For patients with advanced heart disease, experienced physicians who are board-certified guide surgical interventions at North Florida Regional Medical Center. The surgical team also includes nurses and technicians with advanced training and certification in their respective fields, all dedicated to the philosophy of individualized patient care. The team is constantly searching for new ways to raise the bar with lowering complication and mortality rates, as well as shortening hospital stay and recovery time. Thanks to the combination of state-of-the-art technology, expertise and compassionate care, patients can rely on surgeons, nurses and technicians to help them get better and back to their lives. Our cardiac surgery team performs 500-600 procedures each year, and it is predicted that 500-600 open heart procedures will be performed in 2017. While some patients have a single cardiac surgery, others need more than one type of procedure. Surgeons routinely perform combination procedures for patients.
Dr. Charles T. Klodell is a cardiothoracic surgeon that specializes in heart and lung surgical procedures including minimally invasive aortic and mitral valve repair or replacement, aortic aneurysm repair, transcatheter aortic valve replacement (TAVR) and open heart surgery. He has a special interest in minimally invasive procedures, valve repair, and innovative uses of technology and pharmacology to alleviate patient discomfort. Dr. Klodell graduated from the University of Louisville School of Medicine, earning his medical degree with honors. Following training in general surgery and subspecialty training in thoracic and cardiovascular surgery, he has obtained additional subspecialty training in valve repair, surgery for heart failure, minimally invasive surgery, and thoracic robotic surgery.
Coronary Artery Bypass Graft Surgery
This procedure, often called CABG, is a type of surgery that improves blood flow to the heart. It’s used for people who have severe coronary artery disease. The blood flow has been blocked by the build-up of a substance called plaque inside the arteries. During CABG, surgeons harvest a healthy artery or vein from the body and graft or connect it to the blocked coronary artery. The grafted artery or vein bypasses the blocked portion of the artery. Using best practice methods, our team has achieved complication rates significantly better than the national average and has reduced the time patients are on the heart-lung machine to levels well below the national average. A reduced time on the heart-lung machine is linked to improved outcomes and faster recovery following CABG surgery. Our team has also reduced total length of hospital stay for our CABG patients. For many patients, this means a hospital stay that is two days shorter than the national average.
Blood is pumped through your heart in only one direction. Heart valves play a key role in this one-way blood flow, opening and closing with each heartbeat. When valves are diseased and not functioning properly, surgery is often needed to repair or replace the valves. There are 4 valves in the heart – aortic, mitral, tricuspid and pulmonic. Most valve surgeries are done to repair or replace the mitral or aortic valves. These valves are on the left side of the heart, which works harder than the right. They control the flow of oxygen-rich blood from the lungs to the rest of the body. At North Florida Regional, surgery is performed for patients with disorders of all of the heart’s valves. Comparing patient outcome data to national benchmarks reveals a high level of quality in valve surgery at North Florida Regional with mortality rates, complication rates and length of stay significantly better than the national average. As with CABG surgery, valve surgery patients also benefit from the lesser amount of time on the heart lung machine.
Closing Holes in the Heart
Most holes in the heart that need treatment are repaired in infancy or early childhood. For some patients, these holes are undiagnosed and only detected when they are scheduled for a different kind of cardiac surgery. A patent foramen ovale (PFO) or atrial septal defect (ASD) can be closed by our surgeons at the same time another procedure such as CABG, valve surgery or arrhythmia correction is performed.
Transcatheter aortic valve replacement, or TAVR, is a minimally invasive surgical procedure that replaces a patient’s valve without removing the old, damaged valve. TAVR is for patients with aortic stenosis who may be at somewhat elevated risk for traditional surgical aortic valve replacement. Typically, patients who qualify for TAVR have severe aortic stenosis and may or may not qualify for open aortic valve replacement. For more information on how TAVR can help you, please visit flheartandlung.com.
The aorta is the largest blood vessel in the body, starting at the heart and passing down through the chest and abdomen. The thoracic aorta is the part of the aorta in the chest. The aorta carries blood from the heart to blood vessels that supply the lower body.
During Aortic Surgery, a small incision will be made in the patient’s leg. A sleeve is then inserted in this incision and into the aorta and advanced to the aneurysm. The sleeve takes pressure off the wall and prevents it from expanding or leaking. The incision is then closed.
In some cases, open surgery may be needed. For this, an incision is made in the chest. The weakened area of the aorta is then replaced with a graft and sewn into place. Blood will be able to flow through the graft. The chest incision will then be closed with stitches or staples.
Minimally Invasive Heart Valve Surgery
While traditional open heart surgery involves a full sternal incision and complete division of the sternum, minimally invasive valve surgery uses smaller incisions causing less trauma to the patient and encompasses a spectrum of approaches. For example, the aortic valve can be addressed either through an upper partial J-type sternotomy where the sternum is only opened from the sternal notch down to the third or fourth interspace on the right hand side leaving two thirds of the sternum intact, or occasionally through a small right anterior mini-thoracotomy in the second and third intercostal spaces. Similarly, the mitral valve may be approached through either a lower partial sternotomy, or through a right anterior mini-thoracotomy through the interspace.
Minimally invasive valve surgery conventionally refers to the aortic or mitral valve most commonly, although it’s possible (it can be the preferred method) for any of the 4 cardiac valves.
The studies that have compared conventional valve surgery to minimally invasive valve surgery have demonstrated significant patient bene t in appropriately selected patients. These benefits include a reduced length of hospital stay, decreased pain, expedited recovery, more rapid return to full activity, a reduced need for transfusion during hospitalization, and improved cosmetic result.
While not every patient is an appropriate candidate for minimally invasive heart surgery, we begin each new patient evaluation with the mindset of this less invasive surgical option. During every evaluation for aortic stenosis, we also consider if the patient would be better served by transcatheter aortic valve replacement (TAVR).
On Surgery Day
For your convenience and safety, parking is free and available in the garage located on the west side of the hospital across from the Emergency Department and in the garage located next to the Women’s Center on the east side of the hospital.
On the day of surgery, please arrive at the main entrance of the hospital and take the elevators on your right to the third floor lobby and check in at the registration desk. Family members and loved ones remain in the waiting area until your surgical preparation is complete and can then join you as you wait to be taken to OR. The length of surgical times varies, and staff will keep family and loved ones informed throughout the surgery process.
Download our Surgery Patient Education brochure to learn more.
For information or referral to a cardiac surgery specialist, please call Florida Heart & Lung institute at (352) 333-5610.