Heart and vascular surgery in San Antonio, Texas
When you choose Methodist Healthcare for heart and vascular surgery, your care comes from surgeons who are highly trained in traditional, minimally invasive and robotic surgical options. Our surgical team is with you every step of the way, from diagnosis to preoperative and postoperative care. We also offer cardiac rehabilitation services for continued care during your recovery.
Heart and vascular treatments and surgeries
- Cardiac ablation for heart arrhythmia
- Angioplasty and stenting
- Procedures to implant cardiac assist devices
- Transcatheter aortic valve replacement (TAVR)
- Structural heart procedures
- Heart transplant
- Impella® device placement for heart attack
- Endovascular aneurysm repair (EVAR)
- Surgical bypass
- Carotid endarterectomy
Transcatheter aortic valve replacement (TAVR) is a minimally invasive alternative for patients with severe aortic stenosis who are too high risk for open-heart surgery. Instead of opening up the chest cavity, our surgeons insert a new aortic valve through the femoral artery or through a small incision in the chest.
With the largest heart transplant program in Central and South Texas, we offer medical and surgical therapies for heart failure and other cardiac conditions that meet transplant criteria. Our diverse team consists of physicians, transplant nurse coordinators, social workers and support staff who care for patients throughout their transplant journey.
During a carotid endarterectomy, a vascular surgeon removes the inner lining of your carotid artery, which has been damaged due to plaque buildup. Your vascular surgeon makes an incision on one side of your neck to access the obstructed carotid artery. Your carotid artery is temporarily clamped to stop blood from flowing through it, but your brain will still receive blood from your other artery.
Once the artery is clamped, your vascular surgeon will make an incision into the artery and remove any plaque deposit by removing the lining of the diseased section of the artery. The artery is then stitched back together and the neck opening closed. The entire operation usually takes around two hours from start to finish.
After an angioplasty, a vascular surgeon may insert a stent to reinforce the blocked area of the artery to prevent future obstruction from plaque. A stent is a tiny spring-like mesh tube containing a small balloon. Your vascular surgeon guides the stent through the same opening they used during your angioplasty to the widened section of the atherosclerosis-affected artery.
There, the surgeon inflates the balloon inside the stent, causing the stent to expand to fit the size of the artery. The catheter is then removed and the operation is complete. The stent will support your artery wall from closing again while allowing blood to flow normally inside the artery.
Carotid artery stenting
Similar to a carotid endarterectomy, carotid artery stenting relieves the accumulation of plaque deposits in the carotid artery. Carotid stenting is an alternative surgery if patients are considered to be too high of a risk for the traditional endarterectomy.
Surgical bypass treats the narrowed arteries caused by atherosclerosis, creating a detour around the blocked section of your artery so blood can once again freely flow at normal levels.
Similar to bypass surgery on the heart’s arteries, surgical bypass for peripheral arterial disease involves creating a new pathway for blood flow using a graft. Grafts can be constructed from a portion of one of your veins or a man-made synthetic tube—like a stent. Your vascular surgeon connects the graft above and below the blockage to allow blood to freely pass.
Typically, vascular surgeons use bypasses to treat arteries in the leg that have become blocked.
An angioplasty is a minimally invasive procedure performed by vascular surgeons or radiologists that improves blood flow in an obstructed or narrowed artery.
A vascular surgeon or radiologist will insert a thin catheter into your body and guide it to the blocked area with the assistance of X–ray imaging. Once a catheter’s is blown up to widen the opening, a vascular surgeon or radiologist will insert a thin catheter into your body and guide it to the blocked area with the assistance of X–ray imaging.
This process is repeated until the plaque has been flattened against the artery wall, allowing for blood to resume flowing freely. Typically, an angioplasty only takes a couple of minutes to complete and is relatively pain–free.
Heart assist devices
A new generation of smaller, more durable heart assist devices has emerged. Now patients with advanced end–stage heart failure, that have exhausted all medical therapy, have the option to survive with ventricular assist devices (VAD). These surgically implanted, mechanical devices maintain the heart's pumping ability by supporting the heart’s ventricles.
Our heart transplant team has extensive experience implanting the Heartmate®, Thoratec® and Abiomed® cardiac assist devices. Methodist Healthcare is the only approved destination therapy program in San Antonio that uses the HeartMate® left ventricular assist device as a bridge to transplant or transplant alternative.
Used to treat heart arrhythmias, a pacemaker is a small, battery-operated device that counteracts slow heart rates. The device monitors the heart rate and can send small, electrical impulses to increase the heart rate if it senses that a heart rate is too low.
Pacemakers are metal devices that are placed in the upper chest area with lead wires going to the heart. They are about the size of a pocket watch and can usually be implanted on an outpatient basis using local anesthesia.
In a large number of heart failure patients, the electrical impulses in the heart are slowed and the signals to one, or both, of the heart's lower chambers, are delayed. If that happens, the two lower chambers may not pump at the same time. When the heart's contractions are out of sync, the heart cannot pump enough blood to the body. A special type of pacemaker called a biventricular pacemaker or cardiac resynchronization therapy can send electrical impulses to both lower chambers at the same time to coordinate the pumping function of the heart.
Implanted cardioverter defibrillator (ICD)
An implanted cardioverter defibrillator (ICD) is an electrical cardiac device that is used to treat very fast heart rates and can stop life–threatening abnormal heart rhythms. The ICD monitors the heart rhythm at all times and will notice any abnormal rhythm. Within seconds, it can try to get the heart back into a normal rhythm by delivering painless pacing impulses or a more noticeable shock to the heart. An ICD is implanted into the upper chest with lead wires to the heart, similar to a regular pacemaker.
Ventricular assist device (LVAD)
Some patients with severe heart failure don't have improved symptoms with only medication. If their heart continues to deteriorate and becomes unable to pump enough to sustain life, they may be offered a ventricular assist device for destination therapy or as a bridge to transplant.
During bridge to transplant, patients receive a VAD to support their heart while waiting for a donor's heart. If they are not eligible for transplant, the VAD can provide long–term support for the patient's heart as destination therapy.
VADs are placed for pumping support of the left, right or both chambers of the heart. A VAD is a pump that is surgically connected to the heart in two places to replace the pumping function of the existing heart. These devices are connected to an outside power source, but battery–powered connections are available to allow patients to go home from the hospital.
Each device is different and will depend on the patient's body size and medical condition. The patient must meet certain criteria of their overall health conditions, blood pressure, blood flow and body size to be considered eligible for a VAD. Surgery to insert a VAD involves a variety of certain risks.
Robotic cardiothoracic surgical options
Methodist Healthcare is home to the largest multispecialty robotic surgery program in South Texas. Our health system uses the da Vinci® Surgical System, a robot-assisted surgical platform that allows for minimally invasive heart surgery.
If you are a candidate for heart surgery, ask your doctor if a minimally invasive option using the da Vinci® Surgical System is right for you.