Purpose Of Open Heart Surgery
Open heart surgery is used to treat a number of different heart conditions.
Coronary artery disease , the most common indication, occurs when fatty clumps clog the arteries that supply blood to the heart muscle. This results in reduced blood flow to the heart. If the blockage is significant, angina, trouble breathing, and, in some cases, a heart attack may occur.
Open heart surgery may also be used to:
- Psychological and social evaluation
What Happens During Beating Heart Bypass Surgery
First, your surgeon removes a section of a healthy vein or artery from an area of your body. This is called a graft. The surgeon attaches one end of the graft to an area of the heart above the blockage in your artery. The other end is attached to an area of your coronary artery below the blockage. Once the graft is attached, blood flow to your heart is restored.
The challenge in beating heart CABG surgery is that it can be difficult to suture or “sew” on a beating heart. The surgeon must use a “stabilization” system to keep the heart steady.
The stabilization system consists of a heart positioner and a tissue stabilizer. The heart positioner guides and holds the heart in a position that provides the best access to the blocked arteries. The tissue stabilizer holds a small area of the heart still while a surgeon works on it.
Medtronic’s Starfish®2 and Urchin® Heart Positioners are designed to position and to hold the heart to give the surgeon easy access to the blocked vessel requiring the bypass graft. The Medtronic Octopus® Tissue Stabilizer minimizes limits the motion of a small area of the heart while the rest of the heart continues to beat normally. This allows the surgeon to perform CABG surgery without stopping your heart and without using the heart-lung machine.
What Is Heart Surgery
Heart surgery is done to correct problems with the heart. Many heart surgeries are done each year in the United States for various heart problems.
Heart surgery is used for both children and adults. This article discusses heart surgery for adults. For more information about heart surgery for children, go to the Health Topics articles about congenital heart defects, holes in the heart, and tetralogy of Fallot.
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What To Expect After An Open Heart Surgery
In the initial period after the surgery, the patient will have a tube coming from the recently operated area, in order to drain the excessive fluid. The post-operative care measures involve the administration of intravenous fluids in order to prevent dehydration, a catheter for urine and the connection to a machine to monitor the patientâs vital signs. After the patient is moved to a regular hospital room, treatment will be administered in order to prevent blood clots. After the release from the hospital, the recovery period will start at home and the patient will be instructed to take things slowly and not to rush anything.
After the open heart surgery, the doctor will give the patient a set of recommendations that are meant to protect the recently operated area. The patient should have a healthy diet, with plenty of fresh fruits and vegetables. It is recommended that foods with a high salt content, those that are spicy or excessively greasy should be avoided. The patient will be encouraged to perform regular physical exercise , to quit smoking and drinking alcohol and to take the recommended treatment for the control of the blood pressure and cholesterol.
Transition To Critical Care Unit
Once your vital signs are stable, you will be moved from the PACU to a cardiac, surgical, or transplant intensive care room. This critical care environment is necessary to provide you with one-on-one nursing care and constant monitoring.
In your intensive care room, you can expect the following to occur:
- Your breathing tube will be removed when you are fully awake. Supplemental oxygen may be given by the nose to assist breathing.
- Your chest tube will be removed once the drainage slows down .
- If temporary pacemaker wires or a Swanz-Ganz catheter were placed, they will be removed around the second or third day after surgery.
- Although you may not have much of an appetite after surgery, you will begin drinking clear liquids.
During your recovery, you will also be given various medications to manage common symptoms after surgery, like pain, constipation, and nausea. You may also be given medications to prevent blood clots, maintain normal blood pressure, or to remove excess fluid from your body.
Patients undergoing a heart transplant will begin taking immunosuppressants right away to prevent their immune system from rejecting their new heart.
A hospital stay for open heart surgery typically ranges from five to 14 days. If complications arise, patients may end up staying in the hospital for several weeks.
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How To Prepare For Open
Tell your doctor about any drugs you are taking, even over-the-counter medications, vitamins, and herbs. Inform them of any illnesses you have, including herpes outbreak, cold, flu, or fever.
