Heart Surgeries & Procedures


Open Heart Procedures

Coronary Artery Bypass Graft (CABG) Surgery
Coronary artery bypass graft surgery (CABG) is a procedure used to treat coronary artery disease in certain circumstances. Coronary artery disease (CAD) is the narrowing of the coronary arteries (the blood vessels that supply oxygen and nutrients to the heart muscle), caused by a buildup of fatty material within the walls of the arteries. This buildup causes the inside of the arteries to become rough and narrowed, limiting the supply of oxygen-rich blood to the heart muscle. IP BH
Heart Valve Repair or Replacement
Heart valve repair or replacement surgery is a treatment option for valvular heart disease. When heart valves become damaged or diseased, they may not function properly. Conditions which may cause heart valve dysfunction are valvular stenosis and valvular insufficiency (regurgitation). When one (or more) valve(s) becomes stenotic (stiff), the heart muscle must work harder to pump the blood through the valve. Some reasons why heart valves become stenotic include infection (such as rheumatic fever or staphylococcus infections) and aging. If one or more valves become insufficient (leaky), blood leaks backwards, which means that less blood is pumped in the proper direction. Based on your symptoms and overall condition of your heart, your doctor may decide that the diseased valve(s) needs to be surgically repaired or replaced. IP BH
Transmyocardial Laser Revascularization (TMR)
Transmyocardial Laser Revascularization (TMR) is a surgical procedure for inoperable coronary artery disease patients with angina (chest pain). Patients with coronary artery disease are treated with interventional procedures (angioplasty and stenting), coronary artery bypass grafting (surgery) and medications to improve blood flow to the heart muscle. If these procedures do not eliminate the symptoms of chest pain (also called angina), transmyocardial laser revascularization or TMR is another treatment option Baptist & Cardiology Consultants physicians offer. IP BH
Maze Procedure for Atrial Fibrillation
The maze procedure is a surgical treatment for atrial fibrillation. The surgeon can use small incisions, radio waves, freezing, or microwave or ultrasound energy to create scar tissue. The scar tissue, which does not conduct electrical activity, blocks the abnormal electrical signals causing the arrhythmia. The scar tissue directs electric signals through a controlled path, or maze, to the lower heart chambers (ventricles). IP BH
On/Off Pump Bypass Surgery
Baptist offers both on pump and off-pump bypass (also known as “beating heart”) surgery. Off-pump coronary artery bypass is a form of coronary artery bypass graft (CABG) surgery performed without cardiopulmonary bypass (heart-lung machine) as a treatment for coronary heart disease. During most bypass surgeries, the heart is stopped and a heart-lung machine takes over the work of the heart and lungs. When a cardiac surgeon chooses to perform the CABG procedure off-pump, also known as OPCAB (Off-pump Coronary Artery Bypass), the heart is still beating while the graft attachments are made to bypass a blockage. The potential advantages may include reduced need for blood transfusions and reduced risk of bleeding and stroke. High-risk patients with additional diseases like lung disease, kidney failure and peripheral vascular disease may benefit from this kind of operation. IP BH
Minimally Invasive Heart Surgery
Minimally invasive heart surgery (also called keyhole surgery) is performed through small incisions, sometimes using specialized surgical instruments. The incision used for minimally invasive heart surgery is about 3 to 4 inches instead of the 6- to 8-inch incision required for traditional surgery. Types of minimally invasive surgeries include minimally invasive valve surgery, minimally invasive coronary bypass graft, and more. Benefits include reduced pain, bleeding and shorter recovery time. IP BH
Robotically Assisted Heart Surgery
Robotically assisted heart surgery, also called closed-chest heart surgery, is a type of minimally invasive surgery. The cardiac surgeon uses a specially designed computer console to control surgical instruments on thin robotic arms. Robotically assisted technology allows surgeons to perform certain types of complex heart surgeries with smaller incisions and precise motion control, offering patients excellent outcomes. In robotic surgery, small incisions — less than 2 inches — are used, compared with the 3- to 4- inch incision used in traditional minimally invasive heart surgery. Minimally invasive robotic assisted heart surgeries include robotically assisted valve surgery, robotically assisted bypass surgery, robotically assisted ASD and PFO repair, robotically assisted heart rhythm devise implant surgery and atrial fibrillation surgery. Benefits include smaller incisions, smaller scars, shorter hospital stay, and reduced risk of infection and bleeding, as well as a shorter recovery time. IP BH

