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Open-heart Surgery: Procedure, Risks And Recovery

World Health Day is celebrated on 29 September every year. In this article, we will take a look at an intensive form of surgery, open-heart surgery.

Open-heart surgery is an umbrella term used for describing any type of surgery that involves cutting open the chest and performing surgery on the muscles, valves, or arteries of the heart. It is also termed as traditional heart surgery.

Open-heart surgery has changed with the intervention of new technologies and equipment, allowing the surgery to be done without making large or wide openings and only small incisions. The surgery is done to repair any damages in your heart.

So, when is open-heart surgery required? The surgery is required to perform a coronary artery bypass. Apart from this, open-heart surgery is also performed to repair or replace heart valves, repair damaged or abnormal areas of the heart, implant medical devices that help the heart beat properly and replace a damaged heart with a donated heart [1] [2] .

Now, let us take a look at the different aspects of the surgery, such as its procedure, risks and so on.

Preparing For Open-heart Surgery

Before undergoing medical treatments, it is necessary that you follow the guidelines given by the doctor to avoid any complications during or after the surgery [3] [4] .

  • Talk to your doctor about any drugs you are taking, even over-the-counter medications, vitamins, and herbs.
  • Inform about your illnesses.
  • In the two weeks before the surgery, your doctor may ask you to quit smoking and stop taking blood-thinning medications.
  • Discuss your alcohol consumption.
  • You may be given a special type of soap to be used, which will kill bacteria on your skin and will lessen the chance of infection after surgery.

Open-heart Surgery Procedure

The surgery, although intensive in nature, does not pose a high death risk. Taking between three to six hours, the surgery is done through the following steps [5] .

The person undergoing surgery should eat a healthy evening meal and refrain from drinking or eating after midnight.

  • The surgery begins with the patient being given general anaesthesia, which will help the person to fall asleep be pain-free through the whole surgery.
  • The surgeon will make an 8- to 10-inch cut in the chest.
  • Then, the surgeon cuts through all or part of the patient's breastbone to expose the heart.
  • Once the heart is exposed, the patient will be connected to a heart-lung bypass machine which allows the blood to move from the heart.
  • The surgeon uses a healthy vein or artery to make a new path around the blocked artery.
  • After that, the surgeon closes the breastbone with wire, leaving the wire inside the body.
  • And finally, the original cut is stitched up.

Risks Of Open-heart Surgery

The risks about the surgery are as follows [6] :

  • Pneumonia
  • Chest wound infection
  • Heart attack or stroke
  • Irregular heartbeat
  • Breathing difficulty
  • Chest pain and low fever
  • Memory loss
  • Blood clot
  • Lung or kidney failure
  • Blood loss

Open-heart Surgery Recovery

The recovery and follow-up after open-heart surgery are to be considered with great attention. Taking care of yourself at home immediately after the surgery is critical.

During the recovery phase, your body will experience tiredness and some pain as well [7] .

Incision care: Make sure to keep your incision site warm and dry, and wash your hands before and after touching it. If you want to shower, do only if the incision is healing properly. The shower (with warm water) should not be more than 10 minutes.

Regularly inspect the site of the incision to check for signs of infections such as [8] :

  • redness around the incision,
  • increased drainage, oozing, or opening from the incision site,
  • fever and
  • warmth along the incision line.

Pain management: One of the other relevant steps, proper pain management can help speed up your recovery and decrease the chances of complications like blood clots or pneumonia. It is normal to feel muscle pain, throat pain, pain at incision sites, or pain from chest tubes. Your doctor will likely prescribe pain medication that you can take at home [9] .

Get proper rest: Some patients experience trouble sleeping after open-heart surgery but it is necessary to get as much rest as possible.

To improve your sleep quality, you can take the pain medication a half-hour before bed, arrange pillows to decrease muscle strain and avoid caffeine [[10] .

Rehabilitation: Individuals are given the opportunity of participating in a comprehensive rehabilitation program which will help the individual through programs such as exercise, reducing risk factors, and dealing with stress, anxiety, and depression [11] .

On A Final Note....

Carrying out an open-heart surgery does not prevent artery blockage from happening again. Make sure to follow a healthy diet, lead an active lifestyle, quit smoking and control your blood pressure and cholesterol levels.

