At East Bay Cardiovascular & Thoracic Associates, our doctors provide a number of cardiac specialty services for Danville patients. Our team of top cardiac specialists is meticulous at every step of the treatment process, from ensuring an accurate diagnosis to expertly performing any necessary procedures to supporting optimal healing during your recovery.
Our commitment to advancing cardiovascular and thoracic surgery is matched by our dedication to providing patient-centered care. Our team of seasoned experts understands the intricate nature of heart and lung conditions, ensuring personalized and comprehensive care for every patient.
Coronary artery disease, or CAD, is the most common type of heart disease and the leading cause of death in the US for both men and women.
CAD occurs when the arteries that supply blood to the heart muscle become narrow and hardened. A buildup of plaque on the inside walls of the arteries, called atherosclerosis, prevents the heart from receiving the oxygen it needs and therefore can result in chest pain or a heart attack.
Over time, CAD weakens the heart muscle and can lead to heart failure and arrhythmias (irregular heartbeat).
Symptoms and Causes of Coronary Artery Disease
If your coronary arteries cannot supply enough blood to your heart, you may experience signs and symptoms of the disease. These symptoms can include:
Atherosclerosis of the coronary artery can be caused by various factors, including:
Coronary Artery Bypass Grafting (CABG) Procedure
One of the cardiac specialty services we provide is a Coronary Artery Bypass Graft (CABG). This surgery is sometimes necessary for patients with severe coronary artery disease (CAD). In this procedure, a healthy artery or vein is taken from the body and grafted to bypass the blocked portion of the coronary artery, creating a new path for oxygen-rich blood to the heart muscle.
The CABG surgery is typically a 3-6 hour open-heart procedure performed under general anesthesia. Your surgeon will discuss their specific techniques and methods for the treatment with you.
Risks of a CABG
Every surgery comes with risks, and a CABG is no different. Risks may include, but are not limited to:
Mitral valve regurgitation is when the mitral valve in your heart leaks and lets backward flow back into the heart. Mitral stenosis is a narrowing of the mitral valve, causing circulation to the main pumping chamber of the heart to be blocked.
Over time, both regurgitation and stenosis can cause the heart to have to work harder to pump blood to the body and can result in heart failure. Both of these conditions may require Mitral Valve Replacement or Repair surgery as treatment.
Symptoms of Mitral Regurgitation and Stenosis
Signs of Mitral Valve Regurgitation may include:
Symptoms of Mitral Valve Stenosis may include:
The Mitral Valve Replacement and Repair Procedure
When the mitral valve is severely diseased, it can lead to heart failure or other conditions. Depending on the condition and its severity, your surgeon will discuss the best cardiac specialty services for fixing your heart issue. The most likely method for mitral regurgitation will be a mitral valve repair surgery, while a replacement is more common for those with mitral stenosis.
Mitral Valve Repair
In mitral valve repair surgery, patients are taken to the operating room and put under general anesthesia. Methods vary from a full open-heart procedure, to more minimally invasive techniques such as robot assisted surgeries.
There are a lot of new developments in technology to aid this procedure. New devices and methods are being created to lessen the recovery time and make it more minimally invasive.
The patient will be put on a heart lung machine to take over the job of oxygenating the blood while the surgeon repairs the heart. In this procedure, the surgeon may attach new pieces to the structure, but the patient is left with their original valve.
Mitral Valve Replacement
Mitral valve replacement surgery is typically the best option when the majority of the mitral valve is not functioning properly. This procedure is typically done as an open-heart surgery, but new minimally invasive and catheter techniques may be another option.
The surgeon will discuss with you the plan for the surgery and what type of replacement valve is the best option for you. There are both tissue valve replacements and mechanical ones.
The patient will be put on a heart lung machine to oxygenate the blood during the procedure. The old valve will be removed, and a new one will be attached.
Risks of Mitral Valve Replacement or Repair
The specific risks of the procedure will depend on the patient’s general health, as well as the condition and its severity. Risks may include but are limited to:
Aortic valve disease is a condition in which the valve between the left ventricle of the heart and the aorta isn’t functioning properly. The condition can be congenital or can result from other causes. Aortic valve disease includes aortic stenosis, or the narrowing of the valve that prevents it from fully opening; and aortic regurgitation, where the valve does not close properly causing backward blood flow into the left ventricle.
