Thursday, April 11, 2024

Reasons For Open Heart Surgery

What Happens To Your Body During Open Heart Surgery

What are my choices for open-heart surgery?

Open heart surgery may be performed with your heart beating or not. If your heart isn’t beating during the surgery, which is more common, it is called on-pump surgery. A heart-lung machine will do the job of your heart and lungs by circulating your blood away from your heart.

If your heart is beating by itself during the surgery, this is called off-pump surgery. This is far less common than on-pump surgery and only works for coronary artery bypass grafting surgery. It can also be called beating-heart surgery.

Most surgeries on open hearts follow specific steps. These steps may vary depending on your unique procedure and situation. Generally, your surgeon could take these different stages:

  • Cutting a long incision down your chest
  • Cutting into the breastbone and spreading your ribcage apart
  • If you have an on-pump surgery, putting you on a heart-lung machine and giving medication to stop your heart from beating
  • Performing the procedure to heal your heart
  • Bringing back blood flow to your heart
  • Severing the connection between you and the heart-lung machine
  • Closing up the incision on the breastbone
  • Sewing the skin incision back together

Left Ventricular Embolization Of An Aortic Balloon

An 83-year-old man with severe symptomatic aortic stenosis, deemed to be at high risk for conventional surgery was referred to our institution for a transcatheter aortic valve implantation. A transapical approach was chosen because his anatomic features were not suitable for transarterial access. The aortic annulus measured by transesophageal echocardiography was 23.8 mm .

A 26-mm Edwards SAPIEN valve was implanted with fluoroscopy and TEE guidance with one-step inflation, as previously described.1 Although there were no technical problems during deployment, the prosthesis embolized into the left ventricle a few seconds after hemodynamic recovery . The stiff wire was kept in place, preventing the prosthesis from rotating and obstructing the left ventricular outflow tract . Because conventional surgery had been declined for this patient, we tried to find an interventional solution.

To the best of our knowledge, this is the first case that demonstrates the feasibility of recapturing a balloon-expandable prosthesis after left ventricular embolization. Among various potential causes of such a complication,2 mild valve calcifications and a possible underestimation of the true annular size by TEE are the most likely. A multimodal annulus sizing with a computed tomography scan3 could have been helpful but was not included in our selection process at this time before balloon-expandable prosthesis implantation.

Wei Li, Georgios Giannakoulas, in, 2011

Why Might I Need Coronary Artery Bypass Surgery

Your doctor uses coronary artery bypass graft surgery to treat a blockage or narrowing of one or more of the coronary arteries to restore the blood supply to your heart muscle.

Symptoms of coronary artery disease may include:

  • Swelling in the hands and feet

Unfortunately, you may not have any symptoms in early coronary artery disease, yet the disease will continue to progress until theres enough artery blockage to cause symptoms and problems. If the blood supply to your heart muscle continues to decrease as a result of increasing blockage of a coronary artery, you may have a heart attack. If the blood flow cant be restored to the particular area of the heart muscle affected, the tissue dies.

There may be other reasons for your doctor to recommend CABG surgery.

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What Are The Risks Of Open

The risk of post-surgical complications increases as people age or if their procedure is urgent or an emergency. Patients that have multiple medical problems can be at higher risk for some debilitating complications such as a stroke or kidney failure. Some people may experience transient memory loss and problems concentrating or thinking clearly after surgery. Other risks include:

  • Infection, fever, swelling and other signs of inflammation
  • A reaction to the medicine used to make the patient sleep during the surgery
  • Irregular heartbeats
  • Damage to the tissues in the heart, kidneys, liver and lungs

Who Is In Theater For Open Heart Surgery

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A team of doctors and other health professionals work together in the operating theater during open heart surgery.

The team is likely to include:

  • the lead surgeon who will direct others surgeons who will assist during the operation
  • the anesthesiologist, who is in charge of giving and anesthesia and monitoring vital signs
  • the pump team, also known as perfusionists, operate the heart-lung machine and other technical equipment that supports open heart surgery
  • nurses and technicians, who assist the surgical team and prepare the operating theater for surgery

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What Should I Expect Coming Home From Open Heart Surgery

Every person and every procedure has a different healing process. After surgery, your doctor will teach you how to care for your incisions, what to watch out for, and how to understand the difference between abnormalities and post-surgery symptoms.

Typical symptoms you may have after your surgery are:

Reasons For Open Heart Surgery

Open heart surgery tends to be thought of as one procedure. However, it actually references any cardiac surgery that requires opening up the chest. An incision about eight to ten inches long is made through both skin and breastbone to allow the surgeon to perform the necessary procedure.

More and more medical advances allow for many surgeries that were traditionally open heart to be performed through robotic assistance or other minimally invasive measures. This makes for a blurry line when saying This surgery is open heart, this surgery is not. Bearing that in mind, these are some of the more common reasons for open heart surgery.

