Adult Cardiac Surgery
Coronary Artery Bypass Grafting (CABG)
Mitral Valve Repair
Aortic Valve Surgery
Atrial Fibrillation Surgery
Members of the division offer surgical procedures for treatment of coronary artery occlusive disease and valvular heart disease, as well as diseases of the major thoracic vessels.
Coronary bypass surgery, with and without the use of the heart lung machine is an area which extensive experience is available. This experience also includes the preferential use of arterial grafts particularly in the younger patients, the use of both mammary arteries, the use of radial arteries and other arterial vessels as conduits for bypass. Endoscopic saphenous vein harvesting techniques are used to minimize tissue trauma and greatly expedite patient comfort and recovery time.
Our long experience with the surgical treatment of valvular heart disease includes sophisticated approaches to the repair of diseased cardiac valves, as well as their replacement. Intraoperative transesophageal echocardiography is used as an adjunct to guide, evaluate, and assess the success of the procedures.
The division also has extensive experience in the treatment of diseases of the large vessels, including aneurysms and dissections of the ascending aorta, arch and descending aorta. This experience includes working with tanning glue (glutaraldehyde-resorcinol-formaldehyde) to strengthen the tissues and reduce the risk of bleeding.
The Atrial Fibrillation Center at UIC was created by specialized members of the Division of Cardiothoracic Surgery and the section of Cardiology for the comprehensive Treatment of Atrial Fibrillation. At the Atrial Fibrillation Center, a team of Cardiac Electrophysiologists (EP), Nurse Practitioners, Research Coordinators, Cardiac Surgeons, and the EP Lab Staff are dedicated to the treatment of Atrial Fibrillation. Patients will be seen by both an electrophysiologist specialist and an Arrhythmia Surgeon. The treatment for each patient is individualized and taken into account the severity and frequency of symptoms, risk of thromboembolic events, overall cardiac function, and other comorbid conditions.
The medical treatment of atrial fibrillation consists of attempts to cardiovert the patient chemically and/or electrically, but this is associated with a relatively low cure rate. When it fails to achieve cardioversion, medical therapy consists of slowing the irregular ventricular rate with drugs such as beta blockers and calcium channel blockers and providing anticoagulation to prevent or minimize the risk of stroke; however, anticoagulation is associated with its own set of complications and sequelae.
The fact that pharmacological therapy of AF is at best 50% effective has led to a search for surgical approaches over the last 20 years. The approaches developed during that time are based on the major contributions of Cox to understanding the electrophysiological mechanisms of atrial fibrillation and devising a surgical approach to ablate the arrhythmia and convert the heart to regular sinus rhythm. Despite its high efficacy, however, the Cox Maze operation with the cut-and-sew technique has not gained wide acceptance because of the complexity of the procedure and the length of time required to perform it. In the last 10 years or so, several other alternatives have been developed, using various forms of energy to achieve transmural lesions without cutting and sewing, and with variable degrees of success. These include radiofrequency ablation, microwave ablation, cryoablation, all of which are currently utilized by UIC specialists to treat atrial fibrillation refractory to medical therapy.
Over the past five years, UIC heart surgeons performed 50 surgical AF ablation procedures. All of these operations were performed in conjunction with another concomitant procedure, most commonly mitral valve replacement or repair. No operation was performed for AF alone. The patients included 30 women and 20 men, with an age range of 48 to 76 years. Three patients had concomitant coronary artery grafting, and 47 had concomitant mitral valve surgery. With the exception of a patient who underwent surgical pulmonary vein isolation and one patient who had epicardially applied cryoablation together with coronary bypass grafting, the other 48 patients had endocardial application of the energy source to produce transmural lesions. The lesion set created in these 48 patients consisted of ablation of the left atrial appendage, a left atrial isthmus lesion with its attendant coronary sinus lesion, and a right atrial isthmus lesion, as described above. There has been no operative mortality in this group, with all except for two patients resuming sinus rhythm. All patients were maintained on amiodarone for 6–12 months after the surgical procedure, and the medication was discontinued after that.
For referrals to the University of Illinois Hospital Atrial Fibrillation Center, the EP specialists and surgeons below can be reached through the UIHHSS toll free number 1-888-IL-HEART or through the University of Illinois Hospital Call Center at 312-355-4300.
Avitall Boaz, MD
Daood Darbar, MD
Arrhythmia Surgery Specialists
Malek Massad, MD
Khaled Abdelhady, MD
Our extensive experience in the surgical treatment of cardiac arrhythmias has been recently focused on surgery for atrial fibrillation and has met with rewarding success