Symptoms of Aortic Stenosis and Regurgitation
Signs of Aortic Valve Stenosis may include but not limited to:
Symptoms of Aortic Valve Regurgitation
Signs of Aortic Valve Regurgitation may include but not limited to:
The Aortic Valve Replacement Procedure
When the aortic valve is severely diseased, it can lead to many conditions, including heart failure. Depending on the condition and its severity, your surgeon will discuss with you the best plan to fix your heart issue.
There are new laparoscopic and minimally invasive techniques that may be available, but most often aortic valve replacements require an open-heart approach. The patient will be put on a heart lung machine to take over the job of oxygenating the blood to bypass the heart so the surgeon can repair the valve.
The old valve will be removed and replaced with a new one. There are both tissue valves (can come from a pig, cow, or cadaver donor) or mechanical ones. Your physician will likely prescribe medications along with your surgery to prevent clots and infections.
Risks of an Aortic Valve Replacement Procedure
While this surgery typically has a high rate of success, there are risks to every surgical procedure. Some risks of the surgery may include but not limited to:
A transcatheter aortic valve replacement, or TAVR, is one of our minimally invasive cardiac specialty services. It is used to replace the aortic valve due to aortic valve stenosis.
This procedure is a good option for patients who cannot undergo open-heart surgery, are in very poor health, or have too many risk factors. This procedure is a good option for patients in poor health or those who have multiple risk factors that would make them a poor candidate for open heart surgery.
TAVR might be a good option for you if:
The TAVR Procedure
The patient will be under general anesthesia. A heart lung bypass machine is typically not necessary for this procedure.
During TAVR, the surgeons may access the heart either through the femoral artery in the groin, or through the chest. A catheter with a small balloon attached will be guided up to the heart and inflated between the valve to widen it and to press the replacement valve into place. When the valve is secure, the catheter is removed and the doctor will check for proper circulation.
Medications to prevent blood clot or infection will likely be prescribed by your doctor. The new artificial valve will take over for the old one and provide proper blood flow through the aorta.
Risks of TAVR
Like all surgical procedures, TAVR does carry a risk of complications. These may include but not limited to:
A transcatheter mitral valve repair, or TMVR, is a minimally invasive procedure to repair the mitral valve due to mitral valve regurgitation. This procedure is a good option for patients in poor health or have multiple risk factors that would not make them a candidate for open heart surgery.
TMVR might be a good option for you if:
The TMVR Procedure
During the procedure, your surgeon will access the femoral artery through an incision in the groin, through which a catheter will be threaded and placed into the heart. Once the catheter is properly placed into the mitral valve, a device called MitraClip will be deployed onto the leaky part of the valve. This clips the defective part of the valve closed and reduces regurgitation.
Once proper blood flow is confirmed, the catheter is removed and the incision is closed. The MitraClip becomes a permanent part of the heart after this procedure to allow the correct amount of blood flow.
Risks of TMVR
Like all surgical procedures, TMVR carries a chance of complications. These may include the following:
A cardiac lead is the wire that connects an ICD (Implantable Cardioverter Defibrillator) or Pacemaker to the heart. These two devices ensure proper heart rhythm, and so if they are not working properly or if the area is infected, they might need to be removed. One of the cardiac specialty services we perform is laser lead extraction.
Reasons for needing lead extractions may include:
New techniques for extracting leads involves catheter-guided lasers that can safely and effectively free the lead from scar tissue.
The Laser Lead Extraction Procedure
During a laser lead extraction procedure, the patient will be under general anesthesia. An incision in the chest will be made to disconnect the lead from the pacemaker or ICD, then a catheter will be guided into the vein where the lead needs to be removed.
A laser delivers energy that removes scar tissue around the lead until it detaches from inside the vein. The lead and the catheter will then be pulled out through the incision. Depending on the reason for the extraction, a new lead might be placed at this time. The doctor will then close the incision and check that the surgery was successful.
Risks of Laser Lead Extraction
Lead extraction is a complex surgical procedure with some unavoidable risks. Risks may include but not limited to:
Placing an inferior vena cava (IVC) filter is another one of our state-of-the-art cardiac specialty services. An IVC filter is a device placed into the inferior vena cava in order to prevent pulmonary embolism caused from a deep vein thrombosis. This means that if a blood clot breaks off from a deep vein and travels toward the lungs, it will get caught in the filter before it can reach the pulmonary artery and cause a blockage.
