Open Heart Surgery

Open Heart Surgery
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‘Open Heart Surgery’, also called ‘Traditional Heart Surgery’, is the procedure usually done to treat various serious heart complications. In this, an opening in the chest wall, including the breast bone is made to expose the heart. Depending upon the specific procedure and the type of complication, the incision is made which gives the surgeon direct access to the heart. Though it is very common, doctors advise it only in case of severe complications where other procedures are ineffective.

TYPES OF OPEN HEART SURGERY

Depending upon the basis of how the surgery is performed, Open heart surgery is of two types:

  1. On-Pump: In this, a heart-lung bypass machine is connected to the heart and temporarily performs heart functions for the heart and lungs. It pumps oxygen-rich blood to the organs and tissues and allows the surgeon to operate on a heart that is not beating and has no blood travelling through it. This is the traditional way of doing the surgery.
  2. Off-Pump or ‘Beating Heart Surgery’: During this surgery, no heart-lung machine is used and the surgeon operates while the heart is beating. However, the heart rate is monitored through medication or some devices. This procedure only works for certain complications.

DISEASES OR COMPLICATIONS IN WHICH OPEN HEART SURGERY IS RECOMMENDED

Being risky and complicated, Open heart surgery is the last option in the hierarchy of heart surgeries or treatments and is only performed in severe cases or when the other treatments are considered ineffective. Some of the cases that require open heart surgery include:

  1. Arrhythmias, including Atrial Fibrillation: It is the condition in which the heartbeat becomes irregular due to irregular electric signals. Thus, a scar tissue is created to block these irregular signals to the heart. This is called Maze Procedure.
  2. Congenital Heart Defects: A variety of heart defects or complications such as Atrial Septal ( hole in the heart) or Hypoplastic left heart syndrome etc. that are present since birth are treated through this by performing Congenital Defect Repair.
  3. Coronary Artery Disease: CAD is the narrowing of the Coronary Arteries, which are essential for your heart to function properly. Therefore, Heart Bypass Surgery or Coronary Artery Bypass Grafting Surgery is performed. In this, a new route for blood to flow around the blocked part of the coronary artery to the heart muscle is created.
  4. Heart Failure: In the case of heart failure the heart doesn’t function properly or stops functioning at all. Therefore, an immediate Heart Transplant is done to remove the damaged part with the new one.
  5. Heart Valve Disease: When the heart valve doesn’t function properly heart valve repair or replacement is done.
  6. Thoracic aortic aneurysm: It is the weakening of a major blood vessel known as the aorta that feeds blood to the heart due to which a bulge or aneurysm develops. Therefore, open heart surgery is done to treat this case by attaching synthetic vessels in place of the weakened or damaged ones.

RISK FACTORS OF OPEN HEART SURGERY:

Open Heart Surgery carries ‘n’ several risks with it, that is the reason it is done in only severe and critical cases. The major risks include:

  • Chest wound infection (more common in patients with obesity or diabetes, or those who’ve had a CABG before)
  • Heart Attack or Stroke
  • Irregular Heartbeat
  • Lung or Kidney Failure
  • Chest Pain and Low Fever
  • Memory Loss or Fussiness
  • Blood clot
  • Blood Loss
  • Breathing Difficulty
  • Pneumonia

DIAGNOSIS:

Before recommending Open Heart Surgery, the doctors run a number of tests and procedures for diagnosing the exact cause of the problem. These include:

  • Electrocardiogram (ECG): to test and record electrical signals of the heart
  • Echocardiogram: in this sound waves are used to produce the image of the heart
  • Stress Test: This is done to check symptoms during exercise
  • Cardiac Catheterization/ Angiogram: It is done to check blood flow through your heart with an injected dye to check if there are multiple blockages.
  • Chest X-Ray: It is done to check for any abnormalities in the heart.

PREOPERATIVE PROCEDURES:

Depending upon the results of the diagnosis, the doctors recommend open heart surgery for the patient according to the blockages, complications and the area to be treated. However, surgeries are not performed on the spot. Some preoperative measures need to be taken before the surgery. These include:

  • Thoroughly examining the medical history of the patient. The doctor must have in his knowledge all the medications, herbal treatments, or vitamins the patient have been on.
  • The patient should not take certain medicines like blood thinners such as aspirin, warfarin, etc., and Non-steroidal Anti-inflammatory Drugs prior to one or two weeks of surgery.
  • The patient should not eat or drink anything before some hours of the surgery as anaesthesia works best on an empty stomach.
  • The patient should not drink or smoke for some days before and after the surgery.

HOW OPEN HEART SURGERY IS PERFORMED?

After ensuring that all the preoperative precautions have been taken care of, the patient is prepared for the surgery and it is performed. The step-by-step procedure is given below:

  • First of all, the surgical area is sterilized using antibacterial soaps or liquids and the portion is shaved in case of hair growth.
  • Then, the patient is given general anaesthesia to ensure that the patient remains asleep throughout and the procedure is painless.
  • An incision of 8-10 inches is made in the chest cutting through the breastbone to expose the heart.
  • Once the heart is visible, the patient might be connected to a heart-lung machine.
  • After this, the surgeon performs the required operation according to the diagnosis.
  • On completion of the operation, the surgeon closes the breastbone using the wire leaving it inside. Thereafter, the original cut is stitched up.
  • The patient remains in the recovery room until the effect of anaesthesia wears off and the vitals become stable. Then he/she is shifted to the ICU.
  • The patient may get discharged after being hospitalised for seven days.

Being a risky procedure, open heart surgery requires proper and professional consultation. One should beforehand confirm with the doctor the potential risks related to your particular case. However, postoperative complications are unusual if performed professionally. Further, lifestyle changes and maintaining a healthy diet also help in reducing them.

To learn more about Open Heart Surgery, one can consult the cardiology specialists at Yashoda Super Speciality Hospital & Research Centre in Nehru Nagar, Ghaziabad.

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Yashoda Hospital

Yashoda Hospital

Yashoda Hospital is one of the best super specialty hospitals in Ghaziabad, Noida & Delhi NCR. Yashoda Hospital aims at providing the best healthcare services across the country and not just in Delhi NCR, Ghaziabad & Noida. Being a super speciality hospital, Yashoda Hospital has a number of dedicated specialities under one roof- gastroenterology, general surgery, obstetrics & gynaecology, cardiology, pulmonology & internal medicine, orthopedics, urology and many more.

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