Heart and vascular surgery

Our expert surgeons use innovative techniques and advanced equipment to perform both traditional and minimally invasive procedures to repair the heart and vascular system. Our team approach helps ensure you receive comprehensive care throughout your treatment regimen.

We also have cardiothoracic surgeons that provide a broad spectrum of surgical valve repair and replacement services. Using leading-edge technology, our team of specialists can perform procedures to repair or replace aortic, mitral, tricuspid or pulmonic valves.

Many patients in need of valve repair or replacement are considered to be high-risk surgical cases because of previous heart surgeries, pre-existing medical conditions, age or weight. We welcome anyone who would benefit from surgery.

With minimally invasive procedures, you can experience a shorter hospital stay and quicker recovery, compared to a traditional procedure.

Percutaneous coronary intervention (PCI)

A blocked coronary artery can prevent sufficient blood flow to the heart and cause a number of symptoms, including chest pain (angina), fatigue and shortness of breath. Coronary total occlusion (CTO) happens when the coronary artery is completely blocked for an extended period of time.

As an alternative to traditional open-heart bypass surgery, PCI is a minimally invasive technique for unblocking the coronary artery, relieving your symptoms and the strain on your heart. Your cardiac team will determine the best treatment plan for you.

Here is how the PCI process works:

1. Your physician uses a local anesthetic to numb the area and make a small incision.
2. A small catheter is inserted into the incision and is guided to the blockage.
3. The catheter is equipped with a small balloon that inflates and deflates, stretching the artery and clearing the blockage.
4. A mesh stent may also be placed at the blockage site to hold the artery open.
5. After the artery is cleared, the catheter is removed.

If you have a heart rhythm disorder, such as an arrhythmia, our physicians may recommend AFib ablation. This procedure is performed by our electrophysiologists.

AFib ablation is a minimally invasive procedure that requires no surgical incisions. Special catheters that harness extreme cold or heat are used to create the scar tissue on the surface of the heart, disrupting the abnormal electrical signals and restoring sinus rhythm.

Nonvalvular AFib increases your risk for stroke. Traditionally, blood-thinning medications, such as warfarin, reduced stroke risk, but you may not like the medicine or have a medical or lifestyle reason to avoid it. The LAAC implant is a nonpharmaceutical option for reducing stroke risk in patients with nonvalvular AFib.

How does LAAC work?

The minimally invasive, catheter-based procedure to place the LAAC implant is performed in our electrophysiology laboratory. An electrophysiologist inserts a small catheter into the femoral vein in your leg and directs the catheter through the vein to the heart. Once the catheter is in the left atrium, the electrophysiologist releases the implant, which spreads out like a balloon and seals the opening of the left atrial appendage, a finger-shaped sac attached to the left atrium. Heart tissue grows over the implant, sealing the opening of the appendage and preventing blood from pooling in the outcropping, thereby reducing stroke risk.

Why choose LAAC?

AFib causes your heart to beat irregularly, which may make you feel like your heart is fluttering. Irregular heartbeats disrupt the flow of blood through your heart, causing blood to pool and coagulate in your left atrial appendage. If coagulated blood in the appendage breaks off and passes through your blood stream, it may cause a stroke.

What should I expect?

Since the procedure to place the LAAC implant is minimally invasive, you can experience less postoperative pain, compared to a traditional procedure. Placing the LAAC implant typically takes one hour, and you are usually released the same day of the procedure.

If you're seeking an alternative to long-term blood-thinning medication regimens, you can schedule an evaluation with an electrophysiologist by calling (423) 508-6733.

Our team was the first in Chattanooga to offer the convergent procedure as a treatment for persistent AFib. The convergent procedure is a minimally invasive, catheter-based approach to treating persistent AFib.

How does the convergent procedure work?

The procedure takes place in two stages. The first stage occurs in an operating room where a cardiac surgeon makes a small incision in your abdomen. A small scope is inserted to separate the back wall of the left atrium.

The second stage occurs in an electrophysiology lab where an electrophysiologist maps the heart's electrical activity and identifies electrically active areas causing the abnormal heart rhythm. A small incision is made in the groin and a catheter is inserted into the femoral vein that directs it to the inside of the left atrium. The electrophysiologist then ablates the inside wall of the left atrium.

This collaborative treatment produces excellent results for cases of AFib previously thought to be untreatable.

Why choose the convergent procedure?

Traditionally, electrophysiologists use epicardial ablation to treat AFib. However, some forms of the condition persist after treatment because the cells responsible for initiating irregular heartbeats can be challenging to reach via an epicardial approach.

This procedure is used to successfully treat long-standing, persistent AFib and is typically recommended after traditional epicardial ablation is not successful. It is helpful if you have been told there is no other therapeutic option.

To schedule an assessment with a heart specialist to see if the convergent procedure is right for you, call (423) 622-6848.

What to expect after your procedure

You can typically return home the day after the procedure and follow-up with our cardiac surgeon and electrophysiologist. During these follow-up visits, the doctor will decide whether continued use of antiarrhythmic medications is necessary.

While the convergent procedure is performed through minimally invasive approaches, it is a complex treatment and is recommended for persistent AFib that recurs following traditional endocardial ablation.