Cardiology & Cardiothoracic Surgery
We repaired his heart
so he won't break hers
*Minimally invasive heart surgery
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Lake Macquarie Private Hospital is a leader in the field of cardiac services and has been for in excess of thirty years. LMPH has an established record of excellence for complete cardiac care - diagnostic and surgical.
Lake Macquarie Private Hospital provides state-of-the-art cardiac services coupled with highly-experienced medical, allied health and nursing staff.
Lake Macquarie Private Hospital's cardiac services offer patients:
- Access to the latest technologies in cardiovascular diagnostic services
- An interventional cardiology service
- Referral to cardiothoracic surgeons
- Intensive Care Unit
- A specialised modern 10 bed Cardiac Care Unit
- Cardiology/Cardiothoracic ward
- Cardiac Cath Lab
- Post-procedural rehabilitation
The modern Cardiac Catheterisation Suite at Lake Macquarie Private Hospital consists of two Cardiac Catheterisation Laboratories equipped with Philips machines and a 6 bed Recovery area. The Cath Lab has an excellent level of experience as diagnostic cardiology services have been provided at Lake Macquarie Private since 1986.
The Cath Lab delivers Diagnostic, Interventional, and Electrophysiology procedures to people living in Lake Macquarie and Newcastle and within the wider Hunter New England Community, as far afield as Coffs Harbour, Port Macquarie, and Tamworth. Patients are typically booked admissions for a procedure or they can be transferred from other hospitals, some potentially to receive treatment on the same day as their arrival. Some emergency cases via the LMPH Emergency Department can be transferred directly to the Cath Labs for procedures.
The Cath lab prides itself on the fact that our Cardiologists utilise a Radial approach almost 100% of the time to perform Diagnostic and Interventional Angiography procedures. Radial access is a far less invasive technique whereby a small puncture is made to either the right or left radial artery, and a catheter can then be inserted through the puncture and passed up the artery into the heart. After the procedure a pressure device (TR Band) is placed over the top of the puncture site to maintain haemostasis of the artery, and typically patients can mobilise as normal a couple of hours following the procedure.
Interventional Cardiology Procedures in the Cath Lab
An angiogram is a special type of X-Ray using dye to show if there is narrowing of the coronary arteries. Access is via the femoral artery (groin) or radial artery (wrist)
Percutaneous coronary intervention (PCI), commonly known as coronary angioplasty or simply angioplasty, is a non-surgical procedure used to treat the stenotic (narrowed) coronary arteries of the heart found in coronary heart disease. Treatment involves the use of balloons and stents to open the narrowing and hold it open.
Atrial Septal Defect (ASD) and Patent Foramen Ovale (PFO) closures are also performed in the Cath Lab. ASD is a birth defect where there is a hole in the wall (septum) between the two upper chambers of the heart (Atria). PFO is when the normal opening (foramen ovale) between the left and right Atria of the heart fails to close over leaving a flap. Both these two heart defects can be closed with a minimally invasive, nonsurgical procedure during which a closure device is implanted in the wall of the Atrial septum. A catheter, containing the closure device, is inserted via the Femoral vein up to the heart, where the device is deployed to close up the defect.
CTOs (Chronic Total Occlusions) are treated by our Cardiologists. CTOs are caused by a build-up of atherosclerotic plaque within a coronary artery that can reduce or totally block (occlude) the flow of blood in the artery. Cardiologists can attend to this problem using the following methods:
Utilising specialised wires that assist them to make a pathway to pass the through the blockage and then perform an Angioplasty and PCI (Percutaneous Coronary Intervention) to restore blood flow once again to the artery. Sometimes, when the plaque in the artery is particularly hard, the Cardiologists will use a procedure called Rotablation to try and restore blood flow. In this procedure a special catheter is inserted along a wire that has a diamond tip drill at its tip which is powered by compressed air. This drill is used to drive through the plaque to gradually widen the narrowing and make a pathway through the plaque. Once this has been achieved an Angioplasty/PCI can be performed and blood flow is restored once again.
This procedure is done to measure pressures in the right side of the heart and lungs, determine your cardiac output and measure oxygen levels in and around your heart.
These procedures are done to repair structural problems such as septal defects, where there is a hole between the left and right side of the heart. The hole is usually ‘plugged’ using a metallic device which is delivered via the femoral vein.