Its important to talk to your doctor about your alcohol consumption before you prepare for the surgery. If you typically have three or more drinks a day and stop right before you go into surgery, you may go into alcohol withdrawal. This may cause life-threatening complications after open-heart surgery, including seizures or tremors. Your doctor can help you with alcohol withdrawal to reduce the likelihood of these complications.
The day before the surgery, you may be asked to wash yourself with a special soap. This soap is used to kill bacteria on your skin and will lessen the chance of an infection after surgery. You may also be asked not to eat or drink anything after midnight.
Your healthcare provider will give you more detailed instructions when you arrive at the hospital for surgery.
Care Of Your Incisions
As you heal, your incision will look better and the soreness will go away. Changes in the weather, too much or too little activity and sleeping in one position too long may cause increased soreness. You may also feel numbness or itching or see redness or swelling, which will also stop with time. To care for your incisions, we suggest:
- Wash gently with mild soap during your daily shower. Dry carefully with a towel. Pat it dry Do not rub the incision.
- If you have small pieces of white tape over your incision, you must remove them after you have been home for seven days. If the strips come off on their own, you may leave them off.
- If your incisions are puffy, have areas of redness, are oozing, or begin to open slightly, call your surgeon.
- Women should wear a bra. A good support bra will reduce the tension placed on the incision. If the bra bothers you, you may put a small piece of gauze under the bra for added comfort.
- For discomfort or soreness, you may use a heating pad. Apply it four or five times per day on the low setting for about 20 minutes each time. If needed, take pain medication prescribed by your doctor.
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Wearing Certain Types Of Clothing Might Be Hard During Surgery Recovery
Usually in discharge, they tell you to wear button-down clothing for a while, but what they dont tell you is that your skin is super sensitive and wearing tight clothing even a couple of months after might be hard. For women, wearing bras might be tough. Try to find comfortable sports bras you can unclasp or undershirts. I tend to wear bras now that dont have underwires and have a t-shirt cotton feel.
Conventional On Pump Coronary Artery Bypass Surgery
More than 70%2 of all bypass surgeries are performed on a stopped heart. Unlike beating heart surgery, during conventional on pump heart bypass, medication is used to stop your heart.
A heart-lung machine takes over the function of your heart and lungs during the surgery.The heart-lung machine is also called a cardiopulmonary bypass machine. It has a pump to function as the heart and a membrane oxygenator to function as the lungs.
A patient is placed on cardiopulmonary bypass during conventional open heart surgery. The Performer® CPB System, an advanced heart-lung machine, takes over the job of keeping oxygen-rich blood circulating throughout the body during conventional CABG surgery. This allows the surgeon to perform the surgery on a still heart.
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Surgery To Place Ventricular Assist Devices Or Total Artificial Hearts
A VAD is a mechanical pump that is used to support heart function and blood flow in people who have weak hearts.
Your doctor may recommend a VAD if you have heart failure that isn’t responding to treatment or if you’re waiting for a heart transplant. You can use a VAD for a short time or for months or years, depending on your situation.
A TAH is a device that replaces the two lower chambers of the heart . You may benefit from a TAH if both of your ventricles don’t work well due to end-stage heart failure.
Placing either device requires open-heart surgery.
Open Heart Surgery Scar
Given the fact that open heart surgery requires a large incision to be made to the chest, you should take all the necessary measures to protect the incision and make sure that the wound heals properly. Maintaining excellent hygiene is essential, so as to prevent infection and guarantee that you have a clean scar in the end. Avoid soaking the incision in hot water until the wound heals but be sure to take regular showers and keep the area clean. If the scar looks infected, then be sure to contact the doctor and see what treatment options are available.
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Coronary Artery Bypass Grafting
CHD is a disease in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart.
Over time, plaque can harden or rupture . Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort called angina .
If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. This is the most common cause of a heart attack. Over time, ruptured plaque also hardens and narrows the coronary arteries.
During CABG, a healthy artery or vein from the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses the blocked portion of the coronary artery. This creates a new path for oxygen-rich blood to flow to the heart muscle.
Surgeons can bypass multiple blocked coronary arteries during one surgery.
Heart Bypass Surgery Procedure
Youâll be asleep the whole time. Most operations take between 3 and 6 hours. A breathing tube goes in your mouth. It’s attached to a ventilator, which will breathe for you during the procedure and right afterward.