Placement of an IVC filter is a good option for patients who cannot take anticoagulant medications (blood thinners), those who continually develop deep vein thrombosis or pulmonary embolism, or those who have large clots in the inferior vena cava or iliac veins.
IVC Filter Placement and Retrieval
IVC filters can be permanent or temporary (retrievable). Permanent filters cannot be removed or repositioned. Patients at long term risk of embolisms usually need a permanent filter, and retrievable filters are best for patients who have short term risk and will not always need the filter.
Patients are usually sedated with anesthetic rather than asleep under general anesthesia for IVC procedures. IVC filters are usually placed by a catheter through the jugular vein or through the vein of the upper leg. From here, the filter is guided up to the inferior vena cava where it is opened and secured.
The small basket-like structure then can collect any clots. Removable filters have small hooks on the end so they can later be pulled out with a catheter.
Risks of IVC Filters
All surgical procedures come with associated risks. IVC filters can be associated with:
Courteous, patient and caring
“This was my first visit with Dr. Gottlieb. He spent a long time with me going over my past records, took me through my CT scans slide by slide, went over my diet, and thoroughly explained my condition and options to me. I have never been to a physician so courteous, patient and caring. I strongly recommend Dr. Gottlieb to anyone. He was simply fantastic.”
At East Bay Cardiovascular & Thoracic Associates, the consultation process is designed to be thorough and patient-focused. During your initial consultation, our specialist will take the time to understand your medical history, current health concerns, and any specific symptoms you may be experiencing. This step is crucial for us to gain a comprehensive view of your condition and to tailor our approach to meet your individual needs. Our goal is to ensure that you feel informed and comfortable with the proposed diagnostic tests and treatment plans, making this journey together as collaborative as possible.
Recovery is a pivotal aspect of your treatment plan at East Bay Cardiovascular & Thoracic Associates. Following any procedure, our team provides detailed instructions and support to help you navigate the recovery phase with confidence. We offer guidance on everything from medication management to lifestyle adjustments that promote healing and improve overall health. Our specialists are committed to monitoring your progress closely, adjusting care plans as needed to ensure the best possible outcomes. We understand that recovery can be challenging, but with our expert care and support, we strive to make this process as smooth and effective as possible for you.
The price of your treatment will depend on many factors. The severity of your condition, the type of procedure performed, and the techniques required to best achieve your treatment goals will impact the overall cost.
When you first meet with one of our highly trained doctors, he or she will review your medical history and ask you about your concerns in order to determine the ideal treatment approach for you. The cost associated with any recommended cardiac specialty services will then be reviewed with you, along with the details of your treatment plan.
Contact East Bay Cardiovascular & Thoracic Associates to find out more about cardiac specialty services in Danville and our other locations. During an appointment, you will be able to ask questions regarding surgical cost, the recovery process for your unique case, and any other questions you may have.
Our unique blend of advanced medical expertise, patient-centered care, and the use of the latest treatment technologies distinguishes us in the field of cardiovascular and thoracic surgery. We are dedicated to providing personalized care that addresses the specific needs of each patient, ensuring the best possible health outcomes.
Preparing for your consultation involves gathering any relevant medical records, a list of current medications, and a summary of your medical history. It’s also helpful to write down any symptoms or questions you have, to ensure all your concerns are addressed during the consultation.
As with any medical procedure, there are potential risks involved. Our team takes comprehensive measures to minimize these risks, which may include infection, bleeding, or reactions to anesthesia. We conduct thorough pre-procedure evaluations and utilize state-of-the-art surgical techniques to ensure patient safety.
Yes, depending on your condition and treatment, we may suggest lifestyle adjustments such as dietary changes, increased physical activity, quitting smoking, or managing stress. These changes are aimed at improving your cardiovascular health and preventing future complications.
Managing your heart health involves adhering to the treatment plan outlined by your care team, including taking prescribed medications, attending follow-up appointments, and making recommended lifestyle changes. We also encourage patients to maintain a heart-healthy diet, engage in regular physical activity as advised, avoid smoking, and regularly monitor heart health metrics like blood pressure and cholesterol levels.
