Cardiac Surgery at Belfast Trust > Heart Conditions > Conditions we treat

Conditions we treat

Here is a list of the main conditions that we treat in Cardiac Surgery. Click in one of the links below for more information.

Coronary Heart Disease (CHD)

CHD is a preventable disease that remains one of the biggest killers in Northern Ireland today. Changes in risk factors and advances in medical care have contributed to a decline in the total deaths from heart disease over the past 30 years. But in spite of this it remains the main cause of death amongst both sexes, accounting for over 35% of deaths.

Coronary Artery Disease (CAD)

With coronary artery disease, plaque first grows in the coronary arteries until the blood flow to the heart’s muscle is limited. This is also called ischemia. It may be chronic, caused by narrowing of the coronary artery and limitation of the blood supply to part of the muscle. Or it can be acute, resulting from a sudden plaque that ruptures. There are several treatments options for coronary artery disease including:

  • Medical management (anti-anginal medications plus statins, antihypertensives, smoking cessation, tight blood sugar control in diabetics)
  • Percutaneous coronary intervention (PCI) often referred to as “stents”
  • Coronary Artery By-pass Grafting (CABG).  Performed since the early 1970s, this operation gives the best long term results majority of patients with multivessel disease (narrowings in each of the three main arteries to the heart).

Valvular Heart Disease

Narrowed or leaking valves are caused by a diverse range of things including atherosclerosis, congenital abnormalities that present late in life, degeneration of tissues, infection and the late results of rheumatic fever. As atherosclerosis and degeneration of tissues are common causes in an aging population, the number of people requiring valve surgery is increasing. Valve repair or replacement is most commonly required on the Aortic valve followed by the Mitral valve and Tricuspid valve.

In addition to open heart surgery, we perform Trans Aortic Valve Implementation (TAVI) by minimally invasive means. However the durability of this relatively new procedure is still unknown and conventional open-heart surgery therefore remains the optimum treatment for those who are fit to undergo it.

Congenital Heart Disease

Congenital heart disease is a general term for a range of birth defects that affect the normal workings of the heart. Congenital heart disease is one of the most common types of birth defect, affecting up to 9 in every 1,000 babies born in the UK.

The treatment for congenital heart disease usually depends on the defect you or your child has. Mild defects, such as holes in the heart, often don’t need to be treated, as they may improve on their own and may not cause any further problems. But if the defect is significant and is causing problems, surgery is usually required.

Modern surgical techniques can often restore most or all of the heart’s normal function and nowadays about 80% of children with congenital heart disease will survive into adulthood.

However, people with congenital heart disease often do need treatment over their life. This is because people with complex heart problems can develop further problems with their heart rhythm or valves over time.

Thoracic Aortic Aneurysm Surgery

A thoracic aortic aneurysm is a widening of a weakened area in the upper part of the aorta (the major blood vessel that comes from the heart). Due to the increased stress in the wall of an already weakened artery, this can cause a rupture of the wall or a tear in the wall that splits the layers apart (dissection). Both these conditions can be life threatening.

Surgery on aneurysms of the ascending aorta and aortic arch require cardiopulmonary bypass techniques and are therefore performed by cardiac surgeons. Other treatments such as Endovascular repair techniques are currently not possible in this part of the aorta because of the close proximity of coronary arteries and commonly associated valve disease.

Other Conditions

Conditions such as pericardial effusion and pericardial constriction are treated by pericardial window or pericardiectomy by cardiac surgeons and occasionally patients need bypass of obstructed veins (superior vena cava) in the chest. Tumours may be found in the heart and if benign, e.g. myxoma, may be successfuly treated by excision by a cardiac surgeon.

Other Specialties

Our cardiac surgeons also work alongside other specialties to perform operations where the risk of cardiac arrest may be high. Performing these operations in a cardiac theatre, in conjunction with a cardiac surgeon allows cardiopulmonary bypass to be used if needed.

These include resection of cancers of the kidney which have grown up the major veins into the heart and extraction of pacing wires and defibrillator leads adherent to the heart and major veins.