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Coronary Interventional Procedures (Angioplasty/ Stent)
Coronary Interventional Procedures (Angioplasty/ Stent)
Coronary interventional procedures include angioplasty (PTCA), stent, and atherectomy.
Angioplasty (PTCA) is a medical procedure in which a balloon is used to open narrowed or blocked coronary arteries (blood vessels of the heart).
A stent is a flexible coil of mesh that is inserted into a patient's coronary artery to keep that artery open so that blood can pass through it easily. A stent is placed as part of a balloon angioplasty procedure.
Atherectomy is a procedure for treating coronary blood vessels that are narrowed or completely blocked. The procedure is used to increase or restore blood flow through the artery. During the procedure, a blade is introduced into the narrowed area to shave plaque (a thickened area within a blood vessel) away from the vessel wall.
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Heart Bypass Surgery
Heart Bypass Surgery
Heart bypass surgery or coronary artery bypass grafting is a surgical procedure in which a section of a coronary artery, which has been partially or completely blocked, is bypassed by transplanting a healthy section of blood vessel around the diseased area. The conduit to route blood around the obstructed area may be an artery or a vein. There is some information that arteries may have a better long-term patency rate (chance of staying open for years) than veins. The arteries and veins used for the bypass procedure are taken from the patient's own body; they may be harvested from within the chest, the arms or the legs.
A coronary artery bypass is performed by a cardiac surgeon who makes an incision in the patient's chest to expose the patient's heart. Incisions may also be made in the legs or the arms to obtain a vein or artery for the bypass. The patient is connected to a heart-lung machine that takes over the function of the heart and lungs while the surgeon works on the heart. An opening is made in the diseased artery or arteries above and below the blockage. A section of artery or vein is then sewn to the points above and below the blockage in the affected artery, effectively providing a detour around the obstruction. At the conclusion of the bypass procedure, the heart-lung machine is disconnected, allowing blood to flow back through the heart, and the incision is closed.
Most bypass operations are performed by dividing the breastbone to provide access to the heart. Some bypass operations are now performed through "limited" incisions made either between the ribs or partially through the breastbone, with or without the use of the heart-lung machine.
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Heart Failure
Heart Failure
Heart failure refers to a condition in which the heart does not pump efficiently, and consequently, it is unable to circulate enough blood to meet the needs of the body. Inefficient pumping also causes the blood returning to the heart to back up in the veins, which can cause an accumulation of fluid in the tissues and lungs. Because many of these symptoms of heart failure are caused by the congestion of the tissues and lungs with fluid, it is frequently called congestive heart failure.
The most common causes of heart failure in the U.S. are:
Coronary artery disease – The narrowing of the arteries due to plaque buildup.
Cardiomyopathy – A disease of the heart muscle that causes the heart to lose its pumping efficiency.
High blood pressure
Disease of the heart valves
The most frequently reported symptoms of heart failure are: fatigue with exertion, shortness of breath especially when lying down, and general fatigue. Heart failure can be treated in a variety of ways, depending upon the cause of the failure, including coronary bypass surgery, valve replacement surgery, or heart transplantation.
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Back and Neck Surgery (except Spinal Fusion)
Back and Neck Surgery (except Spinal Fusion)
Back and Neck Surgery involves surgical procedures of problems related to the spine bone (vertebrae) including prolapsed disks affecting nerve roots and surrounding tissues. Disk prolapse is a common, painful disorder of the spine in which an intervertebral disk (a disk situated between two vertebrae) protrudes or ruptures. This rupture often causes a painful and at times disabling pressure on a nerve.
This group of surgical procedures includes decompression, laminectomy, and discectomy.
Decompression refers to a surgical procedure to alleviate pressure on the spinal cord or on a nerve root emerging from the cord.
Laminectomy is the removal of the bony arches of one or more vertebrae to expose the affected part of the cord or nerve roots. This procedure is typically used when pressure is caused by a tumor or abscess in a vertebra.
Discectomy is performed to treat spinal disk prolapse. A small incision is made and the offending disk material is removed. This decreases the pressure on the nerve, and consequently, relieves the pain caused by a prolapsed disk.
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Back and Neck Surgery (Spinal Fusion)
Back and Neck Surgery (Spinal Fusion)
Spinal fusion is the surgical treatment of problems related to the spine bone (vertebrae) caused by injury or abnormal curvatures (scoliosis or kyphosis). The surgery stabilizes (fuses) vertebrae together with bone grafts or metal rods. The most common spinal area involved is the lower (lumbar) spine, but upper (cervical) spine involvement can occur.
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Hip Fracture Repair
Hip Fracture Repair
Hip fracture repair surgery repositions the bone fragments resulting from a displaced fracture back into their normal alignment. These newly repositioned fragments are held to the underlying bone with the use of special metal plates and screws.
