Cardiothoracic Surgery — Town Hospital
Town Hospital's Cardiothoracic Surgery department performs open-heart and thoracic surgery with the latest techniques and highest safety standards, supported by an integrated surgical and critical-care team.
What we treat
Cardiothoracic surgery at Town Hospital: an overview
Town Hospital's Cardiothoracic Surgery department in the Fifth Settlement, New Cairo, carries out the operations the heart, lungs and chest wall need when medicines or catheterisation are not enough: coronary bypass (open-heart surgery), valve repair or replacement, chest and lung surgery, and the treatment of fluid or air collecting around the lung. The department has a specialist cardiothoracic surgeon, whose details are in the list of doctors below.
Heart surgery sits inside one system: the Cardiology department does the first tests, the diagnostic and therapeutic cath lab is open 24 hours a day, operations take place in the hospital's operation theatres, and patients spend the first days afterwards in the intensive care and coronary care units. The emergency department, the laboratory and radiology, including the 128-slice CT scanner and the 3 Tesla MRI, run 24 hours a day. The outpatient clinics are open every day from 10 am to 10 pm, and the cardiothoracic surgery clinic's day and time are shown in the up-to-date clinic schedule.
How the decision to operate is made
Few patients come straight to a heart surgeon. The usual route starts with the cardiologist: a consultation, an ECG and an echocardiogram, then a diagnostic catheterisation that shows where the narrowing is and how many arteries are affected. For many people the story ends there, with medicines or a stent. When several arteries are involved, a stent is not a good fit, or there is also a weak heart muscle or a diseased valve, the "heart team" meets: the cardiologist, the cardiac surgeon and the anaesthetist review the images and tests together and put to you the option they judge most suitable, explaining its expected benefits, possible risks and the alternatives. The final decision is made together with you and your family, and it is not rushed.
Conditions the department looks after
The surgeon decides the type of operation and its timing after the consultation, the tests and the heart-team discussion. These are the conditions patients are most often referred with.
Narrowed coronary arteries and bypass surgery (CABG)
The coronary arteries carry blood to the heart muscle. When they narrow because of atherosclerosis, chest pain appears on exertion and a heart attack can follow. Many cases are treated with medicines or a stent placed by catheter, but when three arteries or the left main artery are affected, in some people with diabetes, or when stents are not enough, coronary artery bypass grafting (CABG) is usually the better option. The surgeon takes a blood vessel from inside the chest, the leg or the arm and builds a "bridge" that carries blood past the narrowing to the heart muscle. It is open-heart surgery under general anaesthetic, followed by a stay in intensive care before you move to a room. Read about angina: symptoms, causes and treatment.
Heart valve disease: repair or replacement
The heart has four valves that open and close with every beat. A valve may narrow so that it does not open well, or leak so that blood flows back through it, because of rheumatic fever in childhood, ageing, a defect from birth or an infection. It shows as breathlessness, tiredness or dizziness on exertion, or as a murmur heard with the stethoscope, and the echocardiogram measures how much it affects the heart. When the condition calls for an intervention, the surgeon prefers to repair the valve and keep it whenever possible; otherwise it is replaced with a mechanical or a tissue valve; each type suits a different age and situation and has its own blood-thinning needs. The heart team also discusses whether the case suits a catheter-based procedure instead of surgery.
Surgery of the chest and lungs
Thoracic surgery deals with diseases of the lung, of the membrane around it (the pleura) and of the mediastinum, the space between the lungs. This includes a biopsy of a mass in the lung or chest when imaging cannot say what it is, removing part of a lung for a disease confined to it, and draining pus that has collected around the lung after a severe pneumonia. Assessment usually starts with a chest X-ray and a CT scan, and the surgeon works with the chest physician and, when needed, the oncologist to decide the right route. The department also operates on lung tumours once the case has been assessed, the tumour staged and the plan discussed with the oncologist.
Fluid around the lung (pleural effusion)
Fluid can collect between the lung and the membrane around it because of a weak heart muscle, pneumonia, tuberculosis, liver or kidney disease or a tumour; it presses on the lung and causes breathlessness and a dry cough. It is diagnosed with a chest X-ray and ultrasound or a CT scan, and treatment depends on the cause. Some cases need only treatment of the underlying illness; others need the fluid drawn off with a needle, to analyse it and ease the breathing, or a chest drain; when it keeps coming back, a surgical procedure aims to stop it collecting again.