Vein/Vascular Surgery Procedures

The Baptist Heart & Vascular Care Center offers comprehensive state-of-the-art diagnostic and therapeutic interventions for the entire spectrum of circulatory disorders, from medical management to surgical procedures and treatments as outlined below.

Abdominal Aortic Aneurysms

Abdominal Aortic Aneurysm (AAA) is a weak area of the abdominal aorta that expands or bulges. The pressure from blood flowing through your abdominal aorta can cause a weakened part of the aorta to bulge, much like a balloon. A normal aorta is about 1 inch (or about 2 centimeters) in diameter. However, an AAA can stretch the aorta beyond its safety margin as it expands. Aneurysms are a health risk because they can burst or rupture. A ruptured aneurysm can cause severe internal bleeding, which can lead to shock or even death.

To effectively treat AAA, Baptist offers the Open AAA (Abdominal Aortic Aneurism) Repair and Endovascular Aneurysm Repair (EVAR) procedures. IP BH

Carotid Stenosis (Carotid Artery Disease)
Carotid artery disease is a condition in which the carotid arteries become narrowed or blocked. When the arteries become narrowed, the condition is called carotid stenosis. To effectively treat carotid stenosis, Baptist offers the Carotid Endarterectomy procedure to surgically remove the blockages on the inside of the arteries in order to restore blood flow as well as Carotid Stenting, which is completed in one of our leading-edge interventional laboratories at Baptist Hospital. IP BH
Varicose Veins

Varicose veins are swollen, twisted, and sometimes painful veins that have filled with an abnormal collection of blood. Varicose veins tend to get worse over time. You can ease discomfort and slow varicose veins from getting worse by taking care of them with treatment.

To effectively treat varicose veins, Baptist offers vein stripping (surgery to remove varicose veins in the legs) or Endovenous Laser Treatment (EVLT), which is ultrasound guided minimally invasive removal of varicose veins with a laser. IP BH

Peripheral Artery Disease

Peripheral artery disease (also called peripheral arterial disease) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. When you develop peripheral artery disease (PAD), your extremities — usually your legs — don’t receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking (intermittent claudication). To effectively treat PAD, Baptist offers the following procedures:

  • Endarterectomy – an open surgical procedure to remove blockages from the inside of the arteries. (The process of separating the plaque from the artery wall)
  • Atherectomy – a minimally invasive surgical method of removing blockages from the arteries (mostly done in an interventional lab percutaneously but can be done in the operating room with a minimal incision)
  • Bypass – surgical placement of a vein graft to "bypass” blockages in the peripheral arteries in order to restore blood flow.
IP BH
Acute Limb Ischemia

Acute limb ischaemia is due to either an embolism or thrombosis. With prompt proper surgical care, acute limb ischaemia is a highly treatable condition. To effectively treat Acute Limb Ischemia, Baptist offers the following procedures:

  • Embolectomy – surgical removal of emboli (a clot or mass that has migrated through the vessels form its point of origin causing a blockage)
  • Thrombectomy – surgical removal of Thrombi (blood clots)
  • Bypass Surgery
  • Open Repair
IP BH
Aortic dissection occurs when a tear in the inner wall of the aorta causes blood to flow between the layers of the wall of the aorta, forcing the layers apart. Aortic dissection is a medical emergency that requires immediate live-saving intervention including either an open repair procedure or a Thoracic Endovascular Aneurysm Repair (TEVAR) procedure. IP BH

To learn more about our cardiac surgical services, please call 850.484.6500.


