Cardiothoracic and vascular treatment procedures and interventions

In addition to non-invasive treatment methods, ProHealth Care performs more heart surgeries in Waukesha County than any other provider.

Procedures performed at ProHealth Care include:

AAA stent grafting (abdominal aortic aneurysm repair)

An aneurysm in the aorta can weaken the walls of the blood vessel to the point where if the aneurysm bursts, it could cause fatal internal bleeding. AAA stent grafting uses an endovascular stent graft to reinforce the wall of the aorta and to help keep the damaged area from rupturing. The stent graft is placed inside of the aortic aneurysm with the help of a catheter.

Aneurysm surgery

Open surgery and the minimally invasive procedure called endovascular repair are two options for repairing an aneurysm. The choice of repair can depend on the size and location of the aneurysm.

Angioplasty & cardiac stent placement

Angioplasty is used to clear the blockage that occurs in the arteries as a result of plaque build up. The fatty deposits built up in the arteries is also known as arthersclerosis. To open the narrowed or blocked arteries, a thin, flexible tube (catheter) with a balloon at its tip is threaded through a blood vessel to the affected artery. Once in place, the balloon is inflated to compress the plaque against the artery wall restoring blood flow. With stenting, the same procedure is followed with the difference being that a stent (typically made of metal framework) is inserted after the balloon is inflated to help keep the walls of the artery open.

Aortic femoral bypass

The aortic femoral bypass is used when plaque build up interferes with blood flow to the legs, also known as peripheral artery disease. To improve the circulation to the legs, a surgical bypass is performed to get around the blockage in the artery.  If the blockage is in the arteries in the pelvis, the bypass runs from the aorta in the abdomen to the femoral arteries in the groin.  If the blockage is in the artery of the thigh, the bypass runs from the femoral artery in the groin down to the popliteal artery behind the knee.  If the blockage is more extensive, then the bypass may run from the femoral artery in the groin down to the arteries in the calf.


Unlike stenting or angioplasty which pushes plaque to the outer walls of the artery, artherectomy is a minimally invasive procedure that uses special tools to remove fatty deposits (plaque) from the artery walls.

Atrial fibrillation surgery (MAZE and Minimaze procedures)

Atrial fibrillation occurs when the normal "pacemaker" of the heart is not working properly. It's when the electrical impulse that typically travels smoothly across the nodes of the heart triggering the ventricular areas to contract in a coordinated manner gets side-tracked, causing irregular beating. The MAZE procedure is surgical procedure that cuts off the other maze-like pathways for the electrical impulse to take and forces it to travel through one single path as it should.

Atrial Septal Defect Repair

An atrial septal defect is typically a hole in the wall that separates the heart's left and right atria. This hole allows for oxygen-rich blood from the left atrium to mix with the oxygen poor blood in the right atrium which can result in lower than normal oxygen level in the blood. Repairing the defect involves an endoscopic procedure that patches the hole using tissue from the pericardial sac around the heart.

AV Fistula Catheter insertion

An arteriovenous fistula catheter is typically used for hemodialysis related to kidney disease. The fistula is inserted directly into an artery or vein and becomes a natural part of the body.

Axillofemoral bypass

An axillofemoral bypass is a grafting procedure that bypasses blocked arteries using an artificial artery inserted from the collar bone area to an artery in the leg in order to restore blood flow to the lower extremities

Carotid surgery

Carotid artery surgery is performed to clear the carotid artery of plaque build up and restore blood flow to the brain

Catheter ablation

Catheter ablation is used to help correct an arrhythmia or irregular heart beat. Through catheters inserted at various points of the body, the procedure uses radio waves to produce heat that destroys small areas of heart tissue where abnormal heartbeats may cause an arrhythmia..

