CCHLS performs a number of important heart and lung procedures for patients throughout Central California. Advanced, specialized training and broad experience enable us to accomplish positive outcomes in some of the most complicated cases.
When coronary arteries—the arteries that deliver blood to your heart—become blocked, we may perform surgery to give the blood a new pathway to the heart.
During coronary artery bypass graft surgery (also called CABG, or “cabbage”) a blood vessel is removed or redirected from one area of the body and placed around the area or areas of narrowing to “bypass” the blockages and restore blood flow to the heart muscle. This vessel is called a graft.
Heart bypass surgery is among the most common operations performed in the U.S., with more than 500,000 performed each year.
Dr. Khwaja specializes in off-pump coronary artery bypass surgery for optimal patient care.
Off-pump or beating heart bypass surgery allows surgeons to perform surgery while the heart is still beating. The heart-lung machine is not used. Dr. Khwaja uses advanced operating equipment to stabilize (hold) portions of the heart and bypass the blocked artery. Meanwhile, the rest of the heart keeps pumping and circulating blood to the body.
Valve replacement surgery is an open-heart procedure in which the damaged heart valve is removed and replaced with a new valve.
During valve surgery, the doctor usually makes a large incision through the breastbone (sternum). Blood is circulated outside of the body through a machine to add oxygen to it (cardiopulmonary bypass or heart-lung machine). The damaged aortic valve is removed and replaced with an artificial heart valve.
Dr. Shams Khwaja specializes in a less invasive aortic valve replacement surgery using mini-sternotomy. In minimally invasive heart surgery, Dr. Khwaja makes an incision in the chest that is less than one-third the size used for conventional heart surgery [less than 4 inches]. The aortic valve is located near the front of the chest, so Dr. Khwaja has perfected surgery through this smaller opening.
Mitral valve repair surgery is an open heart surgery performed by Dr. Khwaja to treat problems with the mitral valve, including mitral valve stenosis and mitral valve regurgitation. With stenosis, the opening of the valve becomes narrowed, which decreases the amount of blood that can travel across the valve.
Dr. Khwaja uses different techniques to repair the mitral valve. With mitral valve stenosis, Dr. Khwaja may be able to open the valve using a balloon, known as balloon valvuloplasty.
Often the mitral valve becomes damaged to the point that surgery is necessary. Mitral valve repair techniques were refined during the 1970s and 1980s and are now the preferred method to fix problems with the mitral valve. The benefits of mitral valve repair vs. replacement include long lasting results with mitral valve repair without the need for blood thinners.
Minimally-invasive mitral valve repair techniques, including robotic mitral valve repair surgery, are associated with a shorter recovery time compared to traditional open heart surgery techniques.
Dr. Khwaja uses mitral valve repair to minimize recovery time and the need for blood thinners. Recovery after mitral valve repair is similar to other open heart surgeries, and most patients experience a return to full activity within 3 to 6 months.
Aortic valve-sparing procedures are alternative options to aortic valve replacement in patients with aortic root aneurysm and/or severe aortic regurgitation reducing the risk of prosthesis-related complications.
Dr. Khwaja keeps the patient’s aortic valve (although it may be repaired and re-implanted) and reconnects it to a new section of aortic tissue. By preserving the native aortic valve, patients avoid the need for lifelong anticoagulation therapy.
Endocarditis is an infection of the endocardium, which is the inner lining of your heart chambers and heart valves. Surgery for endocarditis is very specialized and demanding. It requires extensive experience and familiarity with different reconstructive methods, including the use of homografts (human cadaver valves).
Dr. Khwaja’s surgical treatment of infective endocarditis is performed to:
- Remove of all infected tissue
- Drain abscesses (collection of pus)
- Repair the heart tissue
- Repair or replace the affected valve
When the wall of a blood vessel weakens, a balloon-like dilation called an aneurysm sometimes develops. This happens most often in the abdominal aorta, an essential blood vessel that supplies blood to your legs.
For this surgery, Dr. Khwaja makes a large incision in the abdomen to expose the aorta. Once he has opened the abdomen, a graft can be used to repair the aneurysm.
