Open heart surgery is a major surgery, which takes place to rectify a damage to the heart. During this surgery, the doctor will cut open the chest and the operation is performed on the muscles, valves or arteries of the heart. The most common open-heart surgery is the coronary artery bypass surgery.
In this operation, a healthy artery or vein is attached to the blocked coronary artery. Hence, the attached artery is allowed to go around the blocked coronary artery, supplying fresh blood to the heart. This surgery is also sometimes known as Traditional Heart Surgery.
An open-heart surgery becomes a necessity when the coronary arteries become narrow. This happens because of a heart disease and the narrow arteries can lead to a heart attack. The artery that is attached is borrowed from someplace else, usually the chest or the leg. Open-heart surgery is also performed to repair or replace the faulty/damaged valves. The valves that are present in the heart are responsible to stop the blood from flowing back into the parts of the heart once it is pumped out.
The Open-heart surgery can also treat an aneurysm. In this condition, a bulge occurs in the main artery.
When is open-heart surgery needed?
An open-heart surgery is performed to;
- Repair or replace the valves in the heart.
- Repair the damaged or faulty areas of the heart.
- To attach medical devices to promote a normal heartbeat.
- To replace a damaged heart with a donor’s heart.
How is the open-heart surgery performed?
The preparations for this operation starts on the previous night of the surgery.
- Patients can consume normal food on the previous evening. However, they must avoid food and drink after midnight.
- The patients are asked to use an antibacterial soap, especially on the upper body during their bath on the day of the surgery.
- The chest may also be shaved.
- The patients are asked to wear loose and comfortable clothing. This helps them after the completion of the surgery as they will not be able to move easily.
- It is important to submit the complete medical history to the doctor before the surgery. This includes; the recent medication the patient has taken, illness, etc.
- Sometimes, the patient might suffer from anxiety before the operation. During this period, it is important to talk to the doctor. The doctor and his team will surely clear all the doubts, making the patient feel better.
- Sometimes, the doctors run a few tests before the surgery. These tests include; heart monitoring, blood samples, etc.
- The nurse might place a line into the patient’s vein for the transfer of fluids and drugs.
- Anaesthesia is monitored. This will make the patient drowsy and sleepy.
During the surgery
- The time taken to complete the procedure differs from patient to patient. However, the coronary artery bypass usually lasts from somewhere in between 3-6 hours.
- The surgeons cut open the chest about 6-8 inches. This incision is made using a blade in the middle of the chest.
- The team may use a heart-lung bypass machine during the surgery. This machine is used to stop the heart-beat while the surgeon operates on the heart. Therefore, the hearts functionality of pumping the blood is performed by a machine for the time being. Here, the carbon dioxide is removed from the blood, the oxygen is added, and finally, the blood is returned to the patient’s body.
- During this surgery, the doctor might choose to let the heart keep beating and the heart is held using an external device to help the doctor perform the surgery.
- During the surgery, the people who might be present in the operation theatre are;
- The lead heart surgeon, who will direct the other surgeons for a successful operation.
- Anaesthesiologist, who is responsible for monitoring the anesthesia and the vital signs.
- A team who is responsible for monitoring the heart-lung machine and other technical equipment used during the operation. They are called the ‘perfusionists’.
- Other doctors
After the surgery/Recovery Period
- Since it is a major surgery, it is important to keep an eye on the patient at all times. They will need a lot of support and help post-surgery.
- The patient is usually transferred to the ICU after the surgery. He will remain there for 2-3 days post-operation.
- A breathing tube will remain attached to help the patient breathe. The line inserted in the vein is also present to give the pain medications. And, all the monitoring equipment will remain there with the patient.
- Once the patient leaves the ICU, he might have to stay at the hospital for some time. The recovery period post-hospital-stay will take weeks. The rest period is usually about 4-6 weeks.
- The doctor will prescribe a rehabilitation plan for the patient accordingly. This will include; medications, exercises, diet, etc.
- During the recovery period, the patient might go through bouts of tiredness and pain, which is normal.
- It is also important to keep an eye on any infections. If a wound, redness, or some sort of discharge, etc. is noticed around the chest, the patient must immediately go to the hospital.
- Also, if the patient suffers from fever, breathing problems, etc. immediate medical attention is necessary.