TAVI is a minimally invasive procedure which is an option for patients suffering from aortic stenosis (the narrowing of the aortic valve opening) who cannot have an open heart procedure due to their age or medical condition. With TAVI a replacement valve is delivered through a catheter inserted either through a groin artery or a keyhole chest opening. Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow.
An electrophysiological study is used to diagnose and treat cardiac rhythm disturbances. Using special pacing wires, the doctor can identify your rhythm disturbance and choose the best method of treatment.
Radiofrequency ablation is a procedure to cure rapid heart rhythms (tachycardia) in the heart. Abnormal electrical pathways in the heart (short circuits) are usually the cause.
This procedure is very similar to an electrophysiological study (EPS), which is performed beforehand.
Electrical cardioversion is a procedure in which an electric current is used to reset the heart's rhythm back to its regular pattern. The low-voltage electric current enters the body through paddles or patches applied to the chest wall.
A TOE is a procedure that looks at the heart chambers and valves using ultrasound. The probe is passed through the mouth and into the oesophagus. This is always done under anaesthetic or heavy sedation.
This is a small cardiac monitoring system which helps your doctor diagnose irregular heartbeats that may be related to unexplained fainting. It is placed under the skin above the heart and can stay there for up to 3 years.
A pacemaker is implanted to treat an abnormally slow heart rate. Pacemakers can also adjust the heart rate to meet the body's needs, whether during exercise or rest. Implantation of a pacemaker involves positioning leads (thin, insulated wires) in the heart and placing the device in a pocket of skin, usually in the shoulder area.
An ICD is a battery-powered device placed under the skin that keeps track of your heart rate. Thin wires connect the ICD to your heart. If an abnormal heart rhythm is detected the device will deliver an electric shock to restore a normal heartbeat if your heart is beating chaotically and much too fast.
A treatment for atrial fibrillation- an abnormal heart rhythm that originates in the top chambers of the heart.
Lead Extraction is a term used to describe the removal of Pacemaker Lead(s) usually with the use of specialised tools.
This procedure is done potentially either to resolve an infection, to remove excess or faulty leads, or to remove leads that pose a risk of arrhythmia, perforation.
See our list of Cardiologists
Lake Macquarie Private Hospital offers our patients the latest techniques in the surgical treatment of heart and lung conditions. Our multidisciplinary team of highly experienced cardiothoracic surgeons, perfusionists, cardiac nurses and allied health professionals work together to provide the highest quality clinical treatment and care to every patient. Cardiothoracic surgery has a distinguished history at Lake Macquarie Private dating back to 1994.
This procedure is to bypass (skip) blockages within your coronary arteries. These arteries supply blood to your entire heart. These blockages which contain calcium & plaque are what cause your symptoms of chest pain & discomfort, fatigue & shortness of breath.
Through a midline incision on your chest & opening of the breastbone (sternum) the heart can be reached. Commonly, vein from your leg & an artery from just behind your sternum (breastbone) are used to replace these blocked arteries therefore “bypassing” these blockages. This therefore improves the blood flow to the heart muscle which in turn decreases your symptoms of chest pain breathlessness &, or fatigue. Occasionally an artery from your arm may also be used for these “bypasses”.
The aorta is a major blood vessel responsible for distributing oxygenated blood to your entire body. Within the aorta is a valve which prevents blood going back towards the heart. It is made up of either 2 or 3 “leaflets” which are very thin which are responsible for coming together & forming a seal to prevent this backflow. This valve can degenerate with time & leak, & / or form calcium deposits on the leaflets. This therefore stops the valve from opening & closing properly to allow blood to flow through.
Through a midline incision on your chest & opening of the breastbone (sternum) the aortic valve can be reached & either pushed open permanently or cut out, & an artificial valve sewn in.
The valve can either be mechanical (synthetic) or tissue (human or animal). If a mechanical valve is used you will be required to take blood thinners for the rest of your life. If a tissue valve is used it will need replacing in time, anytime from 8 years onwards.
In most cases, mitral valve surgery is an open heart procedure. This means that the surgeon will open your chest (breastbone) & then your heart & remove or repair the damaged valve. If your mitral valve is damaged or diseased this will prevent how blood flows through it. Sometimes the valve cannot fully open or it can leak. Your surgeon therefore will need to either repair the valve or replace it. Many factors need to be considered to make the decision to either repair or replace your valve.
If your valve is replaced it will be with either a mechanical valve (synthetic) or tissue valve (sourced from an animal). If a mechanical valve is used you will be required to take blood thinners for the rest of your life. If a tissue valve is used it will need replacing in time, anytime from 8 years onwards.
