Dr. Mario Castillo-Sang is a Cardiac Surgeon and Director of Mitral Valve and Heart Failure Surgery at the Florence Wormald Heart & Vascular Institute at St. Elizabeth. He sees patients in Edgewood. This article is provided by St. Elizabeth Healthcare.
Q: What does a cardiac surgeon do? When should people seek help from one?
A: Cardiac surgeons operate on the heart and vessels, including the arteries and veins in the chest. These procedures include implanting a heart pump — a mechanical device that helps the heart pump blood properly throughout the body. In my case, I operate, overwhelmingly, more on the mitral valve to repair or replace it, as well as the tricuspid valve. These valves control the flow of blood in the heart. I also regularly implant permanent mechanical heart support pumps called left ventricular assist devices (LVADs). These devices support proper heart function in people who have end-stage heart failure.
Q: What’s something surprising about cardiac surgery that people might not know?
A: We stop hearts for a living, and we wake them up after the operation is finished. In addition, cardiac surgery doesn’t always require a big incision in the chest. It can often be performed through a 1.5-inch incision on the right side of the chest.
Q: What is St. Elizabeth doing around cardiac surgery that is innovative, unique or leading edge?
A: St. Elizabeth is the most experienced center in the region, performing highly complex minimally invasive multi-valvular heart surgery. This includes mitral valve, tricuspid valve and aortic valve procedures. We also remove tumors, perform cardiac ablations for atrial fibrillation, and close atrial septal defects — congenital “holes in the heart.” This can all be done through minimally invasive procedures.
As a minimally invasive surgeon, I teach these techniques to other surgeons from the United States, Canada, and Latin America. At St. Elizabeth, we are the first and only LVAD center in Northern Kentucky. Today, a resident of Northern Kentucky does not need to travel to get top-in-class cardiac surgery care for valve disease or heart failure.
Q: What is currently on the horizon for cardiac surgery? What changes might we expect in the next few years?
A: Surgery is becoming predominantly minimally invasive. There will be a shared space with other transcatheter (via veins and arteries) interventions for those who cannot have open heart surgery. As surgeons, we collaborate with our “heart team,” including cardiologists and other specialists, who evaluate and treat patients with valvular disease and heart failure.
Q: Does St. Elizabeth offer screenings for early detection of illness related to cardiac surgery?
A: Yes, the simplest screening is listening with a stethoscope to find murmurs. If we find a new murmur or one that is getting worse, we order an echocardiogram as a second line of screening. This ultrasound test uses sound waves to show how well the patient’s heart is beating and pumping blood.
Q: From your perspective as a cardiac surgeon, what should people be aware of to prevent disease or catch it early?
A: Mitral valve disease injures the heart silently, unlike coronary blockages, which often present with chest pain and heart attacks. It’s crucial to treat mitral regurgitation or leakage as early as possible before it becomes severe. This should be done even if symptoms are absent or minimal, provided the patient can receive care in a valve center with more than a 95% success rate in repairing mitral valves with less than a 1% mortality rate. Once mitral valve disease symptoms appear, the heart has likely experienced an injury that, over time, may become irreversible. Early intervention in valve disease is vital.
Learn more about Mitral Valve Surgery at St. Elizabeth.