Cardiothoracic and Vascular Surgery (CTVS)

Cardiothoracic and Vascular Surgery (CTVS) is used to address complex conditions affecting the heart, lungs, chest, and vascular system. From life-saving interventions to enhancing quality of life, CTVS plays an indispensable role in managing a wide range of cardiovascular and thoracic disorders.

At MAX Hospital, we understand the critical importance of CTVS in improving patient outcomes and restoring health. With a team of highly skilled and experienced cardiothoracic and vascular surgeons, we are committed to providing personalised care tailored to each patient's unique needs. Our surgeons bring a wealth of expertise to the operating table, backed by years of specialised training and a passion for excellence.

In addition to our exceptional medical team, MAX Hospital is equipped with state-of-the-art technologies and facilities that enable us to perform intricate CTVS procedures with precision and safety. From advanced imaging modalities to cutting-edge surgical techniques, we leverage the latest innovations to achieve optimal results for our patients. If you or your loved one is considering Cardiothoracic and Vascular Surgery, rest assured that MAX Hospital is dedicated to standing by you through every step of your healthcare journey, ensuring your comfort and well-being are our top priorities.

What is CTVS?

CTVS stands for Cardiothoracic and Vascular Surgery. It's a surgical specialty that deals with the surgical treatment of diseases affecting the heart, lungs, oesophagus, and major blood vessels within the chest. This field encompasses a wide range of procedures, including coronary artery bypass grafting, heart valve repair or replacement, thoracic aortic aneurysm repair, lung resections, and surgeries to treat vascular conditions like aortic dissections or peripheral artery disease (PAD).

Why is Cardiothoracic and Vascular Surgery done?

Cardiothoracic and Vascular Surgery (CTVS) is performed to treat a wide range of conditions affecting the heart, lungs, and major blood vessels. These surgeries are done for several reasons, including:

Treatment of Heart Disease

• Coronary Artery Disease: CTVS procedures such as coronary artery bypass grafting (CABG) are performed to restore blood flow to the heart muscle in patients with blocked or narrowed coronary arteries.
• Heart Valve Disorders: Surgery may be necessary to repair or replace damaged heart valves, improving heart function and alleviating symptoms such as shortness of breath or chest pain.
• Congenital Heart Defects: CTVS procedures are performed to correct structural abnormalities present at birth, allowing for normal heart function and circulation.
• Heart Failure: In some cases of severe heart failure, heart transplant surgery or LVAD may be considered as a life-saving treatment option.

Treatment of Lung Disease

• Lung Cancer: CTVS procedures such as lung resections or lobectomies are performed to remove cancerous tumours or masses from the lungs, potentially curing the disease or relieving symptoms.
• Thoracic Aortic Aneurysms and Dissections: Surgery is necessary to repair weakened or damaged sections of the thoracic aorta to prevent life-threatening complications such as rupture or organ damage.
• Pulmonary Conditions: CTVS may be indicated for the treatment of conditions such as pulmonary embolism, lung infections, or pleural diseases requiring surgical intervention.

Treatment of Vascular Disease

• Peripheral Artery Disease (PAD): CTVS procedures such as peripheral vascular bypass surgery or angioplasty with stenting are performed to improve blood flow to the limbs, relieve symptoms of claudication, and prevent limb loss.
• Aortic Aneurysms and Dissections: Surgical repair of aortic aneurysms or dissections is essential to prevent life-threatening complications such as rupture, which can lead to massive internal bleeding.
• Carotid Artery Disease: Surgery may be necessary to remove plaque buildup from the carotid arteries, reducing the risk of stroke in patients with carotid artery stenosis.

Transplantation

• Heart, Lung, or Combined Heart-Lung Transplants: CTVS procedures involve the transplantation of healthy organs from donors to replace diseased or failing organs in patients with end-stage heart or lung diseases.

Overall, Cardiothoracic and Vascular Surgery is done with the primary goals of improving quality of life, relieving symptoms, preventing complications, and extending survival for patients with a variety of cardiovascular and thoracic conditions.

Types of Cardiothoracic and Vascular Surgery

Here are the types of surgeries commonly performed within the Cardiothoracic and Vascular Surgery (CTVS) specialty:

Cardiac Surgery

• Coronary Artery Bypass Grafting (CABG): Surgery to bypass blocked or narrowed coronary arteries, restoring blood flow to the heart muscle.

• Heart Valve Repair or Replacement: Surgical repair or replacement of damaged or diseased heart valves, such as the mitral valve or aortic valve.

• Congenital Heart Defect Repair: Surgery to correct structural abnormalities present at birth, such as atrial septal defects or ventricular septal defects.

• Cardiac Tumour Removal: Surgical removal of tumours or masses within the heart.