Air around the lung (pneumothorax)
A pneumothorax happens when air leaks into the space between the lung and the chest wall and the lung collapses. It can occur out of the blue in tall, slim young people and smokers, because of a lung disease, or after a chest injury, and it causes sudden pain on one side of the chest, worse on breathing in, with breathlessness. A chest X-ray makes the diagnosis. A small pneumothorax may need only observation and oxygen; many patients need a chest drain until the lung expands again, and when it recurs or the leak does not stop, surgery is offered to close the leak and fix the lung in place.
Chest injuries and chest-wall conditions
Road accidents and falls cause broken ribs and collections of blood or air inside the chest. Care for these injuries usually begins in the emergency department, and the thoracic surgeon joins in when the injury needs a chest drain or an operation. The department also looks after tumours and deformities of the chest wall, deciding after imaging whether a case needs an operation or only follow-up.
Chest twinges and pneumonia: when is it a job for the chest surgeon?
Most people looking up chest twinges or pneumonia do not need a surgeon. Short, sharp twinges that change with movement or with pressing on the chest usually come from the chest-wall muscles or cartilage, anxiety or acid reflux, and a cardiologist or physician assesses them first. Pneumonia is treated by the chest physician or the physician with antibiotics, rest and fluids; surgery is needed only when pus collects around the lung or an abscess does not respond to treatment, and the thoracic surgeon then drains it. Read about chest twinges and when chest pain is serious.
Tests and procedures in the hospital
- Heart tests: the ECG, echocardiogram, stress test and Holter monitor in the Cardiology department, the foundation of the decision to operate.
- Diagnostic catheterisation: in the cath lab, open 24 hours a day; it shows the coronary arteries in detail and tells whether a stent or surgery fits better.
- Imaging: the chest X-ray, the 128-slice CT scanner for images of the lungs, chest and arteries, and the 3 Tesla MRI when needed, all 24 hours a day.
- Laboratory tests: blood count, kidney and liver function, clotting, blood group and the rest of the pre-operative work-up, in a laboratory open 24 hours a day.
- Operation theatres: where open-heart and chest operations are carried out under general anaesthetic.
- Intensive care and coronary care: where you spend the first days after the operation under continuous monitoring of the heart and breathing.
Imaging and laboratory services are described on the Diagnostics page.
What to expect before and after the operation
In the days before the operation you have your blood tests and imaging, meet the anaesthetist and go through your medicines; you may be asked to stop certain blood thinners for a period the surgeon sets, and to stop smoking. Open-heart surgery usually takes a few hours, after which you go to intensive care still asleep and on a breathing machine until you wake gradually. Most patients spend one to three days in intensive care and about a week on the ward, where walking and breathing exercises start early because they lower the risk of complications. The breastbone takes six to twelve weeks to heal, so heavy lifting is off limits meanwhile; driving and returning to work are the surgeon's call, often within weeks to a couple of months. These times vary from one patient to another, and smaller chest operations need less.
When you need emergency care straight away
Call an ambulance or go to the nearest emergency department straight away for:
- Pressing or tight pain in the centre of the chest that lasts more than a few minutes, or spreads to the arm, jaw or back.
- Sudden severe breathlessness, or sharp pain on one side of the chest that is worse on breathing in, after an injury or with no clear cause.
- Coughing up blood, fainting, or blue lips.
- After heart or chest surgery: fever, redness or discharge from the wound, a painful swollen leg, a very fast heartbeat, or breathlessness that is getting worse.
Do not drive yourself if you think you may be having a heart attack, and do not wait for the symptoms to pass. Town Hospital's cath lab is open 24 hours a day.
Your care, step by step
- Consultation: most patients are referred by a cardiologist or chest physician. The surgeon reviews your symptoms, history, medicines and previous tests, and examines your heart and chest.
- Tests: the ECG, echocardiogram, diagnostic catheterisation, CT scan and blood tests your case needs, all done in the hospital.
- Decision: the heart team discusses your case, and the surgeon explains to you and your family the operation, its expected benefits, possible risks and the alternatives; the decision is made together.
- Preparation and surgery: a meeting with the anaesthetist, adjustment of your medicines and fasting before the operation, which then takes place in the operation theatres.
- Intensive care, then the ward: a few days in intensive care under continuous monitoring, then the move to a room, where walking, breathing exercises and wound care begin.
- Recovery and follow-up: follow-up with the surgeon and the cardiologist, a review of your medicines, including blood thinners and antiplatelet medicines for those who need them, and clear instructions on activity, diet and smoking; never stop a medicine on your own.
The hospital is contracted with more than 40 payers, including insurance companies, professional syndicates and government bodies, and cover depends on the payer and the terms of the contract.