An intramedullary (IM) rod may also be used to hold the bone fragments in place. This rod is inserted into the center marrow compartment of the long thigh bone (femur).
The goal of hip fracture repair surgery is to allow the fracture to heal to maximize the likelihood of restoring full function to the joint and to relieve pain. Procedures for partial hip replacement are also included in this category of hip fracture repair.
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Total Hip Replacement
Total Hip Replacement
Total hip replacement surgery is performed to replace a diseased hip joint with an artificial hip joint. The surgery is done to free patients from stiffness and pain caused by osteoarthritis (a degenerative joint disease and the most common form of arthritis) and rheumatoid arthritis (a chronic autoimmune disease that occurs when antibodies in the blood system designed to attack viruses and infections mistakenly target the body's own healthy tissues).
Total hip replacement surgery is performed by an orthopedic surgeon who makes an incision in the patient’s hip, removes the diseased joint, and replaces it with the artificial hip joint. In some cases, total hip replacement surgery has to be repeated or "revised." For the ratings analysis, HealthGrades only includes initial procedures, which indicate that the hip replacement procedure is being performed for the first time on a particular patient.
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Total Knee Replacement
Total Knee Replacement
Total knee replacement is performed to replace a diseased knee joint with an artificial knee joint. The surgery is done to free patients from stiffness and pain caused by osteoarthritis (a degenerative joint disease and the most common form of arthritis) and rheumatoid arthritis (a chronic autoimmune disease that occurs when antibodies in the blood system designed to attack viruses and infections mistakenly target the body's own healthy tissues).
Total knee replacement surgery is performed by an orthopedic surgeon who makes an incision in the patient’s knee, removes the diseased joint, and replaces it with the artificial knee joint. In some cases, total knee replacement surgery has to be repeated or "revised." For the ratings analysis, HealthGrades considers only initial procedures, which indicates that the knee replacement procedure is being performed for the first time on a particular patient.
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Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD) is a group of diseases that includes chronic bronchitis, emphysema, and asthmatic bronchitis. The common characteristic of these diseases is obstruction to airflow out of the lungs, and the common symptom is shortness of breath. In the U.S., an estimated 90 percent of COPD is due to smoking. Treatment includes absolute avoidance of smoking, and bronchodilators and oxygen for those with advanced disease.
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Pneumonia
Pneumonia
Pneumonia is also called viral pneumonia, community-acquired pneumonia, or simple pneumonia. It is caused by one of several viruses including varicella (chickenpox), influenza, and adenovirus.
Pneumonia is not a single disease, but the name for several types of lung inflammation caused by infectious organisms. Pneumonia is the sixth most common cause of death in the U.S., primarily because it is a common complication of any serious illness. It is more common in males, during infancy and old age, and in those who have reduced immunity to infection. The symptoms, treatment, and outcome vary greatly, depending on the cause and on the general health of the patient.
Symptoms may include fever, headache, chills, weakness, chest pain, and a cough that produces sputum and occasionally blood. Potential complications include pleural effusion (fluid around the lung), empyema (pus in the pleural cavity), and, rarely, an abscess in the lung.
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Appendectomy
Appendectomy
An appendectomy is the surgical removal of an inflamed appendix. The appendix is a small, fingerlike pouch that projects from the first part of the colon. Removal is done either by abdominal incision or laparoscope, with the patient asleep under general anesthesia. The hospital stay is typically one to three days.
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Bowel Obstruction
Bowel Obstruction
A bowel obstruction is a blockage of the bowel (intestine), preventing passage of material. The bowel is a long tube-shaped organ in the abdomen that completes digestion. Common symptoms include constipation, abdominal swelling, and abdominal pain. Treatment includes intravenous fluids, rest, nasogastric suction, and in some cases, surgery.
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Carotid Surgery
Carotid Surgery
Carotid surgery is a surgical procedure to remove the lining and fatty obstruction of a carotid artery that has been narrowed by atherosclerosis. Atherosclerosis is the narrowing of arteries usually due to the buildup of fatty tissue. The largest and most common clinical problems associated with atherosclerosis of a carotid artery are stroke or transient ischemic attack (TIA).
A carotid surgery restores normal blood flow to the brain, reducing stroke or TIA risk. Before surgery, the site of narrowing is located by means of an x-ray procedure called angiography.
Carotid surgery is a delicate procedure that may take several hours to perform. The procedure is performed in a hospital setting with general anesthesia. The artery is exposed, clamps are applied, an incision is made, and the diseased lining is removed along with the atherosclerotic material and any thrombus (blood clot) that has formed. The incision is closed with stitches. Most patients are able to leave the hospital within a day or two.
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Cholecystectomy
Cholecystectomy
A cholecystectomy is the surgical removal of the gallbladder. The gallbladder is a digestive organ that stores bile produced by the liver. Bile is used in the digestion and absorption of fats in the duodenum. Removal of the gallbladder is done by incision or laparoscopy.
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Diabetic Acidosis and Coma
Diabetic Acidosis and Coma
Diabetes refers to any of several disorders where a lack of insulin leads to the uncontrolled metabolism of carbohydrates. Diabetic acidosis is a complication of diabetes caused by the buildup of by-products of fat metabolism, which occurs when glucose is not available as a fuel source for the body. When glucose is not available, body fat is broken down instead. The by-products of fat metabolism are ketones. When fat is metabolized, ketones build up in the blood and "spill" over into the urine. A condition called ketoacidosis (or acidosis) develops when the blood becomes more acidic than body tissues. Severe diabetic acidosis can result in decreased consciousness (or coma).
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Gastrointestinal Bleed
Gastrointestinal Bleed
Gastrointestinal bleed refers to bleeding that occurs along the gastrointestinal tract, which includes the esophagus, stomach, duodenum, intestines, rectum, and anus. It is a symptom of a disease rather than a disease itself. The cause may not be serious, but locating the source of bleeding is important. Most causes of bleeding are related to conditions that can be cured or controlled, such as ulcers or hemorrhoids.
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Gastrointestinal Surgeries and Procedures
Gastrointestinal Surgeries and Procedures
Gastrointestinal surgeries are operations to correct problems relating to the stomach, large intestines, and small intestines. Gastrointestinal procedures are processes used to correct problems relating to the same areas. Gastrointestinal surgeries and procedures include gastrectomies, vagotomies, gastric repairs, small and large intestine resections, small and large intestine anastomoses.
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Pancreatitis
Pancreatitis
Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the upper part of the small intestine. It secretes digestive enzymes into the small intestine. It also releases hormones into the bloodstream to help the body convert glucose from food into energy. Most acute pancreatitis cases are caused by alcohol abuse or gallstones.
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Peripheral Vascular Bypass
Peripheral Vascular Bypass
Peripheral Vascular Disease (PVD) refers to circulatory disease outside of the heart. Patients with coronary artery disease often have underlying PVD. Peripheral vascular bypass grafting is a surgical procedure in which a section of an artery that has been partially or completely blocked is bypassed by transplanting a healthy section of blood vessel around the diseased area.
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Prostatectomy
Prostatectomy
A prostatectomy is the surgical removal of all or part of the prostate gland. The prostate gland is a gland in the male that surrounds the neck of the bladder and urethra. The prostate contributes to seminal fluid. After this surgery, sperm enters the bladder rather than the urethra.
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Pulmonary Embolism
Pulmonary Embolism
Pulmonary embolism, also referred to as a blood clot of the lung, causes a blockage of a pulmonary artery (a tube that carries deoxygenated blood from the heart to the lungs). A blood clot is a semisolid mass consisting of coagulated red and white blood cells.
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Resection/Replacement of Abdominal Aorta
Resection/Replacement of Abdominal Aorta
This surgical procedure is performed to remove an abdominal aortic aneurysm (AAA). An aneurysm is the ballooning of an artery due to the pressure of blood flowing through a weakened area. The abdominal aorta carries blood to the kidneys and the abdominal and pelvic organs.
An abdominal aortic aneurysm is most commonly caused by atherosclerosis (the narrowing of arteries due to the buildup of fatty tissue). An abdominal aortic aneurysm can rupture, causing significant and sometimes fatal blood loss. Angiography (an X-ray procedure) or ultrasound is used to diagnose AAA.
Resection/replacement of an abdominal aorta may be performed on an elective or emergency basis.
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Respiratory Failure
Respiratory Failure
Respiratory failure occurs when the body is not providing enough oxygen to the cells and is not removing excess carbon dioxide from the cells. Failure may be acute or chronic. Some causes are asthma, emphysema, chronic bronchitis, cystic fibrosis, radiation sickness, and leukemia.
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Sepsis
Sepsis
Sepsis is a toxic condition caused by the presence of microorganisms or their poisonous products in the bloodstream. Pulse and respiration usually rise, accompanied by headache, pains, malaise, loss of appetite, concentrated and diminished urine, constipation, restlessness, insomnia, and irritability.
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Stroke
Stroke
Stroke, also known as Cerebral Vascular Accident (CVA), is the result of a sudden reduction of blood flow to an area of the brain. When this happens, sensation, movement, abilities, or functions controlled by that area of the brain become impaired or lost. About 90 percent of strokes are ischemic infarctions (a sudden clot or buildup within the brain) and 10 percent are hemorrhagic (a rupture or breakage of a blood vessel within the brain).
For most strokes, symptoms develop within a few minutes to an hour and continue for more than 24 hours; the effects are permanent in some cases. The eventual amount of neurologic damage depends on age, state of health, and the size and location of the stroke. In the U.S., approximately 200 people per 100,000 population will experience a stroke. The incidence increases dramatically with age and is higher in men than in women. Multiple strokes are common.
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