Surgical Procedures - Crozer-Keystone Health System - PA

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Cardiothoracic Surgery

Charles Geller, M.D.

Chair: Charles M. Geller, M.D.

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Crozer-Keystone's specialized team of board-certified heart surgeons offer advanced cardiothoracic surgical techniques for a wide range of cardiovascular conditions, from cardiac bypass surgery to complex aortic surgery, state-of-the-art mitral-valve repairs to treatment of carotid artery disease and aortic aneurysm.  

Crozer-Keystone's cardiac surgeons are experts in the following techniques: 

Aortic Aneurysm Repair

An aortic aneurysm is a bulge in the aorta, the main artery of the heart that carries blood throughout the human body. Rupture of an aortic aneurysm often results in death, so early detection is important. They are detected through the use of ultrasound or CT scans. During surgery, the damaged portion of the aorta is replaced with a fabric tube. An endovascular stent graft may also be used in which the stents are inserted into the body via small incisions in the groin, then guided through the blood vessels with a catheter to the aneurysm site.

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Angioplasty is performed to expand the opening in a coronary (heart) artery to increase the blood flow to the heart. During balloon angioplasty, the surgeon guides a catheter with a small balloon at its tip to the proper place in the heart and then the balloon is filled with air. This presses the plaque against the wall of the artery to improve blood flow. In some cases, a catheter may be used to remove a blood clot. Crozer-Keystone has performed more than 5,000 of these procedures since 1992.

Aortic Root Surgery

Arterial Reviscularization

Heart Failure Surgery (Left Ventricular Reconstruction) 

Congestive heart failure occurs when the heart is not pumping blood properly. Symptoms include shortness of breath and exhaustion to perform even the simplest tasks. While many people can relieve symptoms by taking medication, it does not cure the condition. Left ventricle reconstruction surgery may help patients who have suffered a left ventricle heart attack that has caused the left ventricle to enlarge, and in turn, causing the heart failure. During this procedure, a patient's left ventricle is restored to its original size and orientation to improve the heart's ability to pump blood. 

Maze Procedure

Patients with atrial fibrillation may be candidates for the Maze procedure, a surgical intervention most often performed when a patient needs open heart surgery for another problem such as coronary artery disease.   

The Maze procedure involves creating scar tissue in the heart which disrupts the path of abnormal electrical impulses. This keeps the heart’s electrical rhythm in a more ordered form. The Maze procedure may be done by making incisions, by freezing or burning the atrial tissue, or by disrupting the tissue with ultrasonic waves.

Minimally Invasive Cardiac Surgery

Surgeons perform minimally invasive surgery through small incisions two- to three-inches long rather than six- to eight-inches long. The advantages of this type of surgery less scar tissue, less pain, shorter hospital stays and shorter recovery periods. Crozer-Keystone performs the following minimally invasive procedures:

  • Mitral valve repair and replacement
  • Aortic valve replacement
  • Tricuspid valve repair and replacement
  • Atrial septal defect closure
  • Atrial fibrillation surgery (Maze procedure),
  • Saphenous vein harvest for coronary bypass surgery,
  • Radial artery harvest for coronary artery bypass surgery
Off-pump Coronary Artery Bypass

During cardiopulmonary bypass surgery the heart-lung machine takes over the work of the heart and lungs while the heart is stopped for surgical repair. However, using the heart-lung machine may lead to problems for some patients during and after surgery. In off-pump bypass surgery, the heart-lung machine is not used. Rather than stopping the heart, technological advances and new kinds of operating equipment now enable surgeons to hold stable portions of the heart during surgery. With a particular area stabilized, the surgeon can then bypass the blocked artery.

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Open Heart Surgery

The most common open heart surgery is called "coronary artery bypass grafting." During this procedure, heart surgeons use healthy blood vessels from the patient's body to re-route blood flow around blocked coronary arteries. Since 1999, Crozer surgeons have performed this procedure "off-pump" in most patients, without using the heart-lung machine (cardiopulmonary bypass surgery).

Pacemaker Surgery
Repair of the Heart Valves and Aorta

The heart valves control the flow of blood between the heart chambers (atria and ventricles) and between the left ventricle and the major artery (aorta) that supplies the body's blood vessels with blood containing oxygen. Some valve defects can be treated with medicine, while others may be repaired or replaced surgically. When one of these 'gateways' is defective at birth or damaged by an infection, heart disease or aging, it may not allow proper circulation. Crozer cardiac surgeons can repair or replace defective heart valves using the patient's own body tissues, in many cases, or new natural or mechanical valves.

Replacement of Ascending Aorta and Ascending Arch
Ross Procedure

The Ross Procedure is a specialized surgical procedure used to replace a diseased aortic valve. Developed by British surgeon Dr. Donal Ross, the procedure is used on people with extensive aortic valve disease. These patients may experience congestive heart failure, chest pain, fainting, shortness of breath and rhythm disorders.

During a Ross Procedure, the surgeon replaces the patients' damaged aortic valve with their own pulmonary valve, rather than using tissue from an animal or using a mechanical valve. The advantage of using a patient's own tissue is that it eliminates the need for the patient to take blood-thinning medicine.

The success rate for the Ross Procedure is 97 percent and the long-term results have been excellent. The Ross Procedure is recommended for patients who have a 25-year life expectancy and who are not suffering from any other major illnesses.

Rotational Atherectomy

Rotational Atherectomy is occasionally used to open a blocked coronary artery in patients with heavily calcified plaque. Once the catheter has been guided to the narrow section of the artery, a high-speed instrument is used to cut through the plaque.


Using catheterization, arteries are reopened by inflating a tiny balloon at the site of the blockage (“angioplasty”). Sometimes a stent, which is shaped like a tiny tube, is inserted to maintain the passageway. With triple-A, the aneurysm shrinks onto the stent.

Surgical Procedures to Treat Atrial Fibrillation
Transyocardial Laser Revascularization

Transyocardial Laser Revascularization (TMR)

Valve Repair and Replacement

Heart valve repair or replacement surgery is a treatment option for valvular heart disease. When heart valves become damaged or diseased, they may not function properly. Conditions which may cause heart valve dysfunction are valvular stenosis and valvular insufficiency (regurgitation).

When one (or more) valve(s) becomes stenotic (stiff), the heart muscle must work harder to pump the blood through the valve. Some reasons why heart valves become stenotic include infection (such as rheumatic fever or staphylococcus infections) and aging. If one or more valves become insufficient (leaky), blood leaks backwards, which means that less blood is pumped in the proper direction. Based on your symptoms and overall condition of your heart, your doctor may decide that the diseased valve(s) needs to be surgically repaired or replaced. Surgery may be minimally invasive or include the following:

  • Pulmonary autograft or Ross Procedure (See Ross Procedure above.)
  • Human donor valves
  • Animal tissue valves
  • Mechanical valves

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