Adult heart surgeries, mainly coronary bypass surgeries, are performed in the chest, Cardiovascular Surgery Department of IstHealth Hospital. Of the approximately 1,000 heart surgeries performed annually, 78% are for coronary bypass, 22% for Valve and congenital anomalies in adult patients.
Coronary bypass surgery
In coronary bypass operations, three or more vessels are usually intervened. Although the duration of operations varies depending on the number of vessels to be bypassed and the additional attempts to be made, the average is 4 hours. 4-6 hours after the patient is taken to intensive care, he fully wakes up and leaves the respiratory support device. After coronary bypass surgeries, patients are usually able to meet their needs within a week and live alone within 2-3 weeks. In coronary bypass operations, the patient’s chest (mamaria) and arm vein (radial artery) are routinely used (full arterial blood). The leg vein is always the third choice. The death rate in coronary bypass operations at IstHealth Hospital’s Department of Cardiac Surgery is also less than 1% (in developed countries around the world, this rate ranges from 1-3%). The incidence of infection is also below the world standard. In principle, the bypass patient is given an exertion test once a year and coronary angiography after 5 years. There are very few cases of straight coronary bypass surgery admitted to our hospital. Cases include Valve, heart aneurysm, different levels of aortic aneurysm or second organ problems (kidney, lung, etc.) and consists of complex patients of advanced age. Second Operations (reoperation) of patients who have previously undergone heart surgery are often performed in our department. Along with the surgical team, the cardiology (stent if necessary) and intensive care team also specialize in this area. Robotic surgery, which is used in coronary bypass surgeries but whose early results do not give hope, has been abandoned in parallel with world practice.
Preventive treatment in Bypass surgery
In cases where bypass surgery is performed in the Department of Cardiovascular Surgery of IstHealth Hospital, if the mitral valve is missed, further deterioration of the valve is prevented by making plasti. This, in turn, is very important for maintaining heart justice in the long term and protecting the heart from failure.
“Mitral” and “aortic” valve operations are performed very frequently in the Department of chest, Cardiovascular Surgery of IstHealth Hospital. With the increase in education level in Turkey, there has been a decrease in the number of heart valve diseases related to rheumatism. For this reason, surgeries are mainly aimed at the treatment of diseases associated with calcified valves that occur in old age. Operations for advanced age-related calcification, especially in the aortic valves, are performed more often. Rhythm disorders (atrial fibrillation), which are common in Mitral valve operations, are again corrected by radiofrequency ablation, a method specific to the surgical team. This method is applied in only a few centers in our country. Repair methods for the cap are preferred in mitral valve patients. Mechanical caps that last longer are preferred in valve operations. In advanced age patients with a good general condition and a long expected life span, the same type of caps are used. Biological caps are applied in young women who want to give birth, or in patients who are old and will have difficulty taking blood thinners.
Major aortic vessel operations
Endovascular surgery, that is, Endostent, is preferred primarily for large aortic vessel operations. Stents with a diameter of 2-3 centimeters placed in the aorta, such as 1 millimeter stents placed in the heart vessels, can be successfully placed in the chest and abdominal aorta. This process is carried out together with the invasive radiology department and our team is the most experienced team in Turkey. In addition, in large aortic aneurysms, surgical methods in which the entire aorta is replaced are also used.
Leg arteries and varicose veins operations
Among vascular diseases, varicose veins are the most common disease of the balls, and surgery is performed on patients who cannot perform sclerotherapy. In the Department of Vascular Surgery of IstHealth Hospital, successful bypass operations are performed on the abdominal aorta and leg arteries. Artificial vessels are used in these operations.
Sclerotherapy for varicose veins (injection drying)
Injection drying can be done without hospitalization. In some cases, it can be used as a complementary treatment after surgery, as well as it is often used in the treatment of relapses. Micro varicose veins can be treated with laser at the dermatology department of IstHealth Hospital.
Carotid (carotid) surgeries
In those with coronary heart disease, the incidence of carotid artery constricting disease is quite high (8-12%). For this reason, it is vital that the carotid vessels of every patient over the age of 40 who needs coronary bypass surgery are examined with color doppler ultrasonography. In patients with strictures of more than 70-80% before surgery, the carotid artery is operated both before heart surgery and (in special cases) together with heart surgery. In this operation, hard plaques that narrow the carotid artery are cleaned and, if necessary, the carotid artery is widened with a patch. IstHealth Hospital Vascular Surgery team is also very experienced in this regard.
IstHealth Hospital Thoracic Surgery, Op. Dr. Naci serves as a team headed by Erciyes yağan. All kinds of lung operations and tumor staging are performed to patients prepared in the Department of lung diseases (bronchoscopy and respiratory test). Because lung operations due to infections and bronchial deformities have almost disappeared in our age, the operations performed are mostly tumor surgery. Currently, due to the decrease in lung operations, the number of operations on this issue is not very large.
Special methods for treatment
IstHealth Hospital chest, Cardiovascular Surgery team uses 9 augmentation glasses in coronary bypass surgeries. After Bypass operations, the control of the surgery is also performed with a thermal camera. A classic angiogram performed on the patient is examined by making it three-dimensional in a special computer program. The team has the distinction of being the “only team” that uses all these applications in Turkey.
Patient monitoring in intensive care
IstHealth Hospital chest, Cardiovascular Surgery Department also uses very special methods in intensive care patient follow-up. The image of the patient’s monitor in intensive care is monitored from the doctor’s office, home and pocket computer. However, normal patient images are also monitored from the doctor’s handheld computer via satellite with the same system.