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Dr. Ott and his team at the Texas Heart Institute are recognized for their expertise in the field of coronary artery disease. Each patient undergoes a thorough state-of-the-art evaluation at the Texas Heart Institute/St. Luke's Hospital or a complete review of their data that they send or bring from other institutions. A team approach assures that all available options are considered and presented to the patient in an unbiased fashion for their consideration. Stents are always the first option for many patients with coronary artery blockages but it is important to consult a highly experienced team in order to insure that the correct treatment is chosen for each patient's specific anatomy. A patient who has stents implanted inappropriately is unlikely to obtain a good long term result. The surgical option should not be chosen if stenting can offer a less invasive and successful treatment. Physicians at the Texas Heart Institute have experience with over 100,000 open heart surgical procedures and 200,000 heart catheterizations to refer to in advising their patients. Surgical options include "minimally invasive" and "off-pump" techniques which may be appropriate in selected patients as well as robotic heart surgery procedures which are currently investigational with first-generation device technology. Patients at the Texas Heart Institute/St. Luke's Hospital benefit from specialized anesthesiology and nursing care in the operating room and postoperatively, as well as medical specialists in the important subspecialties of pulmonary (lung), nephrology (kidneys) and infectious disease.

Valvular heart problems involve primarily narrowing (stenosis) or leakage (insufficiency or regurgitation) of the aortic valve (primary outlet valve of the heart) or mitral valve (primary valve between the upper and lower chambers of the heart). All blood pumped by the heart passes through these valves. Problems can be caused by rheumatic fever or simply by degenerative changes occurring over many years of opening and closing every second of the day. Certain systemic illness and disease can contribute to the development of valve problems including auto immune disease such as arthritis, infections and kidney failure. A congenital defect in which the aortic valve has only two leaflets instead of three is one of the most common causes of aortic valve narrowing. Aortic valve disease of a degree that requires surgical intervention usually requires replacement of the valve although repair is possible depending on the specific anatomic situation and the experience of the surgeon. The most important decision facing a patient who requires aortic valve replacement is the type of valve to use. The decision can only be made after a thorough, open and honest discussion with a surgeon experienced with all types of valve devices. Valves used for replacement are of two basic types: tissue and mechanical. Mechanical valves are constructed entirely of man made materials usually pyrolite carbon, a diamond hard material attached to a Dacron sewing ring to attach it to the patient's tissue. Current mechanical valves are usually of a tilting disk one way flow design and have the advantage that they do not wear out. Mechanical valves do, however, require lifelong treatment with Coumadin, a blood thinner that can cause increased susceptibility to bleeding particularly in older patients. Tissue valves include several types all of which have the advantage of not requiring Coumadin but only long term treatment with a platelet inhibitor blood thinner such as enteric coated baby aspirin which has few side effects. All tissue valves have the disadvantage that they may wear out with time and require further valve surgery. However, with current advances in valve preparation and preservation techniques, one can expect an 85-90% chance that a tissue valve will remain functional after 15-20 years. These valves are most appropriate for patients over 50-60 years of age and are constructed from either bovine (cow) pericardium or porcine (pig) heart tissue. In younger more physically active patients, homograft valves (cryopreserved (deep frozen) human cadaver valves) may be appropriate because of their favorable hemodynamic characteristics but they require a more extensive operation and may wear out with time. Another valve option suitable primarily for younger patients and children is the so called Ross switch procedure which consists of transferring the patient’s pulmonary valve to replace the diseased aortic valve. The pulmonary valve must then be replaced with a cryopreserved human cadaver valve. This procedure offers an excellent hemodynamic result, but is a much more extensive procedure technically, has a higher operative mortality and leaves the patient with two tissue valves that will eventually wear out rather than just one. Nonetheless, it is appropriate to use in specialized cases. Dr. Ott has the advantage of having extensive experience in valve surgery of all types and will thoroughly discuss the risks and benefits of each in an honest and unbiased fashion based on the individual patient’s data, needs and wishes.