Heart Transplant

One of the most obvious reasons open heart surgery is necessary is to replace the heart entirely. This is also one of the most difficult types of surgery to think about, because it requires finding a heart from someone who has died and was willing to be an organ donor. The heart is taken from its original place and transplanted into the person in need. Heart failure, abnormalities, defects, and even beats or rhythms that are totally out of sync with what they should be cant always be fixed through more conservative surgeries or with medications. In this case, the patient must simply wait for an appropriate donor. However, there are still many risks associated with a heart transplant.

Coronary Artery Bypass Graft

Aortic or Mitral Valve Surgery

Congenital Defect Corrective Surgery

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How Is Open Heart Surgery Performed

Your open heart surgery will be performed in a hospital. It requires a large incision in your chest and through your breastbone . Open surgery allows your surgeon to directly view and access the surgical area.

If you are having on-pump surgery, your surgical team will stop your heart with medicine and the heart-lung machine will pump blood to the body. Your surgeon will take your heart off the machine when the surgery is complete.

Some heart surgeries can now be performed at certain medical centers using minimally invasive techniques. These surgeries include coronary artery bypass surgery and heart valve repair and replacement.

Minimally invasive procedures use smaller incisions instead of the larger incision made in open surgery. The surgeon uses special instruments with an attached camera to see the surgical area on a video screen. Minimally invasive surgery, as compared to an open procedure, generally has a faster recovery time, less pain, and a lower risk of some complications, such as infection.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different procedures and ask why your surgeon will use a particular type for you.

Types of anesthesia that may be used

Your surgeon will perform open heart surgery using either general anesthesia or regional anesthesia.

What Is Traditional Heart Surgery

Do you really need an open-heart surgery?

Traditional cardiac surgery, or open heart surgery as it is often referred, is performed by making a large incision, roughly 6-8, in the chest to gain access to the heart. Once the heart is exposed, the heart is actually stopped and the patient is connected to a heart-lung bypass machine that does the work of the heart and lungs to allow the surgeon to perform the surgery.

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Q How Do I Lower My Risk Of Pneumonia After Heart Surgery

  • After the removal of your breathing tube, your surgeon prescribes an incentive spirometer device that helps you in breathing. It is vital for improving your breathing and deplete the risk of pneumonia. You can do breathing exercises ten-time each hour when you are in the hospital. Ask your physician about how to use an incentive spirometer.
  • How Successful Is Heart Surgery And What Are The Risks

    Risks associated with heart surgery include infection, irregular heartbeat, and bleedingas well as such serious problems as heart attack and stroke. Older people, women, and those with serious diseases, such as diabetes or lung disease, are at higher risk for complications.

    But surgeons using the latest techniques, technologies and approaches often have excellent results, even for many high-risk patients.

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    Sleeping Can Be Hard After Surgery

    Its hard to find a comfortable position to sleep in. If you are a side or belly sleeper it can be hard laying on your back. Finding your favorite chest pillow will be your savior. You might also experience nightmares for a bit after surgery, but it will pass. If you continue to experience them, speak to your doctor and seek help if you feel like you are experiencing PTSD.

    Your Heart Is In Experienced Hands At The Dmc

    Heart Valve Replacement Surgery

    The Detroit Medical Centers open-heart surgery program is made up of cardiovascular surgeons, critical care specialists, physician assistants, cardiac nurses, nurse practitioners and technicians.

    When it comes to your heart, you need someone you can trust. The Heart and Vascular Institute at the DMC has delivered advanced cardiac care to our community for more than three decades. DMC Harper University Hospital is proud to be ranked by U.S. News and World Report for 2022-2023 as High Performing in Chronic Obstructive Pulmonary Disease, Heart Attack and Heart Failure.

    Our range of services includes a comprehensive spectrum of diagnostic testing, which allows us to pinpoint a variety of conditions. We provide advanced cardiac care, including interventional cardiology procedures and open-heart surgery. Our care extends to the post-surgical period where we supervise cardiovascular rehabilitation and continue to monitor your heart health.

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    Q What Are My Restrictions After Open

  • After heart surgery, it is for your betterment to follow the doctor’s guidelines strictly. Your breastbone after heart operation may take two or three months to heal, so you have to be much careful about your actions.The following are the restrictions for heart patients after cardiac surgery.
  • Do not drive without your surgeon’s permission
  • Avoid extreme stretching of arms
  • Don’t lift heavyweight
  • Don’t put pressure on your arms for supporting your upper body
  • Don’t bend, push, pull, and stretch
  • To decrease pressure while coughing or taking deep breaths, hold a pillow for a support
  • What Are Some Types Of Heart Surgery

    There are many types of heart surgery. The National Heart, Lung, and Blood Institute, which is part of the National Institutes of Health, lists the following as among the most common coronary surgical procedures.

