Exploring a top driver of employer healthcare costs: heart surgery

Chances are, you likely haven’t heard someone casually mention they’re having “minimally invasive mitral valve repair with annuloplasty.” But you probably have heard someone say they’re having “heart surgery.”

Heart surgery is surprisingly common. The United States has a high number of cardiac surgeons compared to other countries, with thousands of heart surgeries performed every single day.

But while heart surgery is prevalent, it’s not entirely understood—especially since it’s a blanket term for a variety of different procedures. So, let’s take a closer look at the different reasons why someone might need heart surgery.

5 reasons someone might get heart surgery

1. Aortic aneurysm

An aortic aneurysm is a bulge or ballooning of the aorta, which is the main artery that carries blood away from the heart to the rest of the body. If it’s not addressed, this aneurysm can allow blood to leak between the layers of the artery wall or burst completely, which causes internal bleeding.

Much like many other types of heart problems, these aneurysms are most common in the older population (people over 65). Men are at greater risk of aortic aneurysms than women, and white men, in particular, have the highest risk level—especially if they smoke or previously smoked.

There are two types of aortic aneurysms:

• Abdominal aortic aneurysm (AAA): Occurs in the lower portion of the aorta, near the abdomen
• Thoracic aortic aneurysm (TAA): Occurs in the upper part of the aorta, near the chest

Surgery is recommended for aneurysms that are large (bigger than two inches in diameter), growing quickly, or causing pain and symptoms. The type of surgery a person will need depends on the type and location of their aneurysm. However, the most common procedures to address or remove aneurysms are open surgery of the chest or abdomen or an endovascular aneurysm repair (EVAR), which uses a smaller incision and a catheter.

2. Coronary heart or artery disease

Heart disease is the leading cause of death in the United States—and that holds true across different racial and ethnic groups. Men are at greater risk of heart disease, but lifestyle factors like smoking, high blood pressure, obesity, and diabetes also increase risk.

Coronary heart disease (CHD) and coronary artery disease (CAD) are often used interchangeably, but there’s a slight difference between the two. With CAD, plaque grows in the walls of the coronary arteries, the vessels that supply blood to the heart muscle. This restricts blood flow and prevents the heart from receiving enough blood, causing heart disease. Put simply, CAD is the cause and CHD is the result.

When people experience chest pain, heart attacks, multiple blocked arteries, or heart failure, they typically need surgery. In most cases, this means a coronary artery bypass graft (CABG), a procedure that addresses the blockage or narrowing of the arteries. During this procedure, the surgeon opens the chest, stops the heart, uses a bypass machine to pump blood while the heart is stopped, and inserts tubes into the heart to improve blood flow.

3. Heart valve problems

There are four heart valves, all of which regulate blood flow. They open to allow blood in and close to keep blood from flowing backward into different atriums or ventricles.

Heart valve problems happen when one or more of the valves don’t work the way they’re supposed to, which affects blood flow in the body. There are several different types of heart valve problems:

• Stenosis: The valve narrows and doesn’t open correctly, which restricts blood flow
• Regurgitation: The valve doesn’t close correctly, which causes blood to leak backward
• Prolapse: The valve flaps bulge or collapse, which leads to regurgitation

These issues can cause symptoms like fatigue, chest pain, shortness of breath, or irregular heartbeats. They also increase the risk of heart failure, blood clots, stroke, and even death.

People can be born with heart valve problems. However, the majority of these problems occur in older people, those who have had a previous heart attack or heart disease, or those who have high blood pressure, cholesterol, blood pressure, or other risk factors for heart disease.

Surgery is frequently used to treat heart valve problems. Common options include:

• Commissurotomy: Addresses a tight valve by cutting the valve flaps to loosen it
• Annuloplasty: Addresses a leaky valve by using sutures and a device to help the valve close more tightly
• Valvulotomy: Addresses narrow heart valves using a balloon to increase blood flow

The exact type of procedure used to repair or replace faulty valves depends on the specific issue a person is dealing with.

4. Heart rhythm disorders

Abnormal heart rhythms (frequently called arrhythmia) occur when the heart beats too fast, too slow, or irregularly. There’s a wide variety of types and causes of fast, slow, or premature heartbeats. For example, you might’ve heard of tachycardia (a fast heartbeat) or bradycardia (a slow heartbeat).

Much like with most other heart problems, age, family history, health conditions, and lifestyle habits have the biggest impact on whether a person will deal with a heart rhythm disorder.

Some arrhythmias can be controlled and treated with medications, but others require surgery. There are several different types of procedures for this—many of which use devices that are implanted in the chest and help control the heart rhythm.

5. Heart failure

The term “heart failure” might make you think that the heart isn’t working at all—in reality, it’s not working correctly. This can happen when any of the above heart conditions are left untreated. Over time, the heart muscle is weakened, which means it can’t pump enough blood to the rest of the body.

Age, family history, and lifestyle all play a role here. However, race matters too. Black people, for example, are at greater risk of heart failure, experiencing more cases and at a younger age.

The type of surgery used to treat heart failure varies based on what is causing the weakening of the heart muscle. From valve replacements to implantable devices, there’s a large variety of procedures that can help.

Heart surgery with Carrum Health

The United States has some of the best access to cardiac surgery compared to the rest of the world. But, even so, there are still major barriers to care for many patients. Cost can be a big one, with an estimated cost for heart surgery ranging from $35,000 to $85,000.

Carrum Health can help you ensure that your employees get the affordable, high-quality care they need and deserve—and employers save money as well. Carrum partners with value-based centers of excellence to provide specialty care and procedures, including heart surgery.

Carrum takes the pain out of finding and accessing quality cardiovascular care so that your employees can focus all of their focus and energy on the heart of the matter: their health.

Learn more about how employers can partner with Carrum Health here.

The information contained on this page is for informational purposes only. No material is intended to be a substitute for professional legal or medical advice, diagnosis, or treatment.