Valvular heart problems involve primarily narrowing (stenosis) or leakage (insufficiency or regurgitation) of the aortic valve (primary outlet valve of the heart) or mitral valve (primary valve between the upper and lower chambers of the heart). All blood pumped by the heart passes through these valves. Problems can be caused by rheumatic fever or simply by degenerative changes occurring over many years of opening and closing every second of the day. Certain systemic illness and disease can contribute to the development of valve problems including auto immune disease such as arthritis, infections and kidney failure. A congenital defect in which the aortic valve has only two leaflets instead of three is one of the most common causes of aortic valve narrowing. Mitral valve disease may be due to rheumatic disease but currently is caused most often by mitral valve prolapse syndrome, a poorly understood phenomena in which the valve slowly becomes thickened, elongated and begins to regurgitate blood back into the upper chamber of the heart causing heart failure. The mitral valve somewhat resembles a parachute in that long chords hold it in place. These chords may rupture and result in sudden worsening of the valve leakage. Thanks to advances in modern surgical techniques, most cases of mitral valve prolapse can undergo repair of the valve thus preventing the need for placement of an artifical valve. Repair can be performed in 90-95% of cases of mitral leakage due to prolapse syndrome. This allows the patient to be treated postoperatively with simple blood thinners such as baby aspirin rather than the more powerful anticoagulant Coumadin required after most valve replacements and which has some potentially serious side effects. Dr. Ott and his team have one of the world's largest experiences with mitral valve repair and replacement and can discuss the options carefully and honestly with the patient. Aortic valve disease of a degree that requires surgical intervention usually requires replacement of the valve although repair is possible depending on the specific anatomic situation and the experience of the surgeon. The most important decision facing a patient who requires aortic valve replacement is the type of valve to use. The decision can only be made after a thorough, open and honest discussion with a surgeon experienced with all types of valve devices. Valves used for replacement are of two basic types: tissue and mechanical. Mechanical valves are constructed entirely of man made materials usually pyrolite carbon, a diamond hard material attached to a Dacron sewing ring to attach it to the patient's tissue. Current mechanical valves are usually of a tilting disk one way flow design and have the advantage that they do not wear out. Mechanical valves do, however, require lifelong treatment with Coumadin, a blood thinner that can cause increased susceptibility to bleeding particularly in older patients. Tissue valves include several types all of which have the advantage of not requiring Coumadin but only long term treatment with a platelet inhibitor blood thinner such as enteric coated baby aspirin which has few side effects. All tissue valves have the disadvantage that they may wear out with time and require further valve surgery. However, with current advances in valve preparation and preservation techniques, one can expect an 85-90% chance that a tissue valve will remain functional after 15-20 years. These valves are most appropriate for patients over 50-60 years of age and are constructed from either bovine (cow) pericardium or porcine (pig) heart tissue. In younger more physically active patients, homograft valves (cryopreserved (deep frozen) human cadaver valves) may be appropriate because of their favorable hemodynamic characteristics but they require a more extensive operation and may wear out with time. Another valve option suitable primarily for younger patients and children is the so called Ross switch procedure which consists of transferring the patient's pulmonary valve to replace the diseased aortic valve. The pulmonary valve must then be replaced with a cryopreserved human cadaver valve. This procedure offers an excellent hemodynamic result, but is a much more extensive procedure technically, has a higher operative mortality and leaves the patient with two tissue valves that will eventually wear out rather than just one. Nonetheless, it is appropriate to use in specialized cases. Dr. Ott has the advantage of having extensive experience in valve surgery of all types and will thoroughly discuss the risks and benefits of each in an honest and unbiased fashion based on the individual patient’s data, needs and wishes.

Valvular heart problems involve primarily narrowing (stenosis) or leakage (insufficiency or regurgitation) of the aortic valve (primary outlet valve of the heart) or mitral valve (primary valve between the upper and lower chambers of the heart). All blood pumped by the heart passes through these valves. Problems can be caused by rheumatic fever or simply by degenerative changes occurring over many years of opening and closing every second of the day. Certain systemic illness and disease can contribute to the development of valve problems including auto immune disease such as arthritis, infections and kidney failure. Mitral valve disease may be due to rheumatic disease but currently is caused most often by mitral valve prolapse syndrome, a poorly understood phenomena in which the valve slowly becomes thickened, elongated and begins to regurgitate blood back into the upper chamber of the heart causing heart failure. The mitral valve somewhat resembles a parachute in that long chords hold it in place. These chords may rupture and result in sudden worsening of the valve leakage. Thanks to advances in modern surgical techniques, most cases of mitral valve prolapse can undergo repair of the valve thus preventing the need for placement of an artificial valve. Repair can be performed in 90-95% of cases of mitral leakage due to prolapse syndrome. This allows the patient to be treated postoperatively with simple blood thinners such as baby aspirin rather than the more powerful anticoagulant Coumadin required after most valve replacements and which has some potentially serious side effects. Dr. Ott and his team have one of the world's largest experiences with mitral valve repair and replacement and can discuss the options carefully and honestly with the patient.

Valvular heart problems involve primarily narrowing (stenosis) or leakage (insufficiency or regurgitation) of the aortic valve (primary outlet valve of the heart) or mitral valve (primary valve between the upper and lower chambers of the heart). All blood pumped by the heart passes through these valves. Problems can be caused by rheumatic fever or simply by degenerative changes occurring over many years of opening and closing every second of the day. Certain systemic illness and disease can contribute to the development of valve problems including auto immune disease such as arthritis, infections and kidney failure. Mitral valve disease may be due to rheumatic disease but currently is caused most often by mitral valve prolapse syndrome, a poorly understood phenomena in which the valve slowly becomes thickened, elongated and begins to regurgitate blood back into the upper chamber of the heart causing heart failure. The mitral valve somewhat resembles a parachute in that long chords hold it in place. These chords may rupture and result in sudden worsening of the valve leakage. Thanks to advances in modern surgical techniques, most cases of mitral valve prolapse can undergo repair of the valve thus preventing the need for placement of an artificial valve. Repair can be performed in 90-95% of cases of mitral leakage due to prolapse syndrome. This allows the patient to be treated postoperatively with simple blood thinners such as baby aspirin rather than the more powerful anticoagulant Coumadin required after most valve replacements and which has some potentially serious side effects. Dr. Ott and his team have one of the world's largest experiences with mitral valve repair and replacement and can discuss the options carefully and honestly with the patient.