The mitral valve can be accessed through small incisions and without cutting the breastbone. Specialized instruments are utilised by the cardiothoracic surgeon when he deems the patient suitable for this procedure.
Commonly known as a ‘hole in the heart’, an atrial septal defect is a hole between the two upper chambers of your heart. Formed in utero & therefore present from birth, they can go unnoticed or undetected for many years.
Open heart surgery may be required to close this hole. This means that the surgeon will open your chest (breastbone) & then your heart & close the hole either directly or use a ‘patch’ sewn to the wall of these two upper chambers.
A special catheter is inserted into a vein, usually in your groin. The catheter is then positioned in your right ventricle. Under x-ray guidance, your doctor uses the biopsy catheter to take tissue samples, usually from your right ventricle. The tiny pieces of heart tissue are sent to the lab for examination under a microscope and a biopsy may be done to diagnose the cause of heart failure or heart disease, such as dilated cardiomyopathy. This is caused by a bacterial or viral infection. The procedure can also diagnose restrictive cardiomyopathy, caused by many different pathological processes. Knowing the cause of heart failure can help to determine the treatment plan.
The aorta is a major blood vessel responsible for distributing oxygenated blood to your entire body. An aortic aneurysm is a bulging or enlargement of the aorta which can occur anywhere along this large artery. The appearance of an aneurysm can be very different with ballooning or bulging out to one side or quite uniform. Occasionally aneurysms form a ‘sac’ in a weakened area of the aorta.
To repair this aneurysm, open heart surgery is required. This means that the surgeon will open your chest (breastbone) in order to access the aorta. The section of aorta that is damaged by the aneurysm will need to be replaced with a ‘graft’ which is synthetic & tubular & made of a strong woven fabric.
A minimally invasive video-assisted technique to examine the lungs and interior of the chest. Some procedures including pleurodesis, lung biopsy and lung resection may be performed using the technique.
A thoracotomy is an incision to access your chest cavity usually to access specifically one of your lungs. This incision however can also be used for other procedures to access your aorta. The incision is made along the side of your chest wall & can vary greatly in length from approximately 6cm up to about 20cm.
Lung surgery is usually to remove a section or portion of your lung or the entire lung itself. Generally described as a wedge, lobe or lung.
Depending on your clinical condition will determine how much lung is removed & why. Surgical techniques have greatly improved making lung surgery easier to access & recover from.
A Nuss procedure is offered to younger patients who have either a sunken appearance of their chest or a bulging out of their chest (breastbone). This is a cartilage abnormality which is present from birth & can also lead to breathing & / or exercise intolerance as the patient ages from childhood.
A Nuss bar (named after the surgeon who invented the procedure) is inserted from a small incision on the side of the chest & advanced across the breastbone area. It is bent into a preformed & measured shape which stays inside the body for up to 3 years. It is then surgically removed with the cartilage reshaping during this time & correcting the appearance of the breastbone. Up to 3 small incisions may be made for this procedure which give excellent corrective results.
A Ravitch sternochrondoplasty procedure is offered to older (adult) patients who have either a sunken appearance of their chest or a bulging out of their chest (breastbone). This is a cartilage abnormality which is present from birth & can also lead to breathing & / or exercise intolerance as the patient ages. An incision is made across the front of the chest below the nipple line & the effected cartilage is cut out on both sides of the sternum (breastbone). A thin metal plate if required may be used to maintain the desired shape & appearance of the chest. Alternatively & more commonly the muscle is sewn directly to the remaining cartilage which will maintain the now flatter appearance of the chest.
A procedure performed using minimally invasive video techniques to block nerves causing excessive sweating of the hands and arms.
This operation removes the diseased part of the lung
A radical surgical procedure that involves the removal of the whole lung, usually to remove tumorous tissue.
Treatment for a collapsed lung.
A thymectomy is an operation to remove the thymus. It usually results in remission of myasthenia gravis with the help of medication including steroids. However, this remission may not be permanent.
VATS is a minimally invasive technique that uses small incisions and eliminates the need to spread the ribs. During VATS, the surgery is performed through a one-inch incision and is aided by a miniature camera inserted through one of the three 1/4 to 1/2" incisions. The VATS approach has significantly less pain than a large thoracotomy along with a reduced hospitalization period. Patients usually do not require a stay in the intensive care unit.
See our list of Cardiothoracic Surgeons