Interventional Procedures

Interventional cardiology uses cardiac catheterization to aid in the diagnosis and treatment of cardiovascular disease. Procedures are performed in our state-of-the-art catheterization laboratories at Baptist and Gulf Breeze hospitals. This approach allows doctors to work through tiny incisions, reducing hospitalization, pain and recovery time for patients.

Carotid Stenting
Carotid artery stenting is a procedure in which your cardiologist inserts a slender, metal-mesh tube, called a stent, which expands inside your carotid artery to increase blood flow in areas blocked by plaque. IP BH
Coronary Balloon Angioplasty
Percutaneous transluminal coronary angioplasty (PTCA), or balloon angioplasty, is a procedure used to open narrowed coronary arteries. It is performed with a local anesthesia while the patient is awake. Patients whose angina has not been relieved by medications are generally the best candidates for PTCA. There are several other commonly used treatments for opening blocked arteries such as the Rotablator procedure (tiny rotating blades) or Atherectomies (cutters) to cut away plaque buildup on the artery walls, or Stents (a little metal "scaffold") that widens obstructed arteries. IP BH
Coronary Stent Placement
The Stent is a stainless steel device (scaffold) which compresses the plaque, much like in the coronary balloon angioplasty procedure. It is implanted by guiding a thin, balloon-tipped catheter through the artery to the blockage. The collapsed stent is part of the catheter tip, and when the balloon is inflated the stent expands into place allowing the flow of blood once again through the coronary arteries. After a couple of weeks tissue forms around the stent and it becomes a permanent support for the artery. IP BH
Diagnostic Cardiac Catheterization
A diagnostic cardiac Catheterization, also called coronary angiography or heart catheterization, is a procedure that provides detailed information about the function of the heart and its arteries. By combining that information from blood tests and other diagnostic tests with a cardiac catheterization procedure, your doctor can accurately diagnose a heart condition and the most effective treatment plan. IP BH
Endovascular Stent Graft for Abdominal Aortic Aneurysm

Abdominal Aortic Aneurysm (AAA) is a weak area of the abdominal aorta that expands or bulges. The pressure from blood flowing through your abdominal aorta can cause a weakened part of the aorta to bulge, much like a balloon. A normal aorta is about 1 inch (or about 2 centimeters) in diameter. However, an AAA can stretch the aorta beyond its safety margin as it expands. Aneurysms are a health risk because they can burst or rupture. A ruptured aneurysm can cause severe internal bleeding, which can lead to shock or even death.

Endovascular means that the treatment is performed inside your artery using long, thin tubes called catheters that are threaded through your blood vessels. This procedure is less invasive, meaning that your cardiologist will need to make small incisions in your groin area through which to thread the catheters. During the procedure, your cardiologist will use live x-ray pictures viewed on a video screen to guide a fabric and metal tube, called an endovascular stent graft (or endograft), to the site of the aneurysm., the endovascular stent graft also strengthens the aorta. IP BH

Patent Foreman Ovale Closure

A patent foramen ovale (PFO) is a hole in the heart that didn’t close the way it should after birth. The condition is relatively common. During fetal development, a small flap-like opening — the foramen ovale — is usually present between the right and left upper chambers of the heart. It normally closes within the first or second year of life. When the foramen ovale doesn’t close, it’s called a patent foramen ovale. With each heart beat or when a person with this defect creates pressure inside his or her chest — such as when coughing, sneezing, or straining during a bowel movement — the flap can open, and blood can flow in either direction directly between the right and left atrium. When blood moves directly from the right atrium to the left atrium, this blood bypasses the filtering system of the lungs (the lungs actually do dissolve tiny blood clots). If debris is present in the blood, such as small blood clots, it now passes through the left atrium and can lodge in the brain, causing a stroke, or another organ, such as the heart, eyes, or kidneys.

