Cardiac Services

Cardiothoracic Surgery Procedures

Valvular Heart Disease Surgery

The number of patients undergoing valve surgery continues to increase each year. For many, we repair, rather than replace, the valve. Some valve surgeries are being carried out with small 6-8 centimeter incisions (Figure 4), thus allowing shorter hospital stays. Patients return to normal activities more quickly and without increased risk. More elderly patients are being considered for valve surgery; our oldest patient, undergoing cardiac surgery in 2004, was 98 years old, he continues to enjoy an active life.

A growing number of tissue valves are being implanted because of their increased durability and because they do not require patients to take a blood thinning medication (Coumadin) (86% bioprosthesis, 14% mechanical) (Figure 5).

Figure 5

The mortality rates for aortic valve surgery over the last six years are favorable at Rhode Island Hospital, despite the large number of patients requiring emergency surgery, redo surgery (second and third time) or for treatment of active endocarditis (Figure 3). The risk of the operation observed/expected (O/E) ratio remains below one percent. Aortic valve sparing procedures (David operation) (Figure 6) have been offered at Rhode Island Hospital over the last ten years to patients with a leaky valve, an aneurysm of the ascending aorta or a dissection of the aorta, all with good results.

The results of mitral valve surgery also remain below the national average (an observed/ expected (O/E) ratio of less than one percent) despite a large number of emergency or urgent valve repair or replacement surgeries in the elderly population with heart attacks, endocarditis, cardiomyopathy with multiple risk factors, as well as patients undergoing a second or third operation.

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