Thoracic Surgery

• Lung Resections: Surgical removal of part or all of a lung, commonly performed to treat lung cancer or benign lung tumours.

• Lobectomy: Removal of one of the lobes of the lung.

• Pneumonectomy: Removal of an entire lung.

• Thoracic Aortic Surgery: Surgical repair of aneurysms or dissections affecting the thoracic aorta.

• Thoracoscopic Surgery: Minimally invasive procedures performed through small incisions in the chest wall, including thoracoscopic lung biopsy or thoracoscopy for pleural diseases.

Vascular Surgery

• Endovascular Procedures: Minimally invasive procedures performed within blood vessels, such as angioplasty and stenting for peripheral artery disease (PAD) or carotid artery stenosis.

• Aortic Aneurysm Repair: Surgical repair of aneurysms affecting the aorta, including open repair or endovascular aneurysm repair (EVAR).

• Peripheral Vascular Bypass Surgery: Surgical creation of a bypass around blocked arteries in the legs or arms to restore blood flow.

• Carotid Endarterectomy: Surgical removal of plaque buildup from the carotid arteries to reduce the risk of stroke.

• Venous Procedures: Surgical treatment of venous diseases, including varicose vein surgery or deep vein thrombosis (DVT) treatment.

Transplant Surgery

• Heart Transplant: Surgical transplantation of a healthy heart from a donor to replace a diseased or failing heart.

• Lung Transplant: Surgical transplantation of one or both lungs from a donor to replace diseased or damaged lungs.

• Combined Heart-Lung Transplant: Simultaneous transplantation of both heart and lungs for patients with severe heart and lung diseases.

Cardiothoracic and Vascular Surgery Techniques

Cardiothoracic and Vascular Surgery (CTVS) utilises various approaches and techniques tailored to the specific needs of each patient and the nature of their condition. Some of the commonly used approaches include:

Traditional/Open Surgery

• Involves making a large incision in the chest or abdomen to access the surgical site.
• Allows for direct visualisation and manipulation of tissues, organs, and blood vessels.
• Often used for complex procedures such as coronary artery bypass grafting (CABG), aortic aneurysm repair, or lung resections.

Minimally Invasive Surgery

• Involves making small incisions (keyhole incisions) rather than a large open incision.
• Utilises specialised instruments and a camera (endoscope) to perform the surgery with precision.
• Offers benefits such as reduced post-operative pain, shorter hospital stays, and quicker recovery times.
• Common minimally invasive techniques include:
• Thoracoscopy: Used for lung surgeries and procedures involving the chest cavity.
• Laparoscopy: Used for certain vascular procedures or surgeries involving the abdominal cavity.
• Endovascular Surgery: Utilises catheters and guidewires inserted through blood vessels to access and treat vascular conditions, such as angioplasty or stenting.

Robotic-Assisted Surgery

• Involves the use of robotic systems to assist the surgeon in performing precise, minimally invasive procedures.
• The surgeon controls robotic arms equipped with surgical instruments and a camera, providing enhanced dexterity and visualisation.
• Robotic-assisted surgery is commonly used for procedures such as robotic-assisted coronary artery bypass grafting (CABG) or robotic-assisted thoracic surgery (RATS) for lung resections.

Hybrid Procedures

• Hybrid procedures combine elements of both surgical and interventional techniques to optimise patient outcomes.
• These procedures may involve a combination of open surgery and endovascular interventions, often performed in a single setting.
• Hybrid approaches are particularly useful for treating complex conditions such as thoracoabdominal aortic aneurysms or coronary artery disease with concomitant peripheral vascular disease.

Cardiothoracic and Vascular Surgery Benefits

• Improved Heart Function: Surgery can repair or replace damaged heart valves, correct congenital heart defects, and improve blood flow, leading to better heart function and overall cardiovascular health.
• Extended Lifespan: By addressing heart and vascular issues, surgery can extend a patient's lifespan, particularly in cases of severe heart disease or blockages.
• Symptom Relief: Many patients experience significant relief from symptoms such as chest pain, shortness of breath, and fatigue after undergoing cardiothoracic and vascular surgery.
• Prevention of Complications: Surgery can prevent or reduce the risk of serious complications associated with cardiovascular conditions, such as heart attacks, and heart failure.
• Improved Quality of Life: By restoring normal heart and vascular function, surgery can enhance a patient's quality of life, allowing them to engage in daily activities with greater ease and comfort.

