Surgical Services

Coronary Artery Disease (CAD)

• Routine off-pump coronary artery bypass (OPCAB) using arterial conduits (bilateral internal mammary arteries, radial arteries)
  
• Routine endoscopic vessel harvest (radial and saphenous vein)
  
• Routine avoidance of aortic manipulation and clamping (HeartString and pedicled conduits)
  
• Transmyocardial revascularization (TMR) - concomitant to coronary artery bypass graft (CABG) and stand alone for refractory angina
  
• Hybrid revascularization strategies (percutaneous coronary intervention (PCI) + minimally-invasive CABG) in selected patients  

Mitral Valve Disease

• Mitral valve repair for the vast majority of pure mitral regrurgitation (MR) patients including bileaflet prolapse, rheumatic disease and acute endocarditis
  
• Concomitant valve repair in CABG patients with 2-3+ MR using ischemic MR-specific ring
  
• Minimally-invasive mitral surgery in selected patients  

• Routine minimally-invasive aortic valve replacement (AVR)
  
• Root enlargement when necessary to avoid patientprosthesis mismatch
  
• Stentless prostheses and Ross procedure (autograft) in selected patients
  
• Aortic valve repair for pure aortic regurgitation
  
• Hybrid therapy (minimally-invasive AVR + PCI) for selected patients with concomitant CAD.

Atrial Fibrillation (AF)

• Concomitant right- and left-sided radiofrequency or cryo-Maze at the time of valve or coronary surgery
  
• Minimally-invasive (thoracoscopic) ablation for patients with lone AF
  
• Open "cut-and-sew" Maze for refractory patients with lone AF

Heart Failure

• Left ventricular aneurysm repair
  
• Left ventricular remodeling for anterior wall akinesis (Dor procedure)
  
• High-risk mitral and tricuspid valve repair in low ejection fraction (EF) patients
  
• High-risk CABG in low EF patients with documented viability

Aortic Disease

• Ascending and arch reconstruction for aneurysm or dissection
  
• Valve-sparing aortic root replacement
  
• Endoluminal stent grafting

Peri-operative Care

• Careful pre-operative screening for concomitant disease
  
• Additional imaging for pre-operative planning (e.g., cardiac MRI)
  
• Inpatient pre-operative optimization (e.g., heart failure, COPD, end stage renal disease) if needed
  
• "Bloodless" cardiac surgery
  
• Strict adherence to published evidence-based protocols (cardiopulmonary bypass (CPB), antibiotics, insulin, etc.)
  
• Two surgeons on every case