FAQs About Open-heart Surgery

Q. How long does an open-heart surgery take?

A. It usually takes 3 to 6 hours.

Q. Who is in theatre for open-heart surgery?

A. A team of doctors and other health professionals work together in the operating theatre during open-heart surgery. The lead surgeon, the anesthesiologist, the pump team and nurses and technicians will be present [8] .

Q. What is the success rate of open-heart surgery?

A. Survival rates of open-heart surgery are at about 96-97 per cent.

Q. What is life expectancy after open-heart surgery?

A. According to one study, and 74 per cent survived 10 years and the number has remained relatively stable ever since.

Q. Is open heart surgery high risk?

A. Every open heart surgery presents the risk of complications and the risk is high in individuals over the age of 70 [12] .

Q. Can I sleep on my side after open-heart surgery?

A. It is okay to sleep on your back, side or stomach.

View Article References
  1. [1] Kohler, P., Kuster, S. P., Bloemberg, G., Schulthess, B., Frank, M., Tanner, F. C., ... & Sommerstein, R. (2015). Healthcare-associated prosthetic heart valve, aortic vascular graft, and disseminated Mycobacterium chimaera infections subsequent to open heart surgery. European heart journal, 36(40), 2745-2753.
  2. [2] Sax, H., Bloemberg, G., Hasse, B., Sommerstein, R., Kohler, P., Achermann, Y., ... & Weber, R. (2015). Prolonged outbreak of Mycobacterium chimaera infection after open-chest heart surgery. Clinical Infectious Diseases, 61(1), 67-75.
  3. [3] Ayyildiz, P., Kasar, T., Ozturk, E., Ozyilmaz, I. S. A., Tanidir, I. C., Guzeltas, A., & Ergul, Y. (2016). Evaluation of permanent or transient complete heart block after open heart surgery for congenital heart disease. Pacing and Clinical Electrophysiology, 39(2), 160-165.
  4. [4] Salsano, A., Giacobbe, D. R., Sportelli, E., Olivieri, G. M., Brega, C., Di Biase, C., ... & Santini, F. (2016). Risk factors for infections due to carbapenem-resistant Klebsiella pneumoniae after open heart surgery. Interactive cardiovascular and thoracic surgery, 23(5), 762-768.
  5. [5] Gudbjartsson, T., Jeppsson, A., Sjögren, J., Steingrimsson, S., Geirsson, A., Friberg, O., & Dunning, J. (2016). Sternal wound infections following open heart surgery–a review. Scandinavian Cardiovascular Journal, 50(5-6), 341-348.
  6. [6] Edmunds Jr, L. H., Stephenson, L. W., Edie, R. N., & Ratcliffe, M. B. (1988). Open-heart surgery in octogenarians. New England Journal of Medicine, 319(3), 131-136.
  7. [7] Kornfeld, D. S., Zimberg, S., & Malm, J. R. (1965). Psychiatric complications of open-heart surgery. New England Journal of Medicine, 273(6), 287-292.
  8. [8] Kawamura, T., Wakusawa, R., Okada, K., & Inadat, S. (1993). Elevation of cytokines during open heart surgery with cardiopulmonary bypass: participation of interleukin 8 and 6 in reperfusion injury. Canadian journal of anaesthesia, 40(11), 1016-1021.
  9. [9] Royston, D., Taylor, K. M., Bidstrup, B. P., & Sapsford, R. N. (1987). Effect of aprotinin on need for blood transfusion after repeat open-heart surgery. The lancet, 330(8571), 1289-1291.
  10. [10] Ingrande, J., Gutierrez, K., Lemmens, H. J., Verma, A., Nicolau, D. P., Sutherland, C. A., & Ramamoorthy, C. (2019). Pharmacokinetics of Cefazolin and Vancomycin in Infants Undergoing Open-Heart Surgery With Cardiopulmonary Bypass. Anesthesia & Analgesia, 128(5), 935-943.
  11. [11] Noss, C., Anderson, K. J., & Gregory, A. J. (2019). Erector spinae plane block for open-heart surgery: a potential tool for improved analgesia. Journal of cardiothoracic and vascular anesthesia, 33(2), 376-377.
  12. [12] Gott, V. L., Moller, J. H., Shaffer, A. W., & Shumway, S. J. (2019). Cross-circulation and the Early Days of Cardiac Surgery. Annals of surgery, 269(3), 443-445.

Story first published: Wednesday, September 25, 2019, 18:00 [IST]
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