Cardiovascular & Thoracic Surgery

The presence of heart defects, specifically those impacting the structure of the heart, are known as congenital heart disorders. This type of disease may impact the walls, valves or arteries of the heart, all of which impact blood flow and can range in severity.

Coronary artery disease (CAD) is the most common form of heart disease. CAD occurs when there is a build-up of plaque (a fatty substance) in the vessels that supply your heart with blood, also known as the coronary arteries. Overtime, this can cause the vessels to stiffen and narrow. When the amount of plaque becomes extensive, it can significantly damage the arteries and restrict healthy blood flow to the heart, impacting its ability to function and increasing the risk of heart attack and other heart diseases.

If the heart is unable to pump enough blood to meet the demands and needs of the body, this is known as heart failure. In some cases, the heart may increase in size or the walls of the heart may thicken to compensate for the decreased function. There are several conditions that may cause the heart to weaken, eventually leading to heart failure, including coronary artery disease and valve disease.

The mitral valve sits between the atrium (upper chamber of the heart) and the ventricle (lower chamber of the heart) on the left side and works to keep blood flowing the correct direction during each heartbeat. When there is damage to the valve tissue, or the two leaflets of the valve are an abnormal size, this is known as prolapse and it prevents the valve from opening and closing properly. As a result, the mitral valve may become leaky, allowing blood to flow backward (regurgitation).

When there is plaque build-up in the mitral valve, this can limit blood flow from the left atrium (upper left chamber of the heart) to the primary pumping chamber the heart, the left ventricle (lower left chamber of the heart). The narrowing and stiffening of the mitral valve (stenosis) not only impacts the ability of the valve to open properly and restricts blood flow, it can also increase pressures inside the heart, leading to fluid build-up (congestion) in the lungs.

The tricuspid valve sits between the right atrium (upper right chamber of the heart) and the right ventricle (lower right chamber of the heart), regulating blood flow. However, when plaque builds up, it can lead to a narrowing and stiffening of the valve, impacting its ability to open and close properly. Oftentimes, to compensate for the restricted blood flow, the left atrium may become enlarged, which impacts circulation and pressures inside the heart. Stenosis may also cause the valve to become leaky, meaning it doesn’t close properly and small amounts of blood flow backward (regurgitation).

For patients with disease affecting a heart valve, surgically repairing or reconstructing the valve may be an option, rather than fully replacing it. With innovative technology and leading expertise, valve repair can be performed using minimally-invasive or robotic techniques with smaller incisions and faster recovery.

When patients have undergone previous procedures or surgeries that have been unsuccessful, or their disease has continued to progress, they may require further treatment to improve quality of life and longevity. Oftentimes, these procedures can be even more complex requiring a specialized approach to effectively redo valve repairs, bypass surgeries and aneurysm repairs.

For those patients experiencing late-stage heart failure, the implantation of a left ventricular assist device (LVAD), helps the lower chambers of the heart pump enough blood to meet the needs of the body. The LVAD device is a battery-operated pump that is surgically implanted in the chest and connected to the heart. The LVAD Program at Georgia Heart Institute is one of the busiest centers in the state with exceptional clinical outcomes and quality.

The Maze procedure, sometimes called the Cox-Maze procedure (CMP) after Dr. Cox, who developed the approach, involves creating scar tissue, or lesions, in a maze pattern on the upper heart chambers. We typically use a device that delivers freezing temperatures to the tissue to create the scar tissue. After that scarring pattern is created, it prevents the tissue from conducting electricity, effectively stopping the stray electrical currents that keep the heart out of rhythm.

When there is disease affecting the mitral valve, namely prolapse (improper closure) or regurgitation (leakage), the valve can be repaired using minimally-invasive techniques. Pulling on expertise from interventional cardiology and cardiac surgery, a MitraClip device is placed and secured on the valve using a catheter, a flexible, specialized tube that is inserted through the femoral artery.

For patients with extensive plaque build-up affecting one or more of the coronary arteries, opena and robotic coronary artery bypass grafting (CABG) is performed to redirect and restore healthy blood flow to the heart. By utilizing minimally-invasive techniques, a healthy blood vessel is taken from other areas and placed in the heart to create a new pathway for blood to flow. While stents or angioplasty may be used to treat some forms of coronary artery disease (CAD), when CAD becomes advanced, impacting multiple vessels, CABG is the most effective long-term care option.

Georgia Heart Institute is one of the only programs in the United States to offer truly endoscopic robotic mitral valve repair. Our specialized team can access the damaged valve through tiny incisions below the armpit, rather than opening the chest cavity through a sternotomy (large incision through the breastbone) to access the heart. This reduces post-surgery pain and recovery time significantly, while offering the same success rates as traditional surgery.

While septal myectomy is usually an open-heart surgery, requiring opening up and spreading the rib cage to access to the heart, we can perform this surgery through five small incisions from 8 – 15 mm, giving access for the robot and the endoscope so the surgeon can see and operate the arms.