Catheter-based procedures are commonly used to diagnose and treat heart-related problems. For example, catheter-based procedures are used to diagnose and treat clogged arteries and heart attacks. A catheter can also be used to guide the placement of a patent foramen ovale closure device — which becomes a permanent implant — that will close the hole (prevent the flap from opening) in the heart wall. Once in the correct location, the PFO closure device is allowed to expand its shape to straddle each side of the hole. The device will remain in the heart permanently to stop the abnormal flow of blood between the two atria chambers of the heart. The catheter is then removed and the procedure is complete. This procedure takes about 1-2 hours to perform in the hospital Cardiac Catheterization Lab. IP BH

Peripheral Angioplasty & Stenting
Peripheral angioplasty is performed much like that of PCTA or percutaneous transluminal coronary angioplasty, but to open blocked arteries or remove blood clots in the patient’s legs.
Rotablator and Atherectomies
The rotablator is a procedure used to clear blocked arteries. Your doctor guides a thin catheter through the artery to the blocked area. The catheter contains a small, specially designed, rotating blade which chips off hard plaque buildup on the artery walls. The chips of plaque are then small enough to be absorbed and expelled into the blood stream. The atherectomy procedure is similar however it contains a cutter which shaves the plaque away from the artery wall. The plaque is then removed through the catheter. Both procedures are used to effectively clear blocked arteries. IP BH
Transcatheter Aortic Valve Replacement or (TAVR)
A revolutionary new treatment option for patients with severe aortic stenosis who are not candidates for traditional open heart surgery. Severe aortic stenosis is a serious problem. If left untreated and not repaired it is potentially fatal. Studies indicate that 50 percent of severe aortic stenosis patients will not survive more than an average of two years after the onset of symptoms. Until TAVR, treatment for severe aortic stenosis had been open aortic valve replacement – a type of open heart surgery to replace the affected valve with a donor valve. However, for patients who are too ill or not a candidate for open-heart surgery, the minimally invasive TAVR procedure is conducted to implant a new valve through a catheter, making only a small incision in the groin or chest. This revolutionizes care for patients, making relief more accessible to patients who would otherwise have no options.
Transcatheter Mitral Valve Repair
Approximately half of heart failure patients suffer from mitral valve regurgitation, a condition indicated by degeneration of the mitral valve that causes the valve to bellow back into the left atrium with each heartbeat, allowing blood to leak backward through the mitral valve. This condition can potentially cause fluid backup into the lungs. Symptoms may be minimal at first and but eventually can include fatigue, shortness of breath, or a rapid, fluttering heartbeat.

Transcatheter mitral valve repair (TMVR) with MitraClip® is a minimally invasive procedure that closes the center of the mitral valve and reduces the leak. In the case of high-risk patients unable to undergo open heart surgery, MitraClip provides a minimally invasive option that can drastically improve outcomes in even the frailest patient.
Watchman ®
Watchman is a device that is implanted in the left atrial appendage (LAA). It forms a physical barrier, permanently closing off this area and thus preventing blood clots from exiting the LAA and entering the bloodstream. The LAA is the site of origin for a majority of stroke-causing blood clots that originate from the heart. The Watchman procedure is performed under general anesthesia in a cath lab. Patients will need to stay in the hospital overnight. Some patients may be able to stop taking warfarin after a few weeks. Candidates for Watchman are those who have non-valvular atrial fibrillation, are unable to tolerate blood thinners in the long term and are considered at high risk for stroke.

To learn more about our interventional services, please call 850.484.6500.