A surgeon makes a long cut down the middle of your chest. Then they’ll spread your rib cage open so that they can reach your heart.
Then the surgeon will remove a blood vessel, called a graft, from another part of your body, like your chest, leg, or arm. They’ll attach one end of it to your aorta, a large artery that comes out of your heart. Then, they’ll the other end to an artery below the blockage.
The graft creates a new route for blood to travel to your heart. If you have multiple blockages, your surgeon may do more bypass procedures during the same surgery .
In some cases, the surgeon may not need to stop your heart. These are called âoff-pumpâ procedures. Others need only tiny cuts. These are called âkeyholeâ procedures.
Some surgeries rely on the help of robotic devices. Your surgeon will recommend the best operation for you.
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What Happens During Open
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.
What Happens After Heart Bypass Surgery
Youâll wake up in an intensive care unit . The breathing tube will still be in your mouth. You wonât be able to talk, and you’ll feel uncomfortable. Nurses will be there to help you. Theyâll remove the tube after a few hours, when you can breathe on your own.
During the procedure, the medical team will probably have put a thin tube called a catheter into your bladder to collect urine. When youâre able to get up and use the bathroom on your own, theyâll remove it.
They also attached an IV line before the surgery to give you fluids and medications. Youâll get it removed once youâre able to eat and drink on your own and no longer need IV medications.
Fluids will build up around your heart after the procedure, so your doctor will put tubes into your chest. Theyâll be there for 1 to 3 days after surgery to allow the fluid to drain.
You may feel soreness in your chest. Youâll have the most discomfort in the first 2 to 3 days after the procedure. You will probably get pain medicines for that.
You should be able to start walking 1 to 2 days after surgery. Youâll stay in the ICU for a few days before you’re moved to a hospital room. Youâll stay there for 3 to 5 days before you go home.
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Cardiac Resynchronisation Therapy And Cardiac Resynchronisation Therapy Defibrillator Device
If you have heart failure, you may need a special type of device called cardiac resynchronisation therapy device. As well as treating heart arrhythmias, this device also synchronises your hearts chambers to contract and relax in a regular way, which improves the pumping action of your heart.
There is also a type of CRT that can be used as above and in addition can deliver a “shock” to treat dangerous heart arrhythmias and then synchronise your hearts chambers to normal rhythm once more. This is CRT-D .
Totally Endoscopic Robotically Assisted Coronary Artery Bypass Grafting
Totally endoscopic robotically assisted coronary artery bypass grafting is a newer technique in heart surgery.
It’s a minimally invasive method of performing a heart bypass.
During a TECAB grafting procedure, the surgeon deflates your lungs and makes a number of small cuts between your ribs.
Robotic arms, controlled by the surgeon, are used to carry out the surgery.
An endoscope is attached to the robotic arms so the surgeon can see inside your body and view the results of the surgery on a screen.
TECAB grafting can be carried out using a heart-lung bypass machine, or it can be done off-pump.
There are lower rates of wound infection with this type of surgery, plus minimal scarring and a faster recovery time.
But as this is a new technique that’s only been carried out on a small number of people, it’s difficult to assess how effective and safe it is in the short and long term, and how the outcomes compare with other types of surgery.
If you’re considering having TECAB, it’s important you understand there are still uncertainties about how safe the procedure is and how well it works.
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Do They Take Your Heart Out During Open Heart Surgery
Before getting to the actual question that do they take your heart out during an open heart surgery? it is really important to figure out what a heart surgery actually is. With the latest technologies and medical machinery, it has become quite simple to operate even the sensitive most parts of the human body, including the brain and heart. One of the many popular surgeries of the heart includes the open heart surgery. Lets find out what it actually is.
You May Experience Collarbone And Sternum Pain After Open
Sometimes you can have prolonged collarbone and sternum pain. Collarbone pain and sternum pain can be caused by the trauma of the surgery on your body or sternal wires. This pain can be sometimes helped with cardiac rehab or a resternotomy. However, make sure to communicate with your doctor about your pain to make sure its normal. After this past open heart surgery, Ive had a lot of pain and clicking in my shoulders and chest. Its caused a lot of chronic pain but working with physical therapy has helped me regain strength.
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