Robotic septal myectomy can have similar or better outcomes than traditional open surgery, while significantly improving the experience for the patient.

This minimally-invasive procedure is used to replace the aortic valve when there is extensive stenosis (narrowing and stiffening of the valve) or aortic insufficiency (leaky valve). Pulling together expertise in interventional cardiology and cardiothoracic surgery, the TAVR device is precisely placed and secured by a specialized catheter inserted through the femoral artery.

Convergent ablation is a treatment for atrial fibrillation, also called AFib. The procedure is a collaborative effort between a cardiac surgeon and an electrophysiologist. Convergent ablation uses radiofrequency to create lesions, or scar tissue, on the heart that block irregular electrical signals. The convergent procedure is more effective at keeping patients in normal heart rhythm than multiple cardiac catheter ablations.

As a part of the digestive tract, the esophagus is a tube in the chest that connects the throat to the stomach, aiding in the digestion of food. When a malignant (cancerous) tumor forms, it can obstruct/narrow part of the esophagus or impact is ability to function. In some cases, esophageal cancer may cause symptoms of heartburn/indigestion, difficulty swallowing or difficulty eating.

When there is damage or a weakening of an artery wall, this can lead to the bulging or ballooning of the artery, which is known as an aneurysm. In this case, the aneurysm has formed on the body’s main artery, the aorta. An aneurysm can impact blood flow to organs and tissues throughout the body. Overtime, as the aneurysm continues growing, the risk of it rupturing (bursting) or dissecting (tearing) increases, both of which are considered medical emergencies.

• Bronchial & Tracheal Cancer: Every time you inhale, you pull in air that travels through the trachea (or windpipe) and onto the bronchi. The bronchi are tubes that connect directly to the lungs, allowing air to flow in and out when you breathe. When malignant (cancerous) growths develop in the bronchi or trachea, this can impact the function of the entire respiratory system. Typically, cancer of the bronchial tubes is considered lung cancer.
• Lung Cancer: The lungs, two organs in your chest, are a vital part of the respiratory system, allowing you to breathe. When malignant (cancerous) growths develop in the lungs, this can impact their ability to function effectively. Oftentimes, lung cancer will form in the bronchi tubes of the lungs, which is where the trachea connects with the lungs. Common symptoms of lung cancer include chronic coughing, consistent breathlessness and recurrent chest infections.
• Lung Masses
• Plural Effusions

If there is blockage or narrowing of the primary airway caused by disease or an infection, a stent (a specialized hollow tube) may be placed to expand the trachea (windpipe) and provide additional support to the structure. These stents are placed during a short, non-invasive procedure that is typically outpatient (requiring no long-term hospital stay).

To treat tumors or trauma in the chest, a resection procedure may be performed in order to remove any soft tissue, cartilage or bone that is damaged or diseased. To ensure that chest structure and function is maintained, artificial bone or rib plating may be used to effectively reconstruct the chest.

There are a variety of different conditions that can affect the function of the diaphragm, the muscle that helps you breathe. If breathing capacity has been limited, a plication may be performed to reposition and/or slightly restructure the muscle to improve lung capacity and breathing.

This surgical procedure is used to treat esophageal cancer or other advanced conditions that have caused significant damage to the esophagus and impacted its ability to function. Performed with minimally-invasive techniques or an open approach, an esophagectomy removes the diseased portion(s) of the esophagus and replaces it with tissue from another organ, oftentimes the stomach.

When a disease or condition has caused a narrowing or blockage of the esophagus, a stent (a specialized hollow tube) may be placed to expand the esophagus and provide additional support to the structure. Esophageal stents are placed during a short, non-invasive procedure that is typically outpatient (requiring no long-term hospital stay).

This surgical procedure is performed when there is significant disease or damage to the lung. Depending on the extent of the disease, a small or large portion of the lung may be removed, along with surrounding tissue or lymph nodes. The two most common types of lung resection surgery are a wedge or segmental resection (small piece of lung is removed) and lobectomy (one of the 5 lung lobes is removed).

Using minimally-invasive techniques, damaged or diseased potions of the lung and/or airway can be removed. This procedure uses advanced technology, including specialized instruments and a video scope, allowing the surgeon to have a complete view of the chest and lungs without opening the chest.

For growths or tumors affecting the chest, lung, esophagus or airway, robotic-assisted surgery may be performed to safely and precisely remove the diseased tissue. During these procedures, our cardiothoracic surgeons utilizes a minimally-invasive approach with the latest innovative robotic technology in a specialized surgical suite.

When aneurysms become large, the most effective treatment option is surgical repair. To replace the weakened portion of the aorta, where the aneurysm has formed, a specialized tube or fabric graft will be placed. Once the procedure is complete, this will allow blood to flow through the aorta without any swelling or bulging. This procedure can be performed using a traditional, open approach or with minimally-invasive endovascular techniques.