Electrophysiology Procedures

The Baptist Heart Rhythm Center electrophysiology team treats patients with abnormal heart rhythms, called arrhythmias. In addition to leading-edge diagnostic and medical treatment capabilities, our team offers the following highly specialized procedures to effectively treat heart rhythm disorders:

Pacemaker Implantation
A pacemaker is a small device that’s placed under the skin of your chest or abdomen to help control abnormal heart rhythms. This device uses electrical pulses to prompt the heart to beat at a normal rate. Pacemakers are used to treat heart rhythms that are too slow, fast, or irregular. These abnormal heart rhythms are called arrhythmias. Pacemakers can relieve some symptoms related to arrhythmias, such as fatigue (tiredness) and fainting. A pacemaker can help a person who has an abnormal heart rhythm resume a more active lifestyle. IP OP BH
Defibrillator Implantation
An implantable cardioverter defibrillator system or implantable cardiac devices (ICD), is a small electronic device that monitors heart rhythm and delivers a shock to correct a potentially fatal heart rhythm if it should occur. The generator is surgically implanted beneath the skin and muscle beneath the collarbone. Wire electrodes attach the pulse generator to the heart. Some of the wires are inserted through veins into the inside of the heart and can sense the heartbeat. Other wires may be attached directly to the heart. These wires are used to deliver the shock, if necessary, which converts the heart back to its normal rhythm. IP OP BH
Electrophysiologic Studies
Electrophysiology testing makes it possible to study heart rhythm disturbances under controlled conditions. By using special insulated wires called catheters, your doctor is able to identify the rhythm disturbance and choose the best treatment method. The procedure is performed in the cath lab. It involves inserting thin plastic catheters into the large blood vessels in your groin and arm, then guiding them to the heart with the help of a special X-ray machine. When the catheters are in place in your heart, a doctor who specializes in electrophysiology will stimulate the heart artificially with electrical impulses delivered through the catheters. Your doctor will watch the heart’s reaction to determine the extent of rhythm disturbance. IP OP BH
Catheter Ablation

Your heartbeat is controlled by a smooth, constant flow of electricity through the heart. A short-circuit anywhere along this electrical pathway can disrupt the normal flow of signals, causing an arrhythmia (an irregular heartbeat). Cardiac ablation is a procedure used either to destroy these short-circuits and restore normal rhythm, or to block damaged electrical pathways from sending faulty signals to the rest of the heart.

Cardiac ablation is performed by a cardiac electrophysiologist — a physician who specializes in diagnosing and treating heart rhythm disorders. The procedure involves inserting catheters — narrow, flexible tubes — into a blood vessel, often through a site in your groin or neck, and threading them through the vein until they reach your heart. You will be given sedatives to make you relaxed and comfortable, and a topical anesthetic to numb your skin before the catheters are inserted.

Using electrodes on the tip of the catheters, the doctor first conducts an EP Study to pinpoint the location of the short-circuit. Once the precise location is confirmed, the "short-circuit" is either destroyed (to reopen the electrical pathway) or blocked (to prevent it from sending faulty signals to the rest of the heart). This is done by sending energy through the catheters to destroy a small amount of tissue at the site. The energy may be either hot (radiofrequency energy), which cauterizes the tissue, or extremely cold, which freezes or "cryoablates" it. IP OP BH

Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy uses a permanently implanted ICD (Implantable Cardiac Defibrillator) or a pacemaker to coordinate the heart rhythm in patients with heart failure who have lost coordination between the two sides of their heart, preventing the heart from pumping efficiently. CRT uses an implanted ICD/pacemaker to send electrical signals to the main pumping chambers on both sides of the heart, making sure they contract at the same time. This enables the heart to pump more efficiently, reducing strain on the heart and relieving symptoms of heart failure. CRT can help patients live longer, require fewer hospitalizations, and have a better quality of life.
Laser Lead Extractions
The expert physicians at Baptist Heart Rhythm Center offer a less invasive and more effective option for the extraction of leads — the wires attached to cardiac pacing devices that follow blood vessels into the heart muscle. The procedure involves the use of an innovative laser device that breaks up scar tissue built up around the leads, so that they can be removed safely and more easily. IP OP BH

To learn more about our electrophysiology services, call 850.484.6500.