Convergent procedure

The convergent procedure is used to treat atrial fibrillation by combining the skills of an electrophysiologist and a cardiothoracic surgeon. Through a tiny incision in the lower chest, the surgeon uses radiofrequency ablation (targeted heat) to destroy tissue in problem areas on the back wall of the left atrium of the beating heart. Four to six weeks later, an electrophysiologist threads a catheter inside of the heart. Using radiofrequency ablation, the electrophysiologist destroys problematic tissue inside of the heart and performs tests to check for any remaining abnormal electrical impulses. To learn more, watch a video on the procedure.


Cryoablation is used to correct arrhythmias (irregular heart beats) by freezing tissue or heart pathways that interfere with the heart's normal distribution of electrical impulses that control the heart's beating.


Emboli are abnormal masses of material (solid, liquid or gas) that are carried in the blood stream from one area to another causing blood vessel blockage and depleting oxygen supply. The most common type of emboli are blood clots. During an embolectomy, the blockage is cleared using balloon, aspiration or surgical methods.


Endarterectomy is a general term referencing a surgical procedure for removing plaque build up in an artery.

Endovascular grafting & surgery

Over time, blood pressure and other factors can cause a weak spot in an artery to bulge like a balloon and eventually rupture. This bulge is called an aneurysm. An endovascular stent graft is placed inside the aneurysm to help prevent rupture. The stent is stronger than the weakened artery and allows blood to pass through it without pushing on the bulge.


An esophagectomy is a surgery performed to remove part or all of the esophagus. It is most often performed to treat esophageal cancer. When removed, the esophagus is rebuilt using parts of the stomach and lower intestine.

Femoral tibial bypass

A femoral-tibial bypass is used to bypass a blocked artery near the knee. The bypass restores blood flow to the lower leg and foo by connecting the common femoral artery near the hip to a tibial artery in the lower leg.


A fistulagram is an X-ray procedure used to look at blood flow and to check for blood clots or other blockages in your fistula. A fistula is a plastic tube connecting a vein to an artery. 

Implant procedures (closure devices, defibrillators, pacemakers)

There are a number of implant procedures that can be performed related to cardiothoracic and vascular care. Cardiac closure devices are often used to treat the defect of a hole in the heart. These implant devices are most often inserted using a catheterization procedure. 

Defibrillators and pacemakers are electronic devices implanted in the chest or abdomen to treat dangerous arrhythmias. Defibrillation is a process in which an electronic device gives an electric shock to the heart. This helps reestablish normal contraction rhythms in a heart having dangerous arrhythmia or in cardiac arrest.

Lead extraction

A lead is a special wire that delivers energy from a pacemaker or implantable cardioverter defibrillator (ICD) to the heart muscle.Sometimes the effectiveness of the lead is compromised due to infection or excessive scar tissue. A lead extraction involves inserting a plastic sheath or tube through a small incision, threading it through to the lead and then extracting it.


The LifeVest™ is a personal defibrillator worn on the outside of the body by a patient at risk for sudden cardiac arrest. It monitors the patient’s heart continuously and delivers shock treatments to restore the heart's normal rhythm if the patient goes into a life-threatening arrhythmia

Limb salvage surgery

In situations of severe injury or possible amputation of limbs, our cardiothoracic and vascular surgeons assist in helping to preserve nearby blood vessels so as to give the patient the greatest possible level of function.


Mediastinoscopy is a procedure in which a small instrument with a light (mediastinoscope) is inserted in the space in the chest between the lungs (mediastinum)

Minimally invasive thoracoscopy or VATS (video-assisted thoracic surgery)

Minimally invasive thoracoscopy is surgery of the chest that is performed with the help of a small video-scope, small incisions and special instruments to minimize trauma. This procedure is also sometimes known as pleuroscopy or VATS (video-assisted thoracic surgery).

Minimally invasive heart surgery and STAR (small thoracotomy arterial revascularization)

Minimally invasive heart surgery is performed through small incisions rather than breaking the breast bone and working on the heart through an open chest cavity. Using the Small Thoractotomy Arterial Revascularization (STAR) procedure to restore blood flow is one type of such minimally invasive procedure. 

