation and restore sinus rhythm.

  1. Drug treatment: Some drugs can restore sinus rhythm in patients who have recently entered atrial fibrillation.
  2. Angiographic method: During angiography, “catheter ablation”, which means burning some conduction pathways, is performed to restart sinus rhythm in the heart. This method may be useful in cases of early AF, especially if there is no other accompanying heart disease.
  3. Operation: In the case of severe rhythm disturbance, a meticulous cardiac surgery is performed to neutralise the impaired cardiac conduction system and thus restore normal sinus rhythm.

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