Dr Mohammed Ali

Vijay Nagar, Indore, Madhya Pradesh

Tumors that originate in the heart are rare, but can be either benign or malignant. Because the heart is such an essential organ, even benign tumors can be life-threatening. Tumours can be in the surface of the heart, wall of the heart and cavities of the heart. It needs to be surgically removed via open heart heart surgery.

The aortic valve is on the left side of the heart and serves as an outflow valve. Its job is to allow blood to leave the left ventricle, which is the heart’s main pumping chamber. Its job is also to close so that blood doesn’t leak back into the left ventricle. The aortic valve can be affected by a range of diseases; the valve can either become leaky (aortic insufficiency / regurgitation) or partially blocked (aortic stenosis). Aortic valve can be replaced by surgery with the help of cardio pulmonary bypass. The replaced valve will function as same as the native valve.The most common type of congenital abnormality is a bicuspid valve. Normally, the aortic valve has three sections of tissue, known as leaflets. This is called a tricuspid valve. A defective valve has only two leaflets, so it’s called a bicuspid valve. Aortic valve replacement is a procedure in which a patient's diseased aortic valve is replaced with an alternate mechanical or bioprosthetic valve.

The mitral valve is located on the left side of the heart. It serves as an inflow valve. Its job is to allow blood from the left atrium to flow into the left ventricle. Surgery may be required if the valve doesn’t fully open or completely close. When the valve is too narrow, it can make it difficult for blood to enter. This can cause it to back up, causing pressure in the lungs. When the valve doesn’t close properly, blood can leak back into the lungs. This can be due to a congenital defect, infection, calcification or a degenerative disease.

The aorta is the largest artery that stems from the heart and branches into smaller arteries to distribute oxygenated blood to all parts of the body. It can be divided into the ascending aorta (part that rises from the heart), aortic arch (part that bends over the heart), descending thoracic aorta (part that moves down the chest region) and abdominal aorta (part that begins at the diaphragm). Bentall's procedure is a cardiac surgery operation involving composite graft replacement of the aortic valve, aortic root and ascending aorta, with re-implantation of the coronary arteries into the graft. This operation is used to treat combined aortic valve and ascending aorta disease. INDICATIONS Aortic Regurgitation (leaking of the aortic valve) Marfan's syndrome (Genetic disease that causes aortic wall weakness) Aortic Dissection (separation of the layers of the aorta wall) Aortic Aneurysm (Enlargement of Aorta)

A coronary artery bypass graft may be necessary for people with coronary heart disease. Coronary heart disease occurs when the blood vessels that provide blood and oxygen to the heart muscle become narrow and hard. This is often called “hardening of the arteries.” Hardening occurs when fatty material forms a plaque on the walls of the coronary arteries. This plaque narrows the arteries, making it difficult for blood to get through. When blood can’t flow properly to the heart, a heart attack may occur. Coronary artery bypass graft (CABG) surgery is performed to restore blood flow through the vessels that supply blood to the heart. During the surgery, a conduit is taken from chest wall (Internal mammary artery), or hand ( Radial Artery) or from the leg(Saphanous vein), and anastamosed across an area of severe narrowing or blockage, thus bypassing the diseased area. The blood is rerouted through the healthy vessel, and blood flow is restored to the heart muscle.

Congenital Heart Defects are problems with the heart's structure that are present at birth. Congenital heart defects(CHD) change the normal flow of blood through the heart. There are many types of congenital heart defects. They range from simple defects with no symptoms to complex defects with severe, life-threatening symptoms. CHDs are classified into cyanotic and acyanotic diseases. Congenital heart defects are the most common type of birth defect. They affect 8 out of every 1, 000 newborns. Many of these defects are simple conditions. They need no treatment or are easily fixed. Some babies are born with complex congenital heart defects. These defects require special medical care soon after birth. some patients growup with the congenital defect and require surgical correction in the adulthood.

Some post cardiac surgery patients may require Re-operation due to complications Re-operative cardiac surgery is common nowadays. Re-operations in cardiac surgery are technically more difficult because of adhesions and a more advanced cardiac status of the patient. Experience and technological evolution have produced a substantial reduction in postoperative mortality nowadays. Morbidity of cardiac re-intervention is higher than in a first operation because of cardio-pericardial adhesions and more advanced cardiac pathology.

LV Aneurysm Repair usually after effects of myocardial infarctions. When the heart muscle partially dies during the heart attack, a layer of muscle may survive and being severely weakned and start to become an aneurysm. The blood may flow into the surrounding dead muscles and inflate the weakened flap of muscle into a trouble. It's one of the many complications that may occur after a heart attack (Myocardial Infarction). They usually arise from a patch of weakened tissue in a ventricular wall, which swells into a bubble filled with blood. This inturn block the passageways leading out of the heart, leading severely constricted blood flow to the body. It can be fatal and usually non-rapturing because they are lined by scar tissue. Surgical treatment of LVA has been employed for a long time with certain success.