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Open Heart Surgery

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Heart surgeries are performed to correct problems with the heart. There are many heart surgeries performed around the world. Of these, the most common cardiac surgery is the open heart surgery. It is also known as “Coronary Artery Bypass Graft” (CABG or cabbage).

What is Open Heart Surgery?

Open heart surgery is the type of operation wherein the chest is cut open and the surgeon operates on the heart muscles, valves, arteries as well as other heart structures. When one talks of open heart surgery, it indicates the chest is opened, and not the heart. The heart may or may not be opened, depending on the type of surgery the surgeon performs.  

The open heart surgery is the treatment of choice in cases where the arteries around the heart are blocked. The coronary arteries are a group of blood vessels that supply blood to the heart. When these arteries are blocked, it causes depletion in the amount of oxygen reaching the heart muscles. Thus, it may damage the heart tissues. This condition is called as the coronary artery disease and requires an open heart surgery or bypass surgery.

The coronary artery bypass grafting is one of the most common surgery conducted on adults. During this surgery, the blocked arteries are removed or bypassed. This is done with the help of arteries taken from another part of the body. Thus, preventing any damage to the heart, due to lack of blood flow.

Today, with modern surgical methods, open heart surgery is called as the traditional heart surgery. There are many new procedures available that require small incisions instead of opening the chest cavity.

Why Does One Require Open Heart Surgery?

As explained in the preceding paragraphs, the CABG is required to treat coronary heart disease (CHD). This happens when the arteries are blocked and become narrow and hard. A fatty material called the plaque sticks to the artery walls, making it very difficult for the blood to flow through. When the heart does not receive enough blood, it may lead to a heart attack. There are other heart problems that require open heart surgery. These include:

  • For repairing any damaged or abnormal heart valves
  • During a heart transplantation
  • Patients with left main coronary artery problems or all three coronary artery problems
  • For placement of medical devices such as pacemaker that helps the heart beat normally
  • For replacing damaged heart valves
  • Patients with defective left ventricles
  • Severe angina

How Does One Prepare for an Open Heart Surgery?

The healthcare provider will explain to you a list of dos and don’ts before the surgery. One may have to quit smoking, stop taking any blood-thinning medications such as aspirin. You will be given a special soap to bathe with before the surgery. This soap helps kill any bacteria living on your skin. Thus, reducing the chances of any infection. You will have to stop eating and drinking after midnight before the surgery. Other specific instructions will be given at the time of admission into the hospital.

How is an Open Heart Surgery Performed?

An open heart surgery requires general anesthesia. It requires about 5 to 6 hours to complete one surgery. The surgery performed bypasses blockages or obstructions in the coronary artery. This helps in restoration of blood flow, hereby increasing the amount of oxygen and nutrients to the heart. This restoration process is called as revascularization.

An incision, that is, median sternotomy is performed, wherein, the surgeon opens the chest through the breastbone. This helps the surgeon to get a good look at the heart.  The heart is stopped during the surgery and the patient is kept alive with the help of a heart-lung bypass machine. The machine helps in moving the blood away from the heart, so that the surgeon can look at the heart clearly. Today, there are many new techniques, that do not require the use of this machine. The process of moving blood away from the heart is called as cardiopulmonary bypass.

The surgeon will take arteries from the chest and arms and veins from the legs to create a detour of the blood flow around the blocked coronary artery. The new artery or vein will be connected to both the aorta and coronary artery. This is called as a bypass around the blocked artery.

With the help of the wire, the doctor will close the breastbone. Using sutures, the chest will be closed. In older patients or patients who have undergone multiple heart surgeries, the breastbone is joined with small titanium plates.

After the surgery, one will wake up in a recovery room. You will then be shifted to an ICU. According to your condition, you will be shifted to a regular room after a day or two. One will be kept under observation for the next 7 days, before the doctor thinks the patient is fit for discharge.

Precautions to Take After An Open Heart Surgery

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The recovery takes up to 6 weeks, before one starts feeling normal again. One will observe a change in their overall condition after about 6 months of the surgery. The surgery has a good outcome in the majority of the cases. But, remember, the surgery will not prevent blockages. In order to prevent blockages, one should improve their heart health. This can be done by:

  • Controlling their blood pressure and cholesterol levels
  • Quit smoking
  • Cut back on junk food, fried foods, salt, fats, sugar, etc.
  • Exercise regularly and live a healthy, active life
  • Healthy diet will help keep the body and heart fit

Risks of an Open Heart Surgery

The open heart surgery has some risks involved that includes:

Open heart surgery is a successful treatment for heart problems. However, it is not the cure for heart diseases. One should speak to their doctor and surgeon regarding the implications of CABG and clear any doubts regarding the surgery beforehand.

Written by: Saptakee sengupta
Date last updated: March 15, 2015