Extrapleural pneumonectomy involves the removal of the entire diseased [cancerous] lung, the pleural lining of the chest wall, the diaphragm, and the pleural lining of the heart. Extrapleural pneumonectomy is a serious operation, only performed on patients in the early stages of before the cancer spreads to the lymph nodes and before it invades surrounding tissues and organs.
Dr. Khwaja performs a variety of minimally invasive procedures for conditions of the lungs, pleura [the lining of the lungs], and mediastinum [the partition between the lungs].
Compared to surgery performed through a long, open-chest incision, minimally invasive lung surgery provides several benefits for patients, including:
- Faster recovery and return to normal activities
- Shorter hospital stay
- Less pain
- Little scarring
- Minimal blood loss
- No cutting of the ribs or breastbone (sternum)
Dr. Khwaja offers a less invasive surgical approach—a video-assisted lobectomy—as treatment of early-stage lung cancer. A lobectomy removes a section of the lung.
This video-assisted thoracic surgery (VATS) technique reduces a patient’s hospital stay and the patient experiences a more rapid recovery with less pain after surgery as compared with the traditional incision into the chest wall [thoracotomy].
In surgery to remove all or part of a lung for lung cancer, Dr. Khwaja makes an incision on one side of your chest (thorax) during a procedure called a thoracotomy. Surgery that uses this approach avoids areas in the chest that contain the heart and the spinal cord.
Dr. Khwaja specializes in using the CyberKnife Robotic Radiosurgery System to provide a non-invasive alternative to surgery for the treatment of both cancerous and non-cancerous tumors.
Radiation therapy uses high-energy X-rays to kill cancer cells and shrink tumors.
The CyberKnife System is the world’s first and only robotic radiosurgery system designed to treat tumors throughout the body non-invasively. It provides a pain-free, non-surgical option for patients who have inoperable or surgically complex tumors, or who may want an alternative to surgery.
Corrective surgeries for congenital heart defects fix or treat defects that a child is born with. A baby born with heart defects has congenital heart disease. Surgery is needed if the defects are dangerous to the child’s health or well-being.
If the condition is not treated during childhood, it can be difficult to find non-pediatric surgeons with expertise in congenital heart surgery. Dr. Khwaja specializes in adult congenital heart surgery.
Types of Congenital Heart Surgery
Surgery becomes necessary when non-invasive procedures fail to correct a heart defect. Dr. Khwaja performs both types of congenital heart surgery:
- Reparative congenital heart surgery is a procedure used to correct the heart defect.
- Palliative congenital heart surgery is a surgical procedure that relieves pain but doesn’t necessarily correct the actual defect.
Bloodless surgery refers to the use of no donated blood during and after the surgery. People refuse blood transfusion for many reasons. For example, Jehovah’s Witnesses reject blood transfusions on religious grounds.
In surgery, Dr. Khwaja must control bleeding meticulously and, when feasible, apply minimally invasive surgical techniques. Instead of donated blood, blood substitutes may be used. During bloodless surgery, the blood from the patient is collected and is given back to the patient, this technique is called blood salvage or cell saver technique. In some cases, patients may also donate their blood for use during the surgery.
The da Vinci Robotic Surgery system is the least invasive approach for surgical removal of primary malignant, metastatic, and benign lesions of the peripheral and central lung.
Dr. Khwaja uses da Vinci for precise anatomical resection as well as complete mediastinal lymph node dissection. This approach provides effective treatment without the need for a formal thoracotomy (open) or an access thoracotomy (VATS).
An aortic aneurysm is a bulging, dilation or ballooning in the wall of a blood vessel, usually an artery, that is due to weakness or degeneration that develops in a portion of the artery wall.
Repair of an abdominal aortic aneurysm may be performed surgically through an open incision or in a minimally-invasive procedure called endovascular aneurysm repair (EVAR). In the EVAR procedure, a stent graft (a fabric tube supported by metal wire stents that reinforces the weak spot in the aorta) is inserted into the aneurysm through small incisions in the groin.