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How Serious Is Open Heart Surgery

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Purpose Of The Bentall Procedure

Open Heart Surgery: What to Expect (English CC)

The problems with the aorta and aortic valve can happen due to a variety of medical problems.

One of the most common is , a genetic condition that causes problems with a persons connective tissue, including some of the tissue in the aortic root and valve. This can cause the area not to form normally or to develop problems over time. In addition to other potential medical problems, a person with Marfan syndrome might have an aneurysm form in their ascending aorta.

However, sometimes people develop problems in these areas for other reasons. Other possible underlying causes include:

  • Other hereditary syndromes that affect the heart
  • Physical trauma
  • Autoimmune disease
  • Congenital heart problems
  • General degeneration

In any case, these problems need to be surgically repaired if the aneurysm is large enough. The most important consideration is the risk that the aneurysm will start to dissect. That means that the layers of the blood vessel will start to separate.

This can cause the artery to burst, leading to a life-threatening emergency. To prevent this, some intervention, such as the Bentall procedure, is necessary. The Bentall procedure might also be needed as an emergency surgery if an aneurysm has already ruptured.

Minimally Invasive Heart Surgery

and Minimally Invasive Coronary Artery Bypass Graft

What the Procedure Does

An alternative to standard bypass surgery . Small incisions are made in the chest. Chest arteries or veins from your leg are attached to the heart to “bypass” the clogged coronary artery or arteries. The instruments are passed through the ports to perform the bypasses. The surgeon views these operations on video monitors rather than directly. In PACAB, the heart is stopped and blood is pumped through an oxygenator or “heart-lung” machine. MIDCAB is used to avoid the heart-lung machine. It’s done while the heart is still beating. Requires several days in the hospital.

Reason for the Procedure

  • Manages blockage of blood flow to the heart and improves the supply of blood and oxygen to the heart.
  • Reduces risk of heart attack.
  • Improves ability for physical activity.

A Chest Pillow Is A Must

Having a pillow to stabilize your chest is a must. Most hospitals will send you home with one, but if they dont, make sure to get one. Chest pillows can help you when you sleep, sneeze, and cough they have has many uses. I had a pillow with me for almost a year after my last surgery and I still usee one during long trips in the car.

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For Weight Loss Achieved By Reducing The Size Of The Stomach

A bariatric surgery is carried out for weight loss and is especially challenging for surgeons as they have to employ particular instruments since the internal organs are hard to separate and in most cases have a layer of slippery fat surrounding them. The risk is greater with possible complications from anaesthesia, even the dosage of drugs need to be higher as they are easily absorbed by the fat. The patients also present a higher chance of contracting pneumonia.

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What Can Be Done To Lessen The Burden

Fourth patient diagnosed with serious infection after open

The surgeries that topped this list all involved the abdominal area. There are several reason for this, Havens said.

First, surgeries involving the abdomen are very common. âWhen we look at the numbers, there may be only 4,000 amputations compared to 600,000 gall bladder surgeries, he said.

Second, the complication rate is fairly high. âWhen you operate on the intestines, if you think about it, itâs full of bacteria, which puts you at a high risk of infection,â Havens said. âAnd if youâre getting an operation on your intestine, youâre likely not eating. You may not have been eating before the surgery. You wonât eat for a while after the surgery. So, often nutrition is a problem.â

Finally, many of these procedures are done more commonly in elderly patients, which can increase risk of complications and death.

Havens said the findings shed light on the procedures that need more attention and resources. He said future research needs to identify why these particular surgeries are so burdensome and what can be done to improve outcomes.

âI think emergency general surgery needs to be defined as a separate and unique specialty like cardiac surgery or vascular surgery,â he said. âThis could stimulate discussion and perhaps lead to training changes to improve the quality and make emergency general surgeries safer so patients could get through this with less burden.â

First published on April 29, 2016 / 8:59 AM

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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 isnât responding to treatment or if youâre 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 donât work well due to end-stage heart failure.

Placing either device requires open-heart surgery.

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What Happens After Open

When you wake up after surgery, you will have two or three tubes in your chest. These are to help drain fluid from the area around your heart. You may have intravenous lines in your arm to supply you with fluids, as well as a catheter in your bladder to remove urine.

You will also be attached to machines that monitor your heart. Nurses will be nearby to help you if something should arise.

You will usually spend your first night in the intensive care unit . You will then be moved to a regular care room for the next three to seven days.

Taking care of yourself at home immediately after the surgery is an essential part of your recovery.

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You May Experience Memory Loss And/or Brain Fog

There are a couple of things that can cause memory loss and brain fog after open-heart surgery. If you were put on bypass, it can cause these issues. It is also called pump head. Post-operative cognitive dysfunction can also cause memory loss. Both of these are usually short-term but can have the possibility of long-term effects. For the first six months, I really struggled with memory loss and brain fog. As time went on, it started to get better and I started to regain my memory and wasnt so foggy-headed.

When Do You Need Heart Valve Replacement Surgery

WATCH Triple Bypass Open Heart Surgery

A heart valve disease develops when the valve becomes either stiff, narrow , or leaky . These two disease states of the valve disrupt the flow of blood in and out of the heart.

Heart valve diseases can be present by birth or occur as a complication of other health conditions, such as rheumatic heart disease.

Many people who have heart valve disease may never experience any symptoms. Sometimes, the valve disease is diagnosed when a woman is pregnant. Doctors may still recommend heart valve replacement surgery to prevent the worsening of the heart condition.

With a diseased valve, heart valve replacement surgery becomes an emergency if you experience:

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He Said To Me I Don’t Have Much More Time

M. chimaera is a difficult infection to diagnose. Initial symptoms are generally nonspecific, such as fatigue, fever and night sweats. Because it can take years for symptoms to present, the infection has often already spread by the time it is discovered.

“And then it can be incredibly difficult to treat and to cure,” said Smith.

In Alberta, there have been 10 confirmed cases of M. chimaera infection related to open heart surgeries. Eight of the patients have died, said Smith. The surviving two spoke to CBC News.

Company Issued Notice In 2015

LivaNova became aware of the contamination at the manufacturing facility in 2014, according to the class action.

In June 2015, the company told hospitals and Health Canada that bacteria could be aerosolized when the device was in operation.

LivaNova said the “disinfection practices that some users have been performing are not always conducted according to our instructions.”

The notice advised hospitals to change the water tanks daily, disinfect the equipment and test the water for bacteria.

“They breached their duty to warn by underplaying the risks of harm, by saying you’re not cleaning the machines properly, it’s not us, it’s you,” said Waddell.

Emails obtained by CBC News show that two months later, the company wrote to Health Canada saying it had contacted all hospital customers and considered the matter closed.

A Health Canada compliance officer agreed, writing: “I agree that this recall can be considered closed at this time.”

But further emails show that various health regions wrote to Health Canada, raising issues with the practicality of LivaNova’s recommendations. They said the process for decontaminating the devices was not working and they were having difficulty finding a lab to test the water.

Internal emails show the Health Canada compliance officer dismissed the latter complaint