by DrCiuffo | Dec 8, 2016 | Blog
A thoracotomy is performed by surgeons in order to get better access to the many thoracic organs, namely the heart, lungs, and esophagus, or for access to the thoracic aorta or the anterior spine. Therefore, a minithoracotomy is any thoracotomy involving less muscle division than the classic posterolateral thoracotomy (which is an incision through the back, and is often widened with rib spreaders). Dr. Ciuffo performs this minimally invasive procedure for patients in need of aortic, tricuspid, mitral, aortic valve surgery, atrial myxoma and atrial septal defect (ASD) repairs or other suitable coronary cases. The Procedure To perform a minithoracotomy, Dr. Ciuffo will not need to break any bones. He will make a surgical incision through a thin muscle layer between the ribs. The avoidance of a split in the breast bone and ribs gives less pain, less chances of wound infection, less bleeding and a much more reliable healing of the surgical wound. To minimize pain, your doctor will inject local anesthetic in the nerves between the ribs (intercostal nerve block). After the Procedure After Dr. Ciuffo completes the surgery, the scar will be barely visible below the neck and away from the midline towards the side of the chest. For women, this scar may even be hidden in the skin fold underneath the breast. Patients can resume their normal activities after the procedure because there are no restrictions in driving a car or carrying weights other than the patient’s own comfort level. Dr. Ciuffo and the Minimally Invasive and Bloodless Heart Surgery Program Dr. Ciuffo is dedicated to helping you understand minithoracotomy. If you have any questions about minithoracotomy or the steps we will... by DrCiuffo | Nov 17, 2016 | Uncategorized, Blog
Healthy hearts have a wall that separates the right and left sides. An atrial septal defect occurs when there is a hole in this wall. This hole can cause problems with blood flow through the heart and body. ASD is not that common: only 0.6% of all babies are born with a hole in their heart wall. However, the consequences of this defect can be deadly. Symptoms ASD can cause newborns to have trouble breathing. This, in turn, leads to other issues like malnourishment, irreversible lung circulation damage, other complications and eventually death. It is very important to recognize this pathology and treat it before it is too late. Treatments There are several different ways to treat ASD. Surgical Therapy. When the atrial septal defect is small, it can sometimes close on its own. However, if the hole is large, it can cause severe symptoms. Minimally invasive atrial septal defect repairs can be performed to restore the normal anatomy for good. The surgery involves a tiny 2″ incision on the chest wall. Dr. Ciuffo will close the ASD with a suture line or a patch of the patient’s own tissue. Minimally invasive patients can benefit from having a very small scar, significantly less pain, and a quick recovery compared to other methods. Medical Therapy. For newborns with a small atrial septal defect with no symptoms, a pediatric cardiologist will most likely observe the patient and wait for the atrial septal defect to close on its own. If this does occur, the baby will have regular physical examinations and echocardiograms. Catheter Therapy. In some cases, the ASD can be closed with a catheter.... by DrCiuffo | Nov 10, 2016 | Blog
Bloodless heart surgery can be a viable option for those patients deemed “inoperable,” who are old or frail, or who can’t have regular heart surgery due to religious reasons. As opposed to traditional heart surgery, bloodless heart surgery actually has certain benefits related to the careful preparation of each patient for bloodless heart surgery, the precise and meticulous technique during surgery, the thorough postoperative follow-up, and the avoidance of potential side effects and complications related to blood transfusions. Preparation Before Surgery The preparation before bloodless heart surgery is integral to the success of the procedure. First, Dr. Ciuffo will determine if there is any evidence of spontaneous bleeding or anemia. The most common causes of chronic anemia are related to bleeding from ulcers in the stomach or intestine, bleeding from diverticulosis, heavy menstruations, primary anemias. A hematology or gastroenterology evaluation can be requested as necessary. Next, Dr. Ciuffo will administer medications such as Erythropoietin, Iron, and Folic Acid to stimulate the patient’s production of more red blood cells. Ideally, each patient considered for surgery should be treated to ensure a healthy hemoglobin level. Lastly, your doctor will create a surgical strategy to minimize the risk of bleeding while accomplishing a complete, thorough treatment of the heart condition. Blood Sparing Techniques Bloodless heart surgery is known for how minimally invasive it is. Dr. Ciuffo uses techniques that avoid breast bone cutting that could lead to postoperative bleeding. These techniques include: Extra Corporeal Circulation (the heart-lung machine) with or without blood storage. The entire blood volume can be kept in circulation at all times, in compliance with the principles and beliefs of the Jehovah’s witness community. Beating Heart Surgery technique for coronary... by DrCiuffo | Nov 3, 2016 | Blog
Coronary heart disease causes plaque to build up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart. To fix this problem, doctors perform a coronary bypass operation. This procedure connects a vein or an arterial graft to the aorta and a spot on the coronary artery downstream from where the blockage is. There are several reasons as to why your coronary disease could be deemed “inoperable:” The Aorta Could Be Heavily Calcified Instead of using the aorta, Dr. Ciuffo will connect to the left and right internal mammary arteries. These vessels run along the chest wall and are already hooked up to the general circulation through the subclavian arteries in the shoulders. This method avoids the need to use the aorta as the hook up to the veins. A beating heart surgery technique can be used to perform the bypass operation without using the heart-lung machine or any clamp across the aorta. There Are Not Enough Conduits or Veins to Work With There are several grafting options to help in this situation. Dr. Ciuffo can harvest conduits from the arms, the back of the legs, the abdominal wall, the peritoneal cavity, and the chest wall. Another option is to thaw out human cryopreserved saphenous veins from tissue banks. Every coronary case is different and should be carefully evaluated by a medical professional to see if a technical option is available to help an individual patient. The Coronary Vessels Are Too Severely and Diffusely Diseased If a coronary vessel has multiple blockages, double grafting can be performed on individual vessels. If the entire length of the coronary... by DrCiuffo | Oct 14, 2016 | Blog
Atrial fibrillation, or AFib, is a heart condition that causes you to have an irregular or fast heart rate. This increased heart rate can then lead to other complications like stroke or heart failure. Symptoms of AFib can be shortness of breath, heart palpitations, and weakness. AFib typically is not a life-threatening condition, but it can decrease your quality of life if left untreated. One way to treat this condition is to get a mechanical heart valve replacement surgery. Mechanical Heart Valve A mechanical valve is an artificial tool that includes a steel alloy ring with an outer cloth suture ring and two half-moon shaped leaflets hinged inside it. The valve replaces a damaged or malfunctioning mitral valve in your heart. This type of valve is very hard, does not wear out, and guarantees a virtually unlimited duration of the valve in ideal conditions. Mechanical Heart Valve Replacement and Atrial Fibrillation You may be suffering from atrial fibrillation if you have another heart problem that requires a surgery like mitral valve surgery, aortic valve surgery, or coronary artery bypass grafting. If the surgery that you require to treat another heart issue is mechanical heart valve replacement surgery, it is likely that your atrial fibrillation will also be treated during the surgery. Disadvantages of Surgery The main disadvantage of mechanical heart valve replacement surgery is that patients who received a mechanical valve have to take blood thinners for the rest of their lives to prevent the formation of dangerous blood clots. This is a necessary and important therapy because normal blood tends to form clots when it is in contact with...
