About Open-Heart Surgery
Open-heart surgery concludes with any type of surgery in which the chest is cut open and surgery is performed on the muscles, valves, or arteries of the heart. Open-heart surgery is mostly called traditional heart surgery. Nowadays, many new heart procedures can be performed with only small incisions, not wide openings. Therefore, the term “open-heart surgery” can be misleading. Open-heart surgery may be done to perform a coronary artery bypass graft (CABG), which may be necessary for people with coronary heart disease. Coronary heart disease occurs when the blood vessels that provide blood and oxygen to the heart muscle become narrow and hard. The “hardening of the arteries” occurs when fatty material forms a plaque on the walls of the coronary arteries; which narrows the arteries, making it difficult for blood to get through. When blood can’t flow properly to the heart, a heart attack may occur.
How is open-heart surgery performed?
Open heart surgery, a term often synonymous with coronary artery bypass grafting (CABG), is a complex and intricate procedure designed to improve blood flow to the heart. It's typically recommended for patients with severe coronary heart disease, where arteries are blocked or narrowed, restricting blood and oxygen to the heart muscle. The surgery aims to create a new pathway for blood to reach the heart, bypassing the affected arteries.
The procedure begins with the patient receiving general anesthesia to ensure they are asleep and pain-free. The surgeon then makes an 8- to 10-inch incision down the middle of the chest and cuts through the breastbone to expose the heart. In traditional open-heart surgery, the patient is connected to a heart-lung bypass machine, which takes over the heart's pumping action, allowing the surgeon to operate on a still heart. However, some newer techniques do not require this machine.
A healthy artery or vein from another part of the body is then grafted to the blocked coronary artery. The grafted vessel creates a new route for blood to flow, effectively bypassing the narrowed or blocked sections of the coronary arteries. The surgeon then uses wires to close the breastbone, which remain in the body and stitches up the initial incision. In some high-risk cases, such as those involving multiple surgeries or elderly patients, sternal plating may be used, where small titanium plates are employed to rejoin the breastbone.
The entire CABG procedure can take between three to six hours, depending on the number of arteries being bypassed and the complexity of the operation. It's a highly skilled surgery that requires a team of expert cardiac surgeons, anesthesiologists, and surgical nurses. The advancements in medical technology and surgical techniques have significantly improved the success rates of open-heart surgeries.
Post-surgery, patients typically spend time in the intensive care unit (ICU) to be closely monitored as they begin their recovery. The recovery process involves managing pain, preventing infection at the incision site, and gradually increasing physical activity. Full recovery can take several weeks or months, and patients are often advised to participate in cardiac rehabilitation programs to regain strength and improve heart health.
When is open-heart surgery needed?
Open heart surgery is a critical procedure performed to address various serious heart conditions. It is most commonly needed for coronary artery bypass grafting (CABG), which is recommended for patients with coronary heart disease (CHD). CHD occurs when the coronary arteries, responsible for supplying blood to the heart muscle, become blocked or narrowed due to plaque buildup, a condition known as atherosclerosis. This can lead to a heart attack if the blood flow becomes too restricted.
Patients may require open heart surgery when they have severe blockages or narrowing in their coronary arteries that cannot be treated with medication or less invasive procedures like angioplasty. It's also necessary when the heart's valves are damaged or diseased, preventing them from opening and closing properly. Valve problems can lead to heart failure, where the heart can't pump blood effectively.
Other conditions necessitating open heart surgery include major heart rhythm problems (arrhythmias), congenital heart defects present at birth, and aneurysms of the aorta, the main artery that carries blood away from the heart. In some cases, medical devices such as pacemakers need to be implanted to help the heart beat properly, or a damaged heart may need to be replaced with a donated heart through transplantation.
The decision to perform open heart surgery is based on several factors, including the severity and type of heart disease, the patient's symptoms, overall health, and the results of tests like angiograms, which show the condition of the coronary arteries. The surgery is a major operation that requires a hospital stay of a week or more, with time spent in the intensive care unit immediately after the procedure.
Open-heart surgery recovery
An open-heart surgery will require a 4-5 days hospital stay and usually takes 6-8 weeks for the breastbone and chest muscle to heal and then patients can gradually return to a normal daily routine.