Our Cardiac Surgeons at Providence Heart Institute are part of a multidisciplinary team of surgeons, physicians, and health care professionals aimed at providing the best individualized care for each of our patients. We deliver immediate access to life-saving treatment. We practice a comprehensive patient-centered approach that offers state-of-the-art diagnostic testing and innovative therapies for patients with coronary artery disease, valvular disease, thoracic aortic conditions, and advanced heart failure in need of insertion of mechanical support. Our surgical team is part of the largest cardiac program in the state of Oregon, giving you a unique collaboration of team members to support you on your medical journey.
Just like all the other areas of your body, the heart has its own arteries. These arteries give the heart muscle the blood it needs so that it can live. These arteries are called the Coronary Arteries. Coronary artery disease means that these vital arteries are either blocked, narrowed, or hardened over time, with a buildup of cholesterol or fatty deposits (called plaque). This blocks blood flow to parts of the heart which can cause the heart muscle to either die or lose function.
When we treat this disease with surgery, it’s commonly called heart bypass, or you may hear healthcare professionals call it coronary artery bypass grafting (CABG for short). During surgery we take blood vessels from other areas of your body (commonly from your legs, chest, or arm) and connect them above and below the blockages, thus creating a bypass. This restores blood flow to the areas of the heart that would otherwise be injured. There are always risks and complications that can occur with this surgery. These risks vary for every person and your doctor will go over these risks with you when you meet them. After your surgery, your doctor may recommend medication, lifestyle, and heart healthy diet changes to help keep these bypass grafts open in the future.
There are four valves in the heart: the tricuspid valve, the pulmonic valve, the mitral valve, and the aortic valve. The mitral valve and the aortic valve are the most common valves that need to be replaced or repaired due to disease. Heart valve disease happens when the heart valves do not open or close the way that they should. There are 3 types of valvular disease: stenosis, prolapse, and regurgitation.
Stenosis: the valves hardened and become stiff, narrowing the opening and restricts forward blood flow.
Prolapse: the flaps of the valve (these are called leaflets) do not close properly, they bulge backwards allowing the blood to move backwards instead of forwards out of the heart. This condition is most common in the mitral valve.
Regurgitation: This can also be called a leaky heart valve. The valve of the heart doesn’t close all the way allowing the blood to flow in two different directions instead of a singular direction out of the heart.
Three severities classify valvular disease: mild, moderate, and severe. Overtime, if not managed or fixed, these diseases can lead to an increase of symptoms and, potentially, heart failure.
There are different ways to treat these conditions, which varies by patient and severity of the case. Open heart surgery is a common treatment to fix the valves in the heart for more severe cases. If it is possible our cardiac surgeons will try to fix the heart valves that you already have, although that isn’t always possible or the best treatment option. If the surgeon has to replace a valve in the heart, there are two options:
Mechanical valves: These valves are very durable and potentially last much longer than the tissue valves. People who get mechanical valves are required to be on blood-thinning medications for the rest of their lives to prevent blood from clotting on the new valve.
Bioprosthetic valves (tissue valves): These valves come from animals (typically either cows or pigs) because the tissue in these animals is similar to the valves in human hearts. People tolerate these valves well and are not typically on blood thinning medications long term. Although this is a great option, these valves potentially have a much shorter life span and are best used in older adults or very specific circumstances in younger people.
The aorta is a very important large blood vessel; its function is to carry all of the blood from the heart to the rest of the body. Thoracic aortic aneurysms are when a portion of the upper aorta is weakened. The goal is to repair a thoracic aortic aneurysm to prevent it from growing and to treat this condition before it dissects (this is when the lining of the blood vessels start to separate) or ruptures. Typically, the progression of this condition is monitored by your doctor. Surgery is generally recommended when the aneurysm reaches about 5-6 centimeters or greater, although this can change on a case by case basis.
When a thoracic aortic aneurysm is surgically repaired the damaged section of the aorta is removed and replaced with a synthetic graft. Sometimes the aortic valve becomes damaged due to the aneurysm and needs to be replaced during the same surgery. These surgeries are generally complex and differ from case to case, making it difficult to explain the different methods to repair the aorta. The treatment proposed by your surgeon will be discussed with you at the time of your consult visit.
Some people with more advanced heart failure may require a ventricular assist device (VAD), a mechanical pump that helps the heart function. Since 2011, the Providence Heart Institute team has been caring for these patients, including those who have a long-term need for VADs, as well as patients who have experienced cardiogenic shock and require temporary mechanical pumps.
As leaders in this field, we are the only heart center in Oregon that offers long-term mechanical heart pumps or VADs for patients who are not eligible for heart transplants.
Our team includes experienced cardiologists, cardiac surgeons, VAD coordinators and nurses who guide you through every step of the process. In addition to expert medical care, you will also receive nutritional support, rehabilitation counseling and education.
Providence Heart Institute is committed to establishing a comprehensive and stable heart transplant program that will provide patients with high-quality care close to home. We are taking careful steps to prepare our program so we can provide excellent outcomes for our patients and serve as our community’s premier heart transplant center for many years.
Our team includes six heart transplant cardiologists who have the specific knowledge needed to provide world-class, expert care to heart transplant patients. We are actively recruiting for additional care team members to join our growing program. We also have extensive experience caring for patients after heart transplants and offer two transplant clinic locations.
The heart transplant team is working to achieve certification from United Network for Organ Sharing, Centers for Medicare & Medicaid Services and The Joint Commission. We’re focused on earning these certifications as quickly as possible, while ensuring we offer the highest quality care.