Cardiothoracic surgery

At HCA Virginia Physicians, our cardiothoracic surgeons provide patients with advanced surgical options to treat conditions of the heart and lungs—including chest wall cancer and heart failure. We understand surgery can be overwhelming, which is why our team is here to support you from pre- through postoperative care. Our goal is to provide outstanding service in a patient-centered atmosphere so that you fee comfortable about your treatment plan and procedure.

For new patients seeking an appointment, please call our office at (804) 320-2751. For existing patients, you may either call our office or schedule an appointment online.

Advanced heart surgery

When advanced treatment is needed, heart surgery can improve quality of life and reduce symptoms related to heart disease, heart failure and other heart disorders. There are many different types of heart surgery that may be used to:

• Boost the heart's pumping power with muscles taken from the back or abdomen
• Bypass or widen blocked or narrowed arteries to the heart
• Implant devices to regulate heart rhythms
• Make channels in the heart muscle to allow blood from a heart chamber directly into the heart muscle
• Remove small amounts of tissue that disturb electrical flow through the heart
• Repair aneurysms, or bulges in the aorta, which can be deadly if they burst
• Repair or replace the valves that control blood flow through the heart's chambers
• Replace the damaged heart with a heart from a donor

Heart surgeries we perform

Our heart surgeons perform a variety of procedures, including:

• Atrial fibrillation (AFib) surgery, including:
  • Full Cox maze procedure
  • Hybrid, minimally invasive maze procedure
  • Modified maze procedure
• Aneurysm surgery, including:
  • Coronary artery bypass grafting (CABG)
  • Endovascular stenting
• Minimally invasive surgery, including:
  • AFib surgery
  • Aortic valve surgery
  • Coronary artery surgery
  • Mitral valve surgery
• Other procedures include:
  • Off-pump surgery
  • Transmyocardial revascularization
  • Valve repair and replacement
  • Ventricular assist device implantation

Coronary bypass surgery

Coronary artery bypass grafting (CABG) is performed on patients with significant blockages in their arteries, known as atherosclerosis. If the blockages are extreme, a patient is at an increased risk for heart attack.

Off-pump coronary surgery

For some patients, our heart surgeons use an innovative approach that does not require the use of the heart-lung machine. Instead, it uses a stabilizing device placed on the surface of the heart that limits the motion of the beating heart. This operation is an off-pump coronary artery bypass grafting (OPCAB).

Although it may not always be an option, OPCAB eliminates some of the risks associated with using the heart-lung machine. In most patients these risks are quite small but in some patients, with severe atherosclerosis, poor kidney function or significant lung disease, these risks may be more serious.

Endoscopic vein harvesting (EVH)

During bypass surgery, the bypass vein is typically harvested (removed) from the leg. Traditionally, this has involved a long incision from the ankle to the groin. Our surgeons use the EVH approach on bypass patients, so that the vein is removed through one to three small incisions, each less than one inch in length. This reduces scarring and recovery time for patients.

Heart valve repair surgery

Heart valve repair is a procedure that corrects a defective heart valve, when a valve does not open or close properly. Several different procedures may be performed to repair a valve, depending on the source of the valve problem.

Two of those procedures are:

• Annuloplasty ring—An annuloplasty ring is a small device designed to help support the valve so the tissue can come together properly.
• Valvotomy—Valvotomy is a type of open-heart surgery in which the surgeon cuts into a valve to repair valvular damage.

Complex mitral valve repair

A complex mitral valve repair—an advanced procedure involving the left heart valve—may include a number of techniques, such as:

• Annuloplasty ring implantation
• Insertion of artificial valve chords
• Partial removal or resection of a faulty valve flap
• Shortening of a faulty valve chord and/or repositioning of the chord
• Reducing the size of the valve ring

Heart valve replacement surgery

Heart valve replacement is an open-heart surgery where a defective valve that cannot be repaired is then replaced with a new valve. Depending on the patients condition and preference, a mechanical or a tissue (bioprosthetic) valve can be used.

Mechanical heart valves

Mechanical heart valves are typically made of metal, carbon and/or artificial materials. These valves are durable and structural failure is very rare. Once a mechanical valve has been attached, all types of mechanical valves require life-long blood-thinner therapy to prevent clots forming on the valve. Thus, the main disadvantage to mechanical valves is the need for continued blood-thinner therapy, however, this drawback is offset by the long-term durability of the valve.

Tissue heart valves

Tissue valves, also called bioprosthetic valves, are made of tissue, but they may also have some artificial parts to provide additional support and allow the valve to be sewn in place. Bioprosthetic valves can be made from pig tissue (porcine), cow tissue (bovine) or pericardial tissue from other species. Typically, these valves do not require the ongoing use of blood-thinner pills. However, over many years, these valves may gradually deteriorate and require a repeat operation for removal and re-replacement of the valve.

Minimally invasive heart surgery

Minimally invasive heart surgery allows surgeons to perform complex heart surgeries through smaller incisions. Instead of a traditional incision that spans vertically down the chest, minimally invasive heart surgery uses a smaller incisions underneath the breast. We offer minimally invasive heart valve repair and replacement surgery, as well as a minimally invasive maze procedure.

Hybrid minimally invasive maze procedure

The surgical maze procedure is one of the most effective treatments of AFib—an irregular heartbeat that can lead to complications. Our surgeons are now able to use am advanced minimally invasive, endoscopic treatment of AFib. This procedure requires no thoracotomy or sternotomy, meaning patients who were not candidates for this procedure in the past now have the option of a surgical maze procedure. The maze procedure uses small incisions to create scar tissue in a maze-like pattern, that helps correct the heartbeat.

Thoracic surgery

Our thoracic surgery team provides comprehensive diagnosis and surgical care to patients with diseases of the lungs, trachea, esophagus, diaphragm, chest wall and mediastinum. When advanced treatment is needed, our surgeons are equipped to perform thoracic surgery to treat the underlying cause of the condition.

Diseases treated by our thoracic surgeons include:

• Benign pulmonary nodules
• Chest wall cancer
• Emphysema
• Inflammatory disease of the mediastinum
• Interstitial lung disease
• Lung cancer
• Lymphoma
• Mediastinal masses
• Mesothelioma
• Myasthenia gravis
• Pleural effusion
• Pleural infection
• Thymoma

Minimally invasive robotic surgery

When possible, our surgeons use advanced robotic technology. This means our surgeons can perform extremely complex thoracic operations with greater precision and control.

We offer the following thoracic procedures using robot-assisted surgery:

• Drainage of pleural effusion
• Lobectomy
• Lung biopsy
• Mediastinal, pericardial and thymic procedures
• Wedge resection