In the past, most people who had heart attacks routinely underwent open-heart surgery to open blocked arteries. Today, only about 10 percent of those patients need surgery.

Like Paul, the vast majority of people who have heart attacks are successfully treated in the cath lab with angioplasty and stents. “Surgery is now used for the more complex heart attack patients,” says Bernard Harrison, MD, a cardiovascular surgeon at Park Nicollet Heart and Vascular Center.

Importance of teamwork
Sometimes, it may not be immediately apparent whether angioplasty or surgery is best, especially when there are more than two blockages or a patient already has a stent. In these cases, the interventional cardiologist and cardiac surgeon may consult with each other during the angiogram.

There are times when an unexpected emergency arises during the angiogram or angioplasty, and the interventional cardiologist will need to page the surgeon. “When there is an emergency in the cath lab, my beeper goes off with a very specific ring – and so do the beepers of my entire staff,” Dr. Harrison explains. “I can go immediately to the cath lab and help determine what needs to be done. If surgery is necessary, I inform the operating room and they prepare my team for surgery.”

The heart surgery team focuses solely on cardiac surgery. “They know exactly how these cases go and, many times, not much is said during the operations,” Dr. Harrison explains. “I’ll just put my hand back, and the staff gives me what I need.”

If the need for emergency surgery occurs in the middle of the night, there is an on-call team that can arrive at the hospital within 20 minutes,” Dr. Harrison continues. “I live very close to the hospital and can act very quickly.”

Bypass surgery most common
When treating heart attacks, bypass surgery is the most common procedure. When planning these surgeries, the cardiac surgeon refers to the angiogram. “The angiogram serves as my road map, showing me all the vessels of the heart and where any blockages are,” Dr. Harrison says. “I also use the angiogram to determine where on the artery I will make my incision and what conduit I will use in its place.”

Not all surgeries for treating heart attacks are emergencies. After the angiogram is performed, the cardiac surgeon plans the strategy for moving forward. In some cases, doctors may take a “wait and see” approach and perhaps try medication to avoid the need for surgery. Other times, they may choose to delay surgery for a week or two until the effects of a medication wear off – often the case when patients are on blood thinners.

Most coronary bypass surgeries take about three to five hours to perform. “Bypass surgery is a very safe procedure,” Dr. Harrison adds. “Even though it is used on our sickest heart attack patients, at least 98.5 percent of all patients do very well. Recoveries are typically uncomplicated and most patients spend about three or four days in the hospital before going home.”

Because of this high success rate, the Society of Thoracic Surgeons rated Park Nicollet Heart and Vascular Center among the top programs nationwide; and Park Nicollet received Health Grades’™ Cardiac Surgery Excellence Award, placing the program among the top 10 percent in the country.

“We are really excited about some new advances, especially beating heart bypass surgeries and minimally invasive procedures that are performed robotically – without the need for opening the chest wall,” Dr. Harrison adds. “Despite these advances, I like to encourage patients to do all they can to avoid heart attack risks by practicing a healthy lifestyle.”

After treatment, most heart attack patients undergo a period of rehabilitation. To learn about more about rehabilitation, read “Working toward recovery”. To learn more surgery for treating heart attacks, visit parknicollet.com/heart.