Current Practices
Coronary artery bypass grafting (CABG): Surgical revascularization for coronary artery disease, often performed using saphenous vein grafts or internal mammary arteries.
2. Valve repair/replacement: Surgical correction for valvular heart disease, including:
– Mitral valve repair/replacement
– Aortic valve replacement
– Tricuspid valve repair/replacement
3. Heart transplantation: Surgical replacement for end-stage heart failure, offering improved survival and quality of life.
Robotic-Assisted Surgery
Enhanced precision and dexterity using robotic systems, improving outcomes for complex procedures.
TAVR (Transcatheter Aortic Valve Replacement)
Minimally invasive valve replacement for aortic stenosis, expanding treatment options for high-risk patients.
Mechanical Circulatory Support
Bridge to transplantation or recovery, including ventricular assist devices (VADs) and extracorporeal membrane oxygenation (ECMO).
Hybrid Cardiac Surgery
Combining surgical and catheter-based interventions to treat complex cardiac conditions.
Transcatheter Mitral Valve Repair
Emerging techniques for treating mitral regurgitation and other mitral valve diseases.
Advanced Treatments
Gene Therapy
Targeting genetic mutations or promoting angiogenesis, with potential applications in:
– Cardiovascular disease prevention
– Treatment of inherited cardiac conditions
– Enhancement of cardiac function
Stem Cell Therapy
Potential for cardiac regeneration, exploring various cell types and delivery methods, including:
– Bone marrow-derived stem cells
– Adipose tissue-derived stem cells
– Cardiac progenitor cells
Artificial hearts:
Total artificial heart replacement, offering a promising solution for end-stage heart failure, with ongoing research focused on:
– Device durability and reliability
– Minimizing complications and adverse events
– Improving patient quality of life
Future Directions
- Precision medicine – Tailoring treatment to individual patient needs, integrating genomics, and personalized therapies.
- Regenerative medicine – Repairing or replacing damaged cardiac tissue using stem cells, biomaterials, or tissue engineering.
- Advanced MCS devices – Improving device durability, functionality, and patient outcomes.
Clinical Implications
1. Multidisciplinary care: Collaboration between cardiologists, surgeons, and other specialists.
2. Personalized treatment: Tailoring therapy to individual patient needs.
3. Ongoing research: Continued innovation and investigation.
Advances in cardiac surgery have improved patient outcomes, reduced morbidity, and enhanced quality of life. Continued innovation and research will further transform the field.
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