Start with what you need treated.

A dual-chamber permanent pacemaker is implanted in patients with conduction system disease affecting both the atrium and ventricle, ensuring the heart's chambers contract in proper sequence. Under local anesthesia, leads are threaded through a vein into the heart and connected to a pulse generator placed in a small pocket under the skin near the collarbone. The procedure typically takes one to two hours and is well tolerated by most patients. A chest X-ray and device check confirm correct lead placement before discharge. Patients are advised to avoid heavy lifting on the implant side for a few weeks. The device requires periodic follow-up to check battery life and programming.

Angioplasty with stent placement is the standard treatment for significant coronary artery blockages causing angina or heart attack. After the balloon widens the narrowed segment, a metal mesh stent, often drug-eluting, is deployed to scaffold the artery open and reduce the chance of renarrowing. The procedure is performed under fluoroscopic guidance and local anesthesia, usually within 30 to 90 minutes. Patients are monitored for several hours to overnight for bleeding at the access site and heart rhythm stability. Dual antiplatelet medication is prescribed for months afterward to prevent clot formation within the stent. Most patients experience prompt relief of symptoms and can return to normal activity within days.

Biventricular pacing, the basis of cardiac resynchronization therapy, is used in heart failure patients whose ventricles contract out of sync due to abnormal electrical conduction. A third lead is placed via the coronary sinus to pace the left ventricle in addition to standard right atrial and ventricular leads, restoring coordinated contraction. The implant is done under local anesthesia and takes about one to two hours. Patients are monitored overnight with imaging to confirm lead position. Many patients notice improved exercise tolerance and reduced breathlessness within weeks to months. Regular device checks are needed to optimize pacing settings for the best benefit.

The Blalock-Taussig shunt is a palliative operation used in newborns and infants with congenital heart defects that severely restrict blood flow to the lungs, such as tetralogy of Fallot or pulmonary atresia. A small tube graft is surgically connected between a systemic artery and the pulmonary artery, allowing more oxygen-poor blood to reach the lungs for oxygenation. The surgery is performed under general anesthesia, typically without needing full cardiopulmonary bypass, and takes two to three hours. The infant is monitored closely in a pediatric cardiac intensive care unit after surgery. This buys time for the child to grow before undergoing a more definitive corrective surgery later. Careful follow-up is required to monitor shunt function and oxygen saturation.

Redo CABG is performed in patients who have had prior bypass surgery but develop new or recurrent blockages, or graft failure over time. The operation is more challenging than a first-time bypass because of adhesions and scar tissue from the previous surgery, requiring careful dissection to safely access the heart. Surgeons often plan the approach using detailed pre-operative imaging to identify graft locations and avoid injury. The procedure is performed under general anesthesia with cardiopulmonary bypass and generally takes longer than a primary bypass. Recovery begins in intensive care with close monitoring of heart function and bleeding. Cardiac rehabilitation over six to eight weeks helps patients regain strength and stamina.

Cardiac tumors, whether benign like myxomas or, less commonly, malignant, are treated surgically because of their risk of obstructing blood flow, damaging heart valves, or breaking off and causing a stroke. The surgeon opens the chest, places the patient on cardiopulmonary bypass, and carefully excises the tumor along with a margin of surrounding tissue to reduce recurrence. The procedure typically takes three to four hours depending on tumor size and location. Patients are monitored in intensive care initially, watching for arrhythmias and bleeding. Pathological examination of the removed tissue confirms the diagnosis and guides any further treatment. Most benign tumors are cured with surgery alone, with a low rate of recurrence.

Coronary artery bypass grafting (CABG) treats severe coronary artery disease by creating new pathways for blood to flow around blocked arteries, using a vein from the leg or an artery from the chest or arm as a graft. The surgeon connects one end of the graft above the blockage and the other below it, restoring blood supply to the heart muscle. Traditional CABG is performed through an incision in the breastbone using a heart-lung bypass machine, while off-pump techniques are used in selected patients. The operation generally takes three to six hours depending on the number of grafts needed. Recovery begins in intensive care before progressing to a general ward and a structured cardiac rehabilitation program. Most patients experience significant relief from angina and improved quality of life.

Balloon atrial septostomy, also called the Rashkind procedure, is a life-saving intervention performed in newborns with congenital heart defects like transposition of the great arteries, where oxygenated and deoxygenated blood do not mix adequately. A catheter with a balloon is passed through the umbilical or femoral vein into the heart, across the atrial septum, and quickly withdrawn to tear a larger opening, improving mixing of blood. The procedure is done under echocardiographic or fluoroscopic guidance and takes about 30 minutes. The infant is closely monitored in a neonatal or pediatric cardiac intensive care unit afterward. It stabilizes the baby's oxygen levels and buys time until definitive corrective surgery can be performed. It is considered a highly effective emergency bridge procedure.

Aortic balloon valvuloplasty is used to relieve aortic stenosis by threading a catheter with an inflatable balloon across the narrowed valve and inflating it to stretch open the fused or calcified leaflets. It is most commonly used in children and young adults with congenital aortic stenosis, and occasionally as a bridge therapy in elderly patients who are not immediate candidates for valve replacement. The procedure is performed under fluoroscopic guidance and takes about one to two hours. Patients are monitored overnight for vascular access complications and valve function. Symptom relief is often significant, though the benefit may be temporary in adults with calcific disease, sometimes requiring later valve replacement. It remains a valuable option for appropriately selected patients.

Cardiac catheterization is both a diagnostic and sometimes therapeutic procedure used to directly visualize the coronary arteries and measure pressures within the heart chambers. A catheter is inserted through an artery in the wrist or groin and advanced to the heart under X-ray guidance, where contrast dye is injected to outline blood vessels on angiography. The procedure typically takes 30 to 60 minutes and is performed under local anesthesia with mild sedation. Patients are observed for a few hours afterward to monitor the puncture site for bleeding. Results help determine whether further treatment such as angioplasty, stenting, or bypass surgery is needed. It remains the gold standard for assessing coronary artery disease.

AV canal (atrioventricular septal defect) repair corrects a complex congenital heart defect involving holes in the wall between the heart's chambers along with abnormal formation of the mitral and tricuspid valves. Surgery involves closing the septal defects with a patch and reconstructing the valves to function separately and effectively. The operation is performed under general anesthesia using cardiopulmonary bypass and typically takes four to six hours. Infants are cared for in a pediatric cardiac intensive care unit immediately after surgery due to the complexity of recovery. Long-term outcomes are generally very good with modern surgical techniques. Lifelong cardiology follow-up is needed to monitor valve function as the child grows.

The Senning procedure is an atrial switch operation used to treat transposition of the great arteries, a congenital defect in which the two main arteries leaving the heart are reversed. The surgeon creates an internal baffle using the patient's own atrial tissue to redirect blood flow so that oxygen-poor and oxygen-rich blood reach the correct circulations. Though largely superseded by the arterial switch operation in newborns, it remains relevant for older patients or specific anatomical situations. The surgery is performed under general anesthesia with cardiopulmonary bypass and takes several hours. Recovery occurs in a pediatric cardiac intensive care unit with close monitoring of heart rhythm. Lifelong cardiology follow-up is essential due to potential long-term complications affecting the heart's right side.