The surgeons in the Division of Cardiothoracic Surgery emphasize that the high quality of cardiac and thoracic care at GHS comes from “team management” of patients among physicians who specialize in cardiac surgery, anesthesiology, pulmonary/critical care and endocrinology. For instance, physicians in the GHS Cardiovascular Anesthesiology Group have advanced training and experience in transesophageal echocardiography and cardiac physiology. There also are 13 board-certified physicians in the specialty of pulmonary and critical care medicine in GHS Pulmonary Disease, Critical Care & Sleep Medicine Division, who help the cardiac surgeons serve patients before and after surgery. The GHS Endocrinology Division also plays a vital collaborative role. It was instrumental in the formation of an interdisciplinary team of physicians, biostatisticians, and ICU and infection control nurses to address glucose control, with a focus on postoperative care in the cardiovascular intensive care unit (CVICU). The surgeons collaborated with cardiologists to develop a Cardiac Valve Program and registry to offer state of the art standardized treatment and follow up for patients with valvular heart disease. A combined weekly conference is held to review patients with complex valvular heart disease.
The Cardiothoracic Surgery division offers a wide range of cardiac surgery procedures. The following treatments are among the many services offered: CABG; aortic valve replacement (AVR); mitral valve replacement (MVR); complex mitral valve repair; minimal access cardiac surgery; aortic root replacement, including the Bental procedure and valve-sparing procedures; surgery of the great vessels, including aortic arch procedures, transmyocardial laser revascularization (TMR); congenital cardiac surgery in adults, including atrial septal defect repair (ASD), ventricular septal defect repair (VSD), anomalous coronary anatomy, aortic coarctation and idiopathic hypertrophic subaortic stenosis; surgical treatment of cardiac tumors, and noncardiac thoracic surgery, including minimal access video assisted thoracoscopic procedures.
GHS surgeons in the Division of Cardiothoracic Surgery also perform surgical ventricular restoration (SVR) procedures for severe ischemic cardiomyopathy. Cardiomyopathy can lead to left ventricular (LV) dilation, which can cause congestive heart failure (CHF). GHS surgeons can treat this complex cardiac pathology with SVR and improve a patient’s functional status.
GHS is also known as a leading surgery center for minimally invasive valve surgery, and GHS and the cardiac surgeons are national preceptors for these cases. The volume of minimally invasive valve surgery procedures ranks GHS as one of the top 12 centers nationally and draws cardiac surgery patients from Greenville, Asheville, Columbia, and areas throughout the Southeast to the Cardiothoracic Surgery division at GHS.
The surgeons have excellent results utilizing the standard open and minimal access MAZE procedures for atrial fibrillation. They have partnered with the cardiologists and developed an atrial fibrillation center where patients receive state of the art treatment and follow up. This arrhythmia center is unique in South Carolina.
Surgeons in the Cardiothoracic Surgery division have 10 years of experience with right and left ventricular assist devices (LVAD/RVAD) including extracorporeal membrane oxygenation (ECHMO) in the CVICU. During the past two years, the ventricular assist device (VAD) has been implanted as a bridge to recovery in patients who have had open-heart surgery and as a bridge to heart transplants in other patients, with a 50 percent survival rate. GHS has a cohesive clinical relationship with the cardiac transplant program at the Medical University of South Carolina and has established protocols for the transport of patients with VADs.
The Cardiothoracic Surgery division also uses endoscopic vein harvesting (EVH) to obtain healthy blood vessels for use in coronary artery bypass surgery. This technique can be used to harvest the greater saphenous vein from the leg or the radial artery from the arm. Using special instruments, a physician assistant makes a small incision and delicately removes the vein from the leg. In addition to being the most cost effective method for vein harvesting, EVH has resulted in decreased infection rates and wound complications, reduced postoperative pain and swelling, enhanced recovery and accelerated ambulation, and minimal scarring for patients.
Another innovation implemented by the division is the use of standardized operative notes with electronic illustrations of patients’ CABG procedures. These notes, compiled in real time during surgery using specialized computer software, feature information about the placement of a patient’s bypass and other critical details. Data fields of the software are aligned to the STS database for use in measuring quality performance. The notes enable quick postoperative communication with referring physicians. Moreover, data can be downloaded and supplied to patients on a credit card sized document. The card features an illustration of their graft anatomy that they can carry with them in case of an emergency or to aid in future interventions.
These innovations have led GHS to be consistently ranked one of the top 50 heart programs by US News and World Report.
For more information on cardiac surgery, or to refer a patient to the Cardiothoracic Surgery division, which serves Greenville, Asheville, Columbia, and areas throughout the Southeast, call (864) 455-6800 or 1-877-GHS INFO (447-4636).