Off-pump coronary bypass

Off-pump coronary artery bypass, otherwise known as "beating heart" surgery, is performed without the use of a heart-lung machine. During traditional bypass surgery, the heart is stopped and the heart-lung machine resumes the work of the heart and lung. During off-pump bypass, the heart continues to beat as the surgeon performs the procedure of grafting arteries to bypass the area of blockage.


Usually performed with the assistance of ultrasound technology, pericardiocentesis is the insertion of a needle to alleviate fluid build up in the sac (pericardium) around the heart.

Peripheral vascular surgery

Peripheral vascular surgery is the surgical rerouting of blood flow around an obstructed artery that supplies blood to the legs and feet. This surgery is performed when the buildup of fatty deposits (plaque) in an artery has blocked the normal flow of blood that carries oxygen and nutrients to the lower extremities.

Pulmonary vein isolation ablation

Pulmonary vein isolation ablation regulates your heart rate by stopping the fast, irregular impulses from the atria, the upper chambers reaching the ventricles, the lower chambers. Pulmonary veins carry blood from the lungs back to the left atrium of the heart. There is a narrow band of muscle tissue around each of the pulmonary veins near to the opening of the left atrium that may trigger the extra electrical signals causing atrial fibrillation. Pulmonary vein isolation is a catheter ablation technique whereby radiofrequency energy is used to destroy this small area of tissue.

Radiofrequency ablation

Radiofrequency energy (heat energy) is used in heart tissue or normal parts to destroy abnormal electrical pathways that are contributing to a cardiac arrhythmia. The ablation is performed through an energy-emitting probe (electrode) that is at the tip of a catheter which is placed into the heart, usually through a vein. 

Stereotaxis catheterization

Stereotaxis Robotic Navigation uses a magnetic field at the tip of a catheter to steer the catheter's location during a catheter ablation procedure.

Thoracotomy for benign and malignant conditions

A thoracotomy is a major surgical procedure that opens the chest so that surgeons can have access to the thoracic organs (heart, lungs, esophagus).


A thrombectomy is a procedure performed to remove a blood clot that is blocking blood circulation.

Traditional bypass

During traditional coronary bypass surgery, a heart-lung bypass machine is used to keep blood and oxygen moving throughout the body during surgery. This allows the surgeon to operate on a still heart. Blood flow is restored to the heart after surgery either by the heart beginning to beat again on its own or is some cases, mild electric shocks are used to restart the heart.

Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement (TAVR) makes it possible for patients with severe aortic stenosis and considered too sick to have traditional open-heart surgery to get their severely diseased aortic heart valves replaced with a minimally invasive procedure. During TAVR, a new valve is put in place using a catheter (see figures below) inserted through a small incision in either the leg (transfemoral), between the ribs (transapical) or through the chest (transaortic). Learn more> 

Valve replacements/repairs

Heart valve repair or replacement surgery may be considered necessary should a valve become damaged or diseased and not function properly. There are a number of repair and replacement procedures performed at ProHealth to help correct dysfunctional valves (e.g., valves that are too stiff or that leak blood interfering with correct blood flow), including mitral valve replacement/repair, aortic valve replacement and the minimally invasive technique of transcatheter aortic valve replacement (TAVR).

Vein ligation and stripping

Vein ligation and stripping is a minor surgery. If several valves in a vein and the vein itself are heavily damaged, the vein is removed (stripped). An incision is made below the vein, a flexible instrument is threaded up the vein to the first incision, and the vein is grasped and removed. During this surgery, one or more incisions are made over the damaged veins and the vein is tied off (ligated).

Ventricular assist device

A ventricular assist device (VAD) is a mechanical pump that's used to support heart function and blood flow in people who have weakened hearts. The device takes blood from a lower chamber of the heart and helps pump it through the body to vital organs, just as a healthy heart would.