What our patients say on Google
Five-star reviews written by Town patients and their families on Google Maps
A successful choice of Town Hospital from admission to discharge. A successful team, including reception, security, nursing, and doctors. Special thanks to Mr. Akrami, Dr. Mustafa Abdel Halim, the entire operating room team, and the ward …Translated by Google
A wonderful hospital! It was my first time there. The emergency service was outstanding. I want to thank Dr. Islam, Ms. Shaimaa, and Mr. Ahmed very much for their excellent treatment of my grandson and for convincing him to get checked …Translated by Google
I thank Dr. Mahmoud Shehata and the nursing staff, Saad Ayman Bassiouni and Professor Fawzi from the catheterization department, for their care before, during, and after the operation. I want to thank you from the bottom of my heart for …Translated by Google
A wonderful, quiet hospital where all the staff demonstrate a high level of professionalism; I highly recommend using their services.
A very reputable hospital, and Dr. Ahmed Saeed, a cardiologist, is extremely respectable and excellent. Mr. Ibrahim from the emergency department and Ms. Tayseer are also very, very respectful and cooperative.Translated by Google
The hospital is beautiful and quiet, the emergency room is clean, and the staff are cheerful. My regards to the lovely Ms. Tayseer for her kindness and excellent treatment of us, and to Mr. Saeed, an outstanding nurse who works …Translated by Google
Frequently Asked Questions
What is open-heart surgery, and when is it needed?
Open-heart surgery is any operation in which the chest is opened to reach the heart under general anaesthetic; the commonest kinds are coronary artery bypass and valve repair or replacement. It is considered when medicines or stents are not enough, for example a narrowing in several coronary arteries or in the left main artery, or a severely narrowed or leaking valve that is affecting the heart muscle. The decision follows the tests, a diagnostic catheterisation and a heart-team discussion between the cardiologist, the cardiac surgeon and the anaesthetist, and is then made together with you after the expected benefits, possible risks and alternatives have been explained.
What is the difference between a stent and bypass surgery, and who decides?
A stent is a small mesh tube placed by catheter through the wrist or the groin to widen a narrowed artery from the inside, without opening the chest; most people are back to normal life within days. Bypass surgery is open-heart surgery in which the surgeon builds a bridge from a blood vessel to carry blood past the narrowing. A stent usually suits a limited narrowing in one or two arteries, while surgery is often better when several arteries or the left main artery are affected, in some people with diabetes, or when the heart muscle is weak. The decision comes from the heart team, that is the cardiologist, the cardiac surgeon and the anaesthetist together, after the diagnostic catheterisation, not from a single doctor, and it is explained to you so that you take part in it.
How long will I be in intensive care, and when can I go home?
You leave the operating theatre for intensive care still asleep and on a breathing machine for some hours, and come off it once you are awake and breathing well. Most patients spend one to three days in intensive care under continuous monitoring of the heart and breathing, then about a week on the ward, where walking and breathing exercises start early. The length of stay depends on the type of operation, your general condition, age and other illnesses, and smaller chest operations usually need a shorter stay. The surgeon sets the discharge date once the heart and the wound are stable and you can move about and eat.
When can I drive and go back to work after heart surgery?
After open-heart surgery the breastbone takes six to twelve weeks to heal, during which heavy lifting and pushing are not allowed. Driving is also off limits in the first weeks, because the seat belt and the arm movements press on the wound and reactions are slower. The surgeon usually allows driving after about four to six weeks if recovery is going well, and a return to desk work at a similar time; heavy physical work needs longer. These are rough guides, and the surgeon's instructions at your follow-up visits are what count.
Do chest twinges need a heart surgeon?
Usually not. Short chest twinges that change with movement, deep breathing or pressing on the chest usually come from the chest-wall muscles or cartilage, anxiety or acid reflux, and are first assessed by a cardiologist or a physician with a consultation and an ECG. You are referred to a heart surgeon only if the tests and catheterisation show a narrowing of the arteries or a valve disease that needs an operation. Pressing pain in the centre of the chest that lasts more than a few minutes, or comes with breathlessness or heavy sweating, is not a twinge: call an ambulance or go to the nearest emergency department straight away.
Does pneumonia need surgery?
Pneumonia is treated by the chest physician or the physician with antibiotics, rest and fluids, and most people recover without any operation. The thoracic surgeon is involved in only a few cases, when pus collects around the lung or an abscess forms inside it and does not respond to medicines; it is then drained with a chest drain or a surgical procedure. Symptoms such as severe breathlessness, blue lips or coughing up blood need the nearest emergency department straight away.