Cardiothoracic and Vascular Surgery Risks

• Bleeding: Surgery carries the risk of excessive bleeding, both during the procedure and afterwards. This risk is typically managed through careful surgical technique and monitoring.
• Infection: Infection is a potential complication following any surgical procedure. Steps are taken to minimise this risk, such as sterile operating environments and antibiotic prophylaxis.
• Blood Clots: Surgery and immobility afterward can increase the risk of blood clots forming in the legs (deep vein thrombosis) or travelling to the lungs (pulmonary embolism). Blood thinners may be prescribed to reduce this risk.
• Organ Damage: In rare cases, surgery may inadvertently damage nearby organs or tissues. Surgeons take great care to minimise this risk through precise techniques and thorough preoperative evaluation.
• Anaesthesia Complications: General anaesthesia carries its own set of risks, including allergic reactions, respiratory problems, and cardiovascular complications. Anesthesiologists closely monitor patients during surgery to mitigate these risks.
• Stroke: During certain cardiac procedures, such as coronary artery bypass grafting or valve replacement, there is a risk of dislodging plaque or blood clots, potentially leading to a stroke. Precautions are taken to minimise this risk, such as the use of blood-thinning medications.
• Recovery Challenges: Cardiothoracic and vascular surgery often require a lengthy recovery period, during which patients may experience discomfort, limited mobility, and the need for rehabilitation to regain strength and function.

It's important for patients to discuss the benefits and risks of cardiothoracic and vascular surgery with their doctor to make an informed decision.

Frequently Asked Questions

How long does it take to recover from Cardiothoracic and Vascular Surgery (CTVS) surgery?

Recovery time can vary depending on the specific procedure performed, overall health of the patient, and any complications that may arise. In general, it may take several weeks to a few months to fully recover from CTVS surgery.

Will I need to stay in the hospital after Cardiothoracic and Vascular Surgery (CTVS) surgery?

Yes, most patients will need to stay in the hospital for a period of time after CTVS surgery for monitoring and postoperative care. The length of hospital stay can vary depending on the type of surgery and individual patient factors.

What can I expect during a consultation with a Cardiothoracic and Vascular Surgery (CTVS) surgeon?

During a consultation, the surgeon will review your medical history, perform a physical examination, discuss your symptoms and treatment options, explain the proposed surgery, and address any questions or concerns you may have.

What kind of pain management can I expect after Cardiothoracic and Vascular Surgery (CTVS) surgery?

Pain management after CTVS surgery typically involves a combination of medications such as opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and local anaesthetics. The goal is to control pain while minimising side effects and promoting healing.

What limitations will I have after Cardiothoracic and Vascular Surgery (CTVS) surgery?

The limitations after CTVS surgery can vary depending on the specific procedure performed and individual patient factors. Generally, patients may experience restrictions on physical activity, lifting heavy objects, driving, and returning to work for a certain period of time during the recovery process.

What is the success rate of Cardiothoracic and Vascular Surgery (CTVS) surgeries?

The success rate of CTVS surgeries can vary depending on the type of procedure and individual patient factors. Overall, many CTVS surgeries have high success rates in improving heart and vascular function, relieving symptoms, and extending lifespan.

What are the long-term implications of Cardiothoracic and Vascular Surgery (CTVS) surgery?

Long-term implications can include improved heart function, extended lifespan, relief from symptoms, and reduced risk of complications associated with cardiovascular conditions. However, ongoing monitoring and lifestyle modifications may be necessary to maintain optimal heart health.

Are there alternative treatments to Cardiothoracic and Vascular Surgery (CTVS) surgery?

In some cases, alternative treatments such as medication, lifestyle modifications, minimally invasive procedures, or catheter-based interventions may be considered as alternatives to surgery. The choice of treatment depends on the specific condition and individual patient factors.

How can I prepare for Cardiothoracic and Vascular Surgery (CTVS) surgery?

Preparation for CTVS surgery may involve undergoing preoperative testing, following any preoperative instructions provided by your healthcare team, arranging for postoperative care and support, and making necessary lifestyle modifications.

What are the common procedures performed in Cardiothoracic and Vascular Surgery (CTVS)?

Common procedures include coronary artery bypass grafting (CABG), heart valve repair or replacement, thoracic aortic aneurysm repair, heart transplant, and procedures to treat peripheral artery disease (PAD) or venous disorders.

What is the recovery process like after Cardiothoracic and Vascular Surgery (CTVS) surgery?

After Cardiothoracic and Vascular Surgery (CTVS), patients typically spend a few days in the ICU, followed by a week or two in a regular hospital room. They receive pain management, physical therapy, and post-operative care instructions. Once discharged, recovery continues at home with medication management, dietary adjustments, gradually increasing activity, and follow-up appointments. Overall, recovery can take several weeks to months.

Review 

Reviewed By Dr. Dinesh Chandra, Associate Director - Cardiac Surgery (CTVS), Cardiac Sciences on 27 Aug 2024.