The teams of surgeons, anesthesiologists and nurses working with Dr. Ott have extensive experience in caring for patients with the most difficult aneurysms. Aortic Aneurysms operations require specialized equipment and a highly coordinated surgical team. Technical expertise and expeditious surgery are a key factor in the success of the operation. Hypothermic (low body temperature) techniques and specialized blood perfusion methods are paramount in preventing neurologic and other complications in these patients who have an otherwise potentially fatal risk of rupture. Newer non-surgical endovascular techniques are utilized when appropriate based upon the patients anatomy and other risk factors. Consultation between the patient and surgeon will clarify the various options for treatment.

Many patients with atherosclerosis (hardening of the arteries) develop stenosis (narrowing) of the carotid arteries in the neck. These are the main sources of blood supply to the brain and blockage of these vessels can cause debilitating or fatal strokes. Cleaning out these blockages provides a permanent solution to the problem in most cases and requires only a one night hospital stay. Surgical results vary dramatically depending upon the experience of the surgical team and techniques used, and it is therefore imperative that patients with carotid stenosis seek out expert surgical care. Dr. Ott has performed over 1,500 carotid procedures. In some cases non-surgical relief of obstruction may be possible. Consult with Dr. Ott regarding your individual case.

Peripheral vascular disease refers generally to blockages of the arteries supplying the legs. Blockage may occur in the aorta within the abdomen before it branches to the legs or between the upper and lower leg where the artery is exposed to a degree of stress. Pain when walking and eventual rest pain and gangrene may result. Bypassing these areas of blockage with polyester (Dacron) or polytetra fluorethylene (Goretex) grafts can correct the problem. Bypasses within the leg itself are usually performed with saphenous vein (an extra vein from the patient leg) or with Goretex tubing. Some patients may benefit from endovascular stenting or angioplasty depending upon the individual anatomy.

Arrhythmias of the heart can be debilitating and life threatening in some cases. While many types are readily controlled by medications, the more serious arrhythmias may require more extensive measures. Specialized electrophysiologists in the cardiology field can sometimes cure the problems with relatively noninvasive means in the cardiac catheterization lab. Some cases will require more extensive operative methods to effect a cure or improvement in the rhythm problem. Combining surgery for other heart problems such as mitral valve repair with surgical treatment of significant rhythm problems is possible. These techniques are specialized and are evolving in major medical centers. Methods include cryoablation (freezing), radio frequency ablation, specialized incisions, and ultrasonic ablation techniques, and require highly specialized medical and surgical teams. Dr. Ott and the electrophysiologists at St. Luke's and the Texas Heart Institute can coordinate a program appropriate to each individual case.

Newer techniques allow some heart procedures to be performed through smaller incisions; a method widely referred to as minimally invasive surgery. A prime example is aortic valve replacement which can be performed in many cases through a four inch incision in the upper chest. Robotic techniques are being developed which may allow even smaller incisions to be used. These devices are currently first-generation technology and must be considered experimental at the current time. Advice from an experienced surgeon is vital when considering the alternatives.

Certain cases of coronary artery disease can be treated with coronary artery bypass using so called "off pump" techniques. While the most important goal in bypass surgery is to obtain the most perfect bypass attainable by the safest possible method, this can be accomplished in some cases without resorting to methods that involve extracorporeal circulation of the blood ("on pump" bypass). Conversely, depending on the patient's individual anatomy and other factors, off pump bypass may be inappropriate, counterproductive or unsafe. Consultation with the most experienced surgeon possible is mandatory when considering the options to insure the safest, most effective and long lasting result from coronary artery bypass surgery as results can vary considerably. A surgeon experienced in the most difficult of surgical cases can best advise the patient and make the most appropriate decisions in the operating room to insure the patient's safety and long term outcome.

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Peripheral vascular disease refers generally to blockages of the arteries supplying the legs. Blockage may occur in the aorta within the abdomen before it branches to the legs or between the upper and lower leg where the artery is exposed to a degree of stress. Pain when walking and eventual rest pain and gangrene may result. Bypassing these areas of blockage with polyester (Dacron) or polytetra fluorethylene (Goretex) grafts can correct the problem. Bypasses within the leg itself are usually performed with saphenous vein (an extra vein from the patient leg) or with Goretex tubing. Some patients may benefit from endovascular stenting or angioplasty depending upon the individual anatomy.

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Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

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Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

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Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.