What is open heart surgery and who needs it

3-minute read

Cardiac surgery has made tremendous advances over the years. Today, minimally invasive heart surgery takes place through tiny incisions with miniature tools. However, some procedures still require a more traditional approach known as open-heart surgery. Open-heart surgery isn't for everyone, but it might be the solution you need to address your heart condition.

Defining open-heart surgery

Every type of cardiac surgery takes place in or around the heart muscle. The goal is to correct problems with your heart, its valves, or the arteries connected to the heart.

Here's what typically happens while your surgeon operates:

• You're given general anesthesia. This makes you go to sleep so you don't experience pain during the procedure. An anesthesiologist monitors you throughout the surgery, adjusting the amount of medication administered as necessary.
• Your surgeon makes an incision in your chest. The incision is typically between 6 and 8 inches long, depending on your procedure and other factors. The surgeon then cuts through your breastbone, spreading your ribs apart to reach your heart.
  
• You are connected to a heart-lung bypass machine. This specialized equipment stops your heart and takes over its responsibility for pumping blood. This allows your surgeon to operate on your heart without it beating. Not all open-heart surgeries involve a heart-lung bypass machine.

Once your surgeon performs the operation, they remove the heart-lung bypass machine (if used) and close your chest wall.

Who needs open-heart surgery

More than 2 million people across the globe have open-heart surgery every year, according to the National Heart, Lung, and Blood Institute. This procedure helps with many heart problems, including:

• Atrial fibrillation (AFib). AFib is the most common form of heart arrhythmia, or irregular heartbeat. AFib causes chest pain, shortness of breath, and other symptoms.
• Congenital heart defects. These issues are present at birth and affect the heart's structure and function.
  
• Coronary heart disease. Often caused by a buildup of plaque in your arteries, coronary heart disease can cause heart attack and other complications if it isn't treated.
  
• Heart failure. This condition develops when your heart doesn't get enough blood to pump or isn't strong enough to pump it.
  
• Heart valve disease. Your heart has four valves, and any of them can become damaged or diseased. A damaged heart valve might leak (called regurgitation) or get too narrow (called stenosis). Heart valve diseases can lead to complications, including stroke and heart failure.

To treat these conditions, your surgeon might prescribe one of these open-heart surgery options:

• Coronary artery bypass grafting (CABG). During bypass surgery, a healthy artery gets connected to a clogged artery. This allows blood to bypass the clogged area and restores blood flow to your heart.
• Heart transplant. Your failing heart is replaced by a donor's heart.
  
• Maze procedure. The surgeon makes tiny cuts in your heart muscle to create a maze of scar tissue that disrupts the electrical activity that causes arrhythmias.
  
• Valve repair or replacement. Damaged or diseased heart valves might be repaired with clips, plugs, or supportive rings. During a valve replacement surgery, the valve is replaced with an artificial heart valve, an animal valve, or a valve from a human donor.

Preparing for open-heart surgery

Before open-heart surgery, you'll need to have imaging, blood work, and other tests. Follow your care team's orders and have these done in a timely manner to ensure there are no obstacles to your procedure.

Also, be sure to ask questions. Learn all you can about the procedure and your recovery. Have a friend or family member join you during your preoperative appointments and take notes so you remember everything you learn.

The day before your appointment, you'll be instructed to stop eating or drinking. You might also need to stop taking certain medications, but only do so if your care team tells you to.

After surgery, you'll stay in a recovery room or the intensive care unit (ICU). Staff members will watch you to ensure you don't experience complications, such as blood clots. After a few days, you might move to a regular inpatient room.

You'll also begin a cardiopulmonary rehabilitation program as soon as it's safe. This supervised program helps you regain strength and prevent future heart problems. You also play a key role in your recovery. Participating in rehabilitation and completing the prescribed exercises can increase your likelihood of a positive outcome after open-heart surgery.

Full recovery depends on the surgery you undergo and other factors. It can take up to 12 weeks and possibly longer for some people.

Is your heart giving you trouble? Experts at the Reid Health Heart & Vascular Center are here to help.