Other Procedures

24-Hour Holter Monitoring
The Holter monitor is used in diagnosing heart rhythm disturbances that may occur at times when you are away from the doctor. It is used in conjunction with a written diary or log of your daily events and activities. The Holter monitor allows doctors to relate those symptoms to actual variations in heart rhythms, providing them with further diagnostic information for determining the most course of treatment. OP BH
Cardioversion
With the patient sedated, pads are applied to the chest and an electrical impulse is delivered to correct some types of abnormal heart rhythms. This procedure is done as an outpatient in the hospital. OP BH
Echocardiography
This test uses ultrasound-high frequency sound waves-to create a videotape of the heart’s chambers, valves, wall motion, and blood flow patterns. This can be done by applying the ultrasound probe to the chest wall. The transesophageal echocardiogram is done by passing the probe down the patient’s throat in order to image the patient’s heart from inside the chest. OP BH
Electrocardiogram (EKG and ECG)
The EKG records the heart’s electrical activity to detect abnormal heartbeats (arrhythmias). it can even show a heart attack in progress. OP BH
Event Recording and Assessment of Rhythm Disturbances
Event recording is often necessary when we cannot catch rhythm disturbances on a 24 Hour Holter Monitor or Electrocardiogram. This type of monitoring allows the patient to transmit rhythm disturbances from outside the doctor’s office with a small transmitter device. OP BH
Nuclear Cardiology
Using a high resolution detector-camera in conjunction with a pharmacologic radionuclide and treadmill test, your doctor can perform a number of different nuclear cardiology studies of the heart: A Myocardial Perfusion test can assess coronary artery disease utilizing the treadmill and a pharmacologic agent. We utilize several different agents in conjunction with the radioisotope depending on the diagnosis and patient history. Cardiac Blood Pool Imaging, also known as a MUGA, is used to evaluate the left ventricular function including wall motion and blood ejection fraction. OP BH
Pacemaker and Defibrillator Checkups
The heart is required to maintain a fast enough heartbeat and rhythm to keep blood flowing throughout the body. Pacemakers and Defibrillators are devices sometimes implanted in the body to keep the heart beating properly. Periodic checkups are required of these devices. OP BH
Peripheral Vascular Testing

Peripheral Vascular Testing is comprised of Carotid Ultrasound, Renal Ultrasound, Abdominal Ultrasound, Arterial and Ankle Brachial Index and Venous Doppler.

Carotid Ultrasound is a test utilizing sound waves to assess the blood flow through the carotid arteries.

Renal Ultrasound utilizes sound waves to assess the size of the kidneys and the blood flow of the renal(kidney) arteries.

Abdominal Ultrasound examines the abdominal aorta for possible aneurysm or dilation of the artery.

Arterial Ultrasound and Ankle Brachial Index (ABI) is performed to evaluate the arteries of the legs for peripheral vascular disease. This is sometime the cause for claudication and leg pain.

Venous Doppler is performed to detect possible deep venous thrombosis or blood clots in the veins of the legs or arms.

OP BH
Transcranial Doppler

Transcranial Doppler (TCD) technology dramatically simplifies the detection of PFO’s or Patent Foramen Ovale. Patent Foramen Ovale (PFO) is increasingly being recognized as a cause of up to 56% of cryptogenic stroke and TIA’s, as well as a possible cause of migraine headaches. Other benefits of TCD include increased cost effectiveness and less patient discomfort compared to transesophageal echocardiography (TEE).

Transcranial Doppler (TCD) allows for non-invasive monitoring of cerebral blood flow. Embolic signals are detected after an injection of agitated saline (micro air bubbles) into an arm vein. This safe non-invasive procedure is done during resting conditions and during Valsalva.

OP BH
Treadmill Testing
Commonly referred to as the Stress Test. Treadmill Testing takes about 45 minutes and evaluates the heart’s response to increased activity, blood pressure and heart rhythm response to activity. It is also used in several ways to diagnose coronary artery disease. OP BH

To learn more about our outpatient cardiac procedures or services, call 850.484.6500.