Articles from Doctors

Minimally Invasive Treatment for Atrial Fibrillation

Cesar Nahas, MD

By Cesar Nahas, MD
Cardiovascular / Thoracic Surgeon

Since 2005, surgeons at Clear Lake Regional Medical Center have been performing the innovative Mini-Maze procedure, which safely and effectively eliminates Atrial Fibrillation, also known as AFib. More than 5.1 million people in the United States are affected by AFib – the most common irregular heart rhythm that interferes with the heart’s ability to pump blood.

In the Mini-Maze procedure, a thoracoscope (tube) is inserted through a tiny incision, destroying a small amount of tissue where the irregular signal starts. The damaged tissue can no longer conduct electrical impulses, interrupting the transmission of the abnormal signal and allowing the rest of the chamber to resume beating normally. By isolating the zone where the arrhythmia originates, we keep the rest of heart from being affected. The procedure doesn’t require opening the chest, so it has a shorter recovery time. Additionally, it is also known to decrease the risk of stroke in a majority of patients.

Changing the Landscape of Treating Abdominal Aortic Aneurysms

By Christos Katsigiannis, MD
Cardiovascular / Thoracic Surgeon

Christos Katsigiannis, MD

Abdominal Aortic Aneurysms (AAA) occur as the aortic wall weakens and expands over time with the natural circulatory pressure. These aneurysms may eventually rupture with extremely high mortality rates for patients. It is estimated that 15,000 people die annually from acute aortic rupture; however, many more are at risk as this is typically an asymptomatic disease.

For more than 50 years, aortic aneurysms have been treated surgically with a large, open incision followed by aortic replacement with a Dacron® synthetic graft, thereby excluding the aortic aneurysm. In the early 1990s, endovascular repair was first described as an alternative to open surgical repair. This involves gaining endovascular access of the iliac arteries and using catheter-based technology to insert aortic endografts to exclude these aneurysms. This practice, called endovascular aortic aneurysm repair (EVAR), has become a standard of care with the appropriate patient anatomy. The advantages of this procedure are significantly reduced morbidity and hospital stay compared to open surgical repair, decreased blood loss during the procedure, and better short-term mortality than open surgical repair. The data has been studied and published in many peer reviewed journals throughout the past 20 years.

At The Heart & Vascular Hospital, we began this procedure in 2001. Over the past decade, we have performed more than 300 EVAR procedures with excellent outcomes. Our techniques have refined over the years, and the OR staff has remained a constant source of support with increasing experience.

Our EVAR procedures usually last one to two hours, and typically the patient will go home the following day. The decreased hospital stay and recovery period compared to the traditional open surgical repair has fundamentally changed the way we manage our patients’ care here. Screening has become an important tool to preventing aortic rupture in certain patients. The main risk factors for AAA are smoking, family history of aortic aneurysm, and male gender (4:1 occurrence vs. female). Medicare has instituted a screening for all Medicare eligible patients as part of the “Welcome to Medicare” physical exam. This simply involves an ultrasound test to screen for AAA, and is approved as a one-time screening tool.