    In addition to these surgeries, a minimally invasive alternative to open-heart surgery that is becoming more common is transcatheter structural heart surgery. This involves guiding a long, thin, flexible tube called a catheter to your heart through blood vessels that can be accessed from the groin, thigh, abdomen, chest, neck, or collarbone. A small incision is necessary. This type of surgery includes transcatheter aortic valve implantation to replace a faulty aortic valve with a valve made from animal tissue, MitraClip® placement for mitral valve abnormalities, and WATCHMAN® placement for nonvalvular atrial fibrillation patients.

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    Heart Procedures And Surgeries

    If you’ve had a heart attack, you may have already had certain procedures to help you survive your heart attack and diagnose your condition. For example, many heart attack patients have undergone thrombolysis, a procedure that involves injecting a clot-dissolving agent to restore blood flow in a coronary artery. This procedure is administered within a few hours of a heart attack. If this treatment isn’t done immediately after a heart attack, many patients will need to undergo coronary angioplasty or coronary artery bypass graft surgery later to improve blood supply to the heart muscle.

    See diagnostic tests and procedures to better understand the tests you may have to undergo to find out if you had a heart attack, how much damage was done and what degree of coronary artery disease you have.

    What Happens During Open

    Inside St. Luke’s OR: Open Heart Surgery

    Heart surgery is complex. Some surgeries may take six hours or longer. You will receive anesthesia and be asleep during the procedure.

    Surgery steps vary depending on the heart condition and procedure. In general, your surgeon:

    • Makes a 6- to 8-inch long incision down the middle of your chest.
    • Cuts the breastbone and spreads your ribcage apart to reach your heart.
    • Connects the heart to a heart-lung bypass machine, if youll have an on-pump surgery. An anesthesiologist gives IV medication to stop your heart from beating and monitors you during the surgery.
    • Repairs your heart.
    • Restores blood flow to your heart. Usually, your heart starts beating on its own. Sometimes, the heart needs a mild electrical shock to restart it.
    • Disconnects the heart-lung bypass machine.
    • Closes the breastbone or other incision with wires or sutures that remain in your body.
    • Uses stitches to close the skin incision.

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    You May Experience Memory Loss And/or Brain Fog

    There are a couple of things that can cause memory loss and brain fog after open-heart surgery. If you were put on bypass, it can cause these issues. It is also called pump head. Post-operative cognitive dysfunction can also cause memory loss. Both of these are usually short-term but can have the possibility of long-term effects. For the first six months, I really struggled with memory loss and brain fog. As time went on, it started to get better and I started to regain my memory and wasnt so foggy-headed.

    Why Would A Person Need Open Heart Surgery

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    How Is Yale Medicine Unique In Its Approach To Cardiac Surgery

    Yale Medicine Cardiac Surgery has a team of world-class heart surgeons who are highly skilled in treating the full range of cardiac diseases and conditions, using a variety of approaches and techniques, from minimally invasive robotic surgeries to complex open surgeries. Yale New Haven Hospitals Heart & Vascular Center is one of the few cardiac centers in the country where cardiac surgery outcomes for procedures such as CABG and mitral and aortic valve replacement consistently exceed national and regional norms.

    Yale is a major referral center for a number of cardiac surgeries. Yale Medicine has the largest volume of aortic cases in Connecticut and is in the top 3 percent of aortic surgical volume nationally. We are one of the highest volume centers in New England for mitral valve repairs, which our surgeons can often perform with a minimally invasive approach that may include use of a highly advanced robotic surgical tool. We also are nationally recognized for excellence in TAVR and are a designated training center for this technique.

    What Is Heart Surgery Like

    First Open Heart Surgery: Early Heart Surgery to Help Congenital Heart ...

    Because there are many types of heart surgeries, one patients experience may be dramatically different than anothers. A patient may be asked to undergo tests before surgery, such as a chest X-ray or an electrocardiogram . Typically, the surgeon will want the patient to stop taking any blood-thinning medications, and stop smoking and possibly drinking alcohol in the weeks before surgery.

    A team of specialists, including cardiac surgeons, anesthesiologists, and operating room nurses, will work together to perform surgery. The length of surgery will vary. CABG typically takes three to six hours, while the implantation of a VAD can take several hours, depending on the severity of the condition and such factors as scar tissue from previous operations, which can make the surgeons work more complex.

    Depending on the surgeryespecially if its open heart surgerythe patient is usually given general anesthesia and will remain asleep through the procedure. He or she may wake up attached to machines that monitor the heart, as well as tubes in the chest to drain fluid from around the heart. Some patients, including those who have surgeries to implant pacemakers, may go home the next day. Others will start their recovery in the intensive care unit, followed by several days in the hospital.

    Pain may linger in the chest and muscles, but this goes away eventually. Some patients are referred to medically supervised cardiac rehabilitation programs.

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    What Does A Heart

    Operating on a heart safely while it is beating is difficult. A heart-lung machine takes over the function of maintaining the circulation of blood and oxygen throughout the body so that the surgeon can work on a still heart. This process is called perfusion, and it is managed by perfusionists. These machines can take over the hearts pumping action for hours.

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