Coming from a hospital in the United States that frequently dealt with such issues, Dr. Pattakos has a great deal of experience dealing with problems or complications stemming from a previous operation at another hospital.  Examples include:

Sternal infection/Mediastinitis: This occurs in a small percentage of heart operations but there is an increased risk of it occurring in cases where both internal mammary arteries were used for bypass surgery, especially if the patient was diabetic or overweight. Treatment consists of surgical removal of dead and infected tissues, possible removal of sternal wires, and possible use of a pectoralis muscle flap in coordination with a plastic surgeon.

Paravalvular leak: When placing a heart valve surgically or even with transcatheter methods there may be a point where the valve is not in good contact with the heart tissues.  Through these “gaps” blood can flow around the heart valve instead of through the heart valve.  This is called a paravalvular leak.  These may be treated using a catheter that will place a “plug” into the “gap” or it may require an open operation to surgically repair the problematic area.

Aortic aneurysms and aortic dissections: In the case of acute aortic dissections the goal of the surgeon is to save the patient’s life by restoring proper blood flow through the aorta.  In certain cases after such an operation there may remain a portion of the aorta that still has a tear or an aneurysmal growth.  This will require an additional future operation to repair the problematic section of aorta.  This may either be carried out with open surgery or with a transcatheter approach that only requires a small puncture in the groin.  A second possible problem is a remaining aortic valve dysfunction which can frequently be treated with a transcatheter valve replacement using the TAVI method. 

Bypass grafts “down” or “closed” after previous coronary artery bypass surgery: Many years after a coronary artery bypass some of the bypass grafts may have lost their blood flow. Treatment for this condition may come with either a stent to open the blockages inside the bypass graft or by open surgical placement of new bypass grafts.  

Complications from a device used for closure of an atrial septal defect: Many atrial septal defects (“holes” between two portions of the heart) are closed using a special transcatheter device that plugs the hole.  In certain circumstances these devices may puncture adjacent portions of the heart such as the aorta and cause an abnormal communication.  This will usually require an open surgical repair of the problematic area.  
For examples of such cases please see the section on LECTURES AND INTERVIEWS
Attending Surgeon 2nd Department of Cardiac Surgery
Assistant Director Division of Transcatheter Heart Valves

Erithrou Stavrou 4, Marousi
210 6867639, 210 6867640
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