The Robert F. Schaper Heart Center
Cardiac Procedures
The Robert F. Schaper Heart Center is a comprehensive cardiac care center dedicated to the discovery, management and control of cardiac disease in the adult population. Tomball Regional Medical Center provides a comprehensive range of procedures from diagnostic exams to interventional (invasive) procedures, as well as noninterventional (noninvasive) procedures that help diagnose and treat cardiac disease.
Coronary Computer Tomography (Coronary CTA) – 64 Slice-NEW
A Coronary CTA is a heart-imaging test, which can help determine noninvasively whether fatty deposits or calcium deposits have built up in the coronary arterie, which supply blood to the heart muscle. If left untreated, these areas of buildup, called plaques, can cause heart muscle disease. Heart muscle disease, in turn, can lead to fatigue, shortness of breath, chest pain and/or heart attack. One of the benefits to having the Coronary CTA performed at Tomball Regional Medical Center is that emergency medical care, if needed, is available immediately.
Thorascopic Microwave Atrial Ablation-NEW
Atrial fibrillation (AF) is a disorder found in about 2.4 million Americans and the condition becomes more common with age. During atrial fibrillation, the heart's two small upper chambers (the atria) quiver instead of beating effectively. Blood isn't pumped completely out of them, so it may pool and clot. If a piece of a blood clot in the atria leaves the heart and becomes lodged in an artery in the brain, a stroke results. About 15 percent of strokes occur in people with atrial fibrillation.
When AF occurs, the electrical signals become disorganized and rapid. This keeps the upper and lower chambers of the heart from working together properly, which can decrease the heart's ability to pump blood. It can be associated with reduced quality of life, lack of energy, feeling tired or anxious, and a five-fold increase in the risk of stroke.
When performing the minimally invasive microwave surgical ablation treatment, your surgeon will use microwave energy with a surgical ablation system to create lesions (helpful scars) on the heart muscle. During the procedure, the physician will make small incisions, called "ports," less than an inch long on the right side of the chest. An endoscope is inserted through the ports to allow the physician to view the heart without opening the chest cavity. The surgeon then will insert special instruments through the ports to perform the procedure. Using a probe, the surgeon will deliver targeting amounts of microwave energy to the heart, creating lesions. The treatment results in precisely placed lesions on the pulmonary veins that block abnormal electrical signals and limit the movement of electrical impulses to normal, defined pathways.
Most patients will be discharged from the hospital one to two days after the surgery. Although recovery time varies for each person, patients usually heal and return to normal activities within two weeks. Fortunately, today's less invasive surgical techniques mean that your recovery will probably be easier and faster than was possible in the past.
NEW—Carotid Stenting is used in certain patients with blockages in the carotid arteries which feed the brain. When these arteries are completely blocked, a stroke occurs. During the procedure, the doctor inserts a catheter into an artery in the arm or leg. From there it can be advanced to the carotid arteries. A protection device is inserted above the blockage to protect the brain, and angioplasty (balloon procedure) is performed and followed by stent placement. The hospital stay usually lasts one day.
COMMON CARDIAC PROCEDURES
Echocardiograms
An Echocardiogram (ECHO) is an examination that uses sound waves to create a moving picture of the heart. The purpose of an echocardiogram is to evaluate the valves and chambers of the heart, as well as murmurs and the pumping function of the heart.
A Stress Echocardiogram is a test that helps diagnose heart disease using ultrasound images. The ultrasound portion of the test is performed in the same way as an echocardiogram. Exercise with a treadmill or stationary bicycle is used to increase the heart rate and show how the heart works under exertion. In some cases when the patient is unable to walk a medication (dobutamine) is used to increase the heart rate. The test is performed to see if the heart is getting enough blood flow and therefore enough oxygen when it is put under stress.
Transesophageal Echocardiogram
When a simple echocardiogram may not produce clear images of the heart, the physician may choose to perform a transesophageal echocardiogram (TEE). When a TEE is performed, the patient is given a mild sedative before the procedure and an anesthetic is sprayed onto the back of the throat in order to suppress the gag reflex. A special viewing tube, called an endoscope, containing a tiny transducer is passed through the mouth and into the esophagus until it is positioned directly behind the heart, where clearer two-dimensional images of the heart can be obtained.
Duplex Ultrasounds (commonly referred to as “Dopplers”)
Arterial Duplex Ultrasound or “Arterial Doppler” is a procedure used to look for blockages in the circulation to the upper and lower extremities due to atherosclerosis or other diseases. Arterial duplex is also used to evaluate artificial arteries called grafts.
Carotid Duplex Ultrasound or “Carotid Doppler” is a procedure that uses ultrasound to look for plaque or other blood flow problems in the carotid arteries. The carotid arteries are located in the neck and supply blood to the brain. Disturbance in the blood flow may indicate atherosclerosis.Venous Duplex Ultrasound or “Venous Doppler” is a procedure used to look for blood clots in arms and legs that could migrate to the lungs.
Cardiac Catheterization
The doctor inserts a thin plastic tube (catheter) into an artery or vein in the arm or leg. From there it can be advanced into the chambers of the heart or into the coronary arteries. This test can measure blood pressure within the heart and how much oxygen is in the blood. It’s also used to get information about the pumping ability of the heart muscle. Coronary angiography or coronary arteriography is used to detect blockages in the coronary arteries. Catheters with a balloon and or stent on the tip are used in the procedure called percutaneous coronary intervention (PCI).
Peripheral Angiography and Intervention
The doctor inserts a catheter into an artery in the arm or leg. From there it can be advanced to blockages in the legs, arms, or carotid arteries. Angiography is used to detect blockages in the arteries. Catheters with a balloon and or stent on the tip are used in the procedure called percutaneous transluminal angioplasty (PTA) with or without stent placement. In special cases, atherectomy may also be performed with devices that remove the plaque from inside the arteries.
Pacemakers and Implantable Cardioverter Defibrillator (ICD)
Sometimes the heart’s electrical system malfunctions. Permanent pacemakers can be implanted to regulate heart rhythm.
Implantable devices can provide automatic electrical therapy on a chronic basis for patients with recurrent tachycardias. The greatest advance in this area is the implantable cardioverter defibrillator (ICD). It’s used in patients at risk for sudden death caused by recurrent, sustained ventricular tachycardia or fibrillation.
Heart Arrhythmias
Arrhythmias are disorders of the regular rhythmic beating of the heart. They're common—as many as 2.2 million Americans are living with atrial fibrillation (one type of rhythm problem). Arrhythmias can occur in a healthy heart and be of minimal consequence. They also may indicate a serious problem and lead to heart disease, stroke or sudden cardiac death. Do your part by learning the facts and taking the steps needed to understand and control arrhythmias.
Bypass Surgery
Sometimes the heart cannot be fixed with angioplasty, stents or implants. The patient needs open-heart surgery. When your coronary arteries are blocked, your doctor may treat the problem by giving the blood a new pathway to the heart.
During coronary artery bypass graft surgery (also called CABG, or "cabbage"), a blood vessel is removed or redirected from one area of the body and placed around the area of narrowing to "bypass" it and restore blood flow to the heart muscle. This vessel is called a graft.
These substitute blood vessels can come from your chest, arms or legs. They're safe to use because there are other pathways that take blood to and from those tissues. The surgeon will decide which graft(s) to use depending on the location of your blockage, the amount of blockage and the size of your coronary arteries.
Heart Valve Replacement Surgery
Heart valve replacement surgery has become a common operation. There are many reasons why a heart valve may not be working as well as it should. A small defect that has been present since birth may worsen over time. Certain diseases such as rheumatic fever or bacterial infections may cause scarring or destroy heart valves. In addition, the aging process can weaken or harden heart valves. Heart valves that are seriously deformed, degenerated or destroyed can be removed surgically and replaced with a new valve mechanism.
Please call 281.401.7777 for a Physician Referral.
