The term “open-heart surgery” refers to any form of surgery that involves opening the chest to operate on the arteries, valves, or muscles of the heart.
For adults, the most common type is coronary artery bypass grafting (CABG).
You may also hear this type of surgery being referred to as “traditional heart surgery.” This is due to the continual advancements in medicine that mean many new procedures relating to the heart can be performed without the use of a wide opening. Therefore, there can be some confusion over what open-heart surgery is.
Equally, if you’ve been recommended for this type of procedure, you probably have a lot of questions that you want answered. As one of the most invasive medical procedures you can go through, this surgery can be incredibly intimidating and concerning.
The Top 10 Things You Need to Learn About Open-Heart Surgery Before You Go Under the Knife
Information is power. And the more control you have going into surgery, the calmer you’ll feel.
Below, we’ve answered 10 of the most common questions about open-heart surgery.
Who Needs Open-Heart Surgery?
For children, this type of surgery is normally necessary if they are born with a problem with their heart. Whereas, for adults, it’s used if they have the following:
- A problem with the valves in their heart
- Blocked arteries
- A main vessel that’s bulging near to the heart
- Need a replacement heart
For example, in cases of CABG, this might be necessary if someone has coronary heart disease. This occurs when blood vessels narrow and harden and aren’t supplying the heart with the oxygen and blood it needs. This process is known as “hardening of the arteries” and significantly increases a person’s chances of suffering from a heart attack.
How Do You Prepare for the Surgery?
Before your operation, you should discuss any medication you are taking with your doctor. This includes vitamins, herbs, and over-the-counter medication. You should also let them know about any illnesses you have, such as flu, cold, herpes outbreak, or fever.
Two weeks before your surgery, you may be asked to stop taking blood-thinning medications (e.g. naproxen, ibuprofen, or aspirin) and to quit smoking.
You should also go through your alcohol consumption with your doctor. For example, if you’ve been having two or three drinks a day up until the day of your surgery, it’s possible that you may go into alcohol withdrawal which may induce life-threatening complications like tremors and seizures.
The day before your surgery, you may need to take a bath or shower with a special antibacterial soap. This helps rid your skin of any bacteria, reducing the risk of infection.
What Happens During Surgery?
The procedure used is entirely dependent on the problem doctors want to solve.
For example, if you’re undergoing coronary artery bypass surgery, a new artery will be grafted to replace the damaged one (this is taken from your leg or chest). This ensures your heart is receiving the supply of blood it needs to function optimally.
Other procedures may involve replacing a faulty valve to prevent blood from flowing back into the heart as it’s pumped out, or repairing an aneurysm (a bulge in the main artery that’s responsible for taking blood away from the heart).
How long all of this takes depends on the procedure, but the National Heart, Lung, and Blood Institute suggests a coronary artery bypass will take anywhere from 3 to 6 hours.
To open up your chest, a 6- to 8-inch incision is made, this cut goes through the breastbone and down the middle of your chest.
Doctors may also use a heart-lung bypass machine to replicate the job of the heart while this is stopped for the operation. It works to take blood from the heart, removes carbon dioxide, adds oxygen, and returns the blood to the body.
Who’s Present During Your Surgery?
During your surgery, a team of specialist doctors and other health care professionals will be present.
This includes a heart surgeon who’s leading the rest of the team and advising other surgeons, an anesthesiologist who gives and monitors your anesthesia, a team that operates the heart-lung machine and various other pieces of equipment during the surgery, and nurses and technicians who prepare the operating theater and assist the rest of the team.
What Are the Risks of Open-Heart Surgery?
Due to the complex nature of surgery involving the heart, there are a number of risks to be aware of. These include:
- Irregular heartbeat
- Stroke or heart attack
- Chest pain
- Kidney or lung failure
- Blood clot
- Memory loss or confusion
- Chest wound infection (this is more common in patients who have diabetes or are obese, or who have undergone this operation before)
- Breathing difficulty
- Blood loss
Some experts also suggest there are increased risks with the lung-heart machine used during surgery, including neurological problems and strokes.
What Happens After Your Surgery?
When you wake up from your surgery, you’ll have several tubes in your chest. These are in place to drain any fluid away from around your heart. You may also be replenished with fluids (and given pain relief) with intravenous (IV) lines in your arm and you will have a catheter in your bladder to drain away urine.
Your heart is monitored by a machine, which you’ll be attached to. This will help alert nurses if any problems do arise.Your first few nights will be spent in an intensive care unit (ICU) before you are moved to a specialist heart ward for 3 to 7 days.
How Do You Recover from this Surgery?
Recovering from this type of surgery takes a long time, often involving a rest period of around 4 to 6 weeks.
During this time, it’s normal to feel tired and to experience some pain. But it’s also crucial that you’re highly vigilant for any signs of infection.
Your health care team will advise what to look out for, including signs of discharge or redness around the wound. Equally, if you develop any worrying symptoms such as excessive sweating, fever, or difficulty breathing, you should seek urgent attention straight away.
And even if you don’t experience many side effects, it’s still important you manage your pain properly as this can reduce your risk of complications like pneumonia and blood clots. Taking this as prescribed, often before sleep or physical activity, is highly recommended.
Sleep is another crucial factor as this helps your body recover quickly. That said, some do struggle to sleep post-surgery. In this case, you can try taking pain relief half an hour before you go to bed, arranging your pillows to try and reduce how much muscle strain you’re experiencing, and avoiding caffeine, especially before you go to bed.
Aftercare at the hospital varies from patient to patient but may include regular follow-up heart scans, blood tests, and stress tests (monitoring your heart while you’re on a treadmill). You may also need to take blood-thinning medication.
What’s the Outlook for Patients?
It’s important not to expect too much of yourself straight after surgery – your recovery will be gradual.
Expect it to be up to 6 weeks before you start returning to your day-to-day activities and up to 6 months before you start to feel the full benefits of the procedure.
For many, surgery will improve their quality of life no end, with procedures like grafts working for many years.
That said, to ensure the longevity of your surgery, you should:
What Are the Alternatives to this Surgery?
There are now alternatives available which don’t require opening up the chest. These enlist the help of robots and endoscope cameras.
For example, treating coronary arteries that have narrowed may be done using the da Vinci robot and a small cut in the skin. Referred to as endoscopic coronary artery bypass surgery, this surgery is less invasive and has a shorter recovery period.
However, as of yet, no advantage has been found to say that this type of surgery is more effective than traditional forms. Both still require similar amounts of hospital stays and care.
Other alternatives include:
- Angioplasty – Where a stent is used to widen a narrowed artery
- Aortic Valve Balloon Valvuloplasty – Where a balloon helps widen a valve
- Transcatheter Aortic Valve Replacement – Here, a catheter is used to insert a new valve,
allowing it to open out once it’s in the right position
Where Can You Find Surgery Support?
It goes without saying that open-heart surgery can be hugely traumatic and life-changing, which is why you’ll want to make sure you have a great support network around you.
Try to enlist the help of nearby family and friends, particularly during the weeks and months that follow your surgery. From help with your grocery shopping to doing chores around the home, you’ll need temporary help from those around you.
You may also want to look at talk therapy to help you deal with the variety of emotions you’ll go through. Talk openly with your doctor and loved ones, explaining your concerns, worries, and hopes.
Are Your Ready for Open-Heart Surgery?
You and your doctor will need to decide that together. While this surgery is a huge ordeal, it should help restore your energy and health, helping you live the life you deserve.
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