It is our sincere commitment to both preserve and enhance your quality of life. Before discussing any specific procedure, we will provide detailed information on your overall medical condition. It may surprise you to learn that many patients seen in our office are advised NOT to have surgery for a variety of reasons. Should surgery be recommended as the best treatment option, we will discuss in detail how to prepare for your procedure and what to expect during your recovery.
When you leave the office you should have a clear understanding of our recommendation and plan. If you do not, please ask questions until you are satisfied. To ask specific questions now or to schedule an appointment at our Phoenix, Scottsdale or West Valley locations, please contact us.
Heart conditions and treatments:
Aortic Valve Replacement
Surgery for replacement of the aortic valve and repair or replacement of the mitral valve is indicated for a variety of conditions. Timing of the procedure and decisions about the exact surgical approach and plan should be highly individualized. If you are a candidate for valve surgery, you can expect a detailed discussion about the options as well as the pros and cons of the many choices available to you.
About Aortic Aneurysm: An aneurysm is an abnormal widening of a blood vessel beyond its normal size. This may be caused by longstanding hypertension (high blood pressure) as well as by certain diseases that affect the strength of the vessel wall. As an aneurysm enlarges, the risk of sudden rupture increases. An acute rupture or a tear in the aortic wall (known as an aortic dissection) is often rapidly fatal.
The ‘ascending’ aorta is the portion of the aorta which comes directly out of the heart and is normally 2 to 3 centimeters (about 1 inch) in diameter. An ascending aortic aneurysm approaching 5 cm or greater warrants close monitoring at the very least and may be best served by elective repair to avoid the risk of sudden rupture.
The decision on whether or not to undergo surgery depends on many considerations including the rate at which the aneurysm is enlarging (if known from prior studies) and the patient’s overall medical condition, body size and family history. The operation involves replacement of the aneurysmal portion of the aorta with a durable fabric tube.
Ascending aortic aneurysms may also dilate to the point that the aortic valve, which sits directly below the aorta, is adversely affected requiring repair or replacement of this valve. Coronary artery bypass grafting may also be required if there is co-existing coronary artery disease. Average hospital stay for elective repair of ascending aortic aneurysms can be as brief as four days, but may be longer depending on these and other pre-existing medical conditions.
Mitral Valve Repair and Replacement
The mitral valve sits between two chambers of the heart: the left atrium and the left ventricle. The mitral valve, as all of the four heart valves, is a “one way valve” or “check valve.” In the case of the mitral valve, it allows blood to easily flow from the left atrium into the left ventricle but prevents backward flow which would make the heart work harder. There are numerous disease conditions cause the mitral valve to leak backward. This is known as mitral regurgitation. Very often, the mitral valve can be repaired to fix this leakage. If the valve cannot be repaired, it may be replaced.
Coronary Artery Bypass
Coronary artery bypass grafting (CABG) is one of the most commonly performed operations in the United States. Although the basic principles have remained largely unchanged for the past 30 years, technical advances and surgical training have advanced to the degree that this complex procedure can be performed with a high degree of anticipated success. A truly successful CABG procedure means far more than simply surviving the operation. Ultimately, the patient should have an improved quality and duration of life in most cases. Anticipated recovery and outcomes are greatly influenced by the relative health of the patient prior to surgery. Dr. Goldstein has been a participant in the The Society of Thoracic Surgeons Adult Cardiac Surgery Database and has consistently produced outstanding results relative to his peers locally and nationally.