Coronary Artery Bypass Graft (CABG) [top]
The CABG procedure is used for the revascularization of heart muscle. When a patient's coronary arteries are blocked or narrowed, adequate blood and oxygen cannot reach the heart muscle, and damage occurs. The CABG procedure uses patent arteries and/or veins as a conduit to bypass the blocked or narrowed artery and reperfuse the heart muscle with oxygenated blood.FACT Surgery is experienced in performing this procedure both on and off Cardiopulmonary Bypass. Bypassing the heart and lungs during surgery, using a Cardiopulmonary Bypass system, is often necessary in order to obtain a still and bloodless field, while maintaining adequate hemodynamics. However, there are many cases where we can perform this surgery off Cardiopulmonary Bypass (Off Pump), decreasing the patient's risk of postoperative complications.
We are skilled in endoscopic vein harvesting, vastly decreasing the size of the graft site incision and risk for infection. Common vessels used as grafts during the CABG procedure are the bilateral internal mammary arteries, radial arteries, and saphenous veins.
Valve Repair and Replacement [top]
Valvular heart disease often requires surgical intervention in order to prevent ventricular dysfunction and heart failure. Aortic, Mitral and Tricuspid valves become hardened or stenotic and make it difficult for blood to pass through the valve. The valve leaflets can also separate, causing regurgitation, or backflow of blood. These are all valvular pathologies that require repair or replacement. A valve replacement can be done using a bioprosthetic (tissue) or mechanical valve. Valve repair involves surgically repairing the leaflets and/or annulus of the valve to achieve physiologic function.
FACT Surgery has mastered minimally invasive valve repair and replacement. This is a technique that reduces the surgical scar and potentially post operative pain, resulting in a shorter recovery period.
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| Carbo-Metics Standard Mechanical Aortic Valve | Carbo-Medics Orbis Mitral Mechanical Valve |
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| Freestyle Stentless Tissue Valve | Mitroflow Aortic Pericardial Heart Valve (Stented) |
Ventricular Assist Devices (VADs) [top]
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As technological advancements continue to create options for heart patients, so does our commitment to heart failure therapy. The Ventricular Assist Device is an implanted mechanical pump that functions as the patient's right or left ventricle. The VAD can be utilized as a permanent device (destination therapy), or as a bridge to transplant or recovery. Commonly used VADs for left ventricular support are the Thoratec HeartMate XVE and HeartMate II. The Thoratec Paracorporeal VAD and Intracorporeal VAD are used for biventricular support. Tampa General Hospital provides VAD coordinators that, in conjunction with FACT Surgery, provide education, support, and follow up for the individual VAD patient. Link to TGH Mechanical Circulatory Device Information Link to Thoratec, Ventricular Assist Device Education |
 Thoratec HeartMate II LVAS |
 Thoratec HeartMate II |
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| Thoratec PVAD | Thoratec IVAD | Thoratec HeartMate XVE | Thoratec HeartMate II |
Surgical Treatment of Atrial Fibrillation [top]
Atrial Fibrillation is caused by aberrant conduction pathways that originate in the upper chambers of the heart and the pulmonary veins. We use radio frequency and a cryo probe to create lesions that interrupt abnormal electrical conduction, and direct it in a predetermined physiologic pathway.Our program performs this procedure both thoracoscopically and using the classic Cox MAZE III approach. We work in conjunction with experienced electrophysiology physicians, and have success rates as high as 95%
Link to Florida Heart Rhythm Institute
Aortic Root Replacement [top]
This procedure involves replacing a section of the aorta with a prosthetic graft. This allows for the diseased aorta (aortic dissection or aortic aneurysm) to be resected, and adequate blood flow to be restored. Acute aortic dissections can be detrimental to the patient if not operated on immediately. Our operating rooms, staff, and Aeromed flight team are available 24/7, allowing us to rapidly diagnose and treat emergencies such as these.
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| Mechanical Valve Conduit | Bioprosthetic Aortic Root |
Extracorporeal Membrane Oxygenation (ECMO) [top]
Extracorporeal Membrane Oxygenation is the use of a modified version of cardiopulmonary bypass to allow for treatment and recovery of severe heart and lung failure. There are two forms of ECMO: Venoarterial (VA) and Venovenous (VV). Venoarterial ECMO bypasses both the heart and lungs, providing adequate cardiac output and oxygenation to the entire body. Venovenous ECMO bypasses the lungs only, relying on the patient's native heart function to provide adequate cardiac output, and oxygenating the blood via external oxygenator. Dr. Christiano Caldeira is one of the few surgeons in the country to utilize this procedure for adult patients with severe cardiogenic shock and Acute Respiratory Distress Syndrome.
Bloodless Surgery [top]
Bloodless surgery is for patients that refuse blood transfusions, and need to have cardiothoracic surgery. This procedure involves recycling the patient's own blood during surgery, and administering alternative forms of volume such as crystalloids, colloids, and cryoprecipitate. The main focus for patients who do not accept blood transfusions is to establish what products they will accept, and perform the surgical procedure based on this. With meticulous and careful preparation, as well as a rightful operation; our bloodless surgery patients have achieved the same great results.
Left Ventricular Reconstruction (Dor Procedure) [top]
Left Ventricular Reconstruction is the surgical remodeling of the dilated heart to a more physiologic shape. This allows for an increase in performance of the weak heart, providing more blood and oxygen to all of the body's tissues, and improving the patient's quality of life. Publication from the Annals of Thoracic Surgery
Lung Transplantation [top]
Patients that are eligible for a lung transplant have end stage lung failure, with unsuccessful results from medical and surgical therapies. Lung Transplantation involves removing the diseased lungs and replacing them with healthier donor lungs. One or both lungs are transplanted depending on the patient's condition, and donor availability.We are skilled in transplanting patients with conditions such as cystic fibrosis and pulmonary fibrosis. F.A.C.T. Surgery and supporting practices form a well developed and skilled transplant program. The transplant patient will be supported through education and follow up on vital transplant related topics such as immunosuppression medications, infection control, and post operative care.
Lung Transplantation at Tampa General Hospital
Lung Transplantation support group One Breath at a Time
Heart Transplantation [top]
F.A.C.T. Surgery and supporting practices form a well developed and skilled transplant program. The transplant patient will be supported through education and follow up on vital transplant related topics such as immunosuppression medications, infection control, and post operative care.Patients that are eligible for a heart transplant have end stage heart failure, with unsuccessful results from conventional medical and surgical therapies. Our Heart Transplant procedure involves removing the patient's failing heart, and replacing it with a healthier donor heart. This is called Orthotopic Heart Transplantation.
Heart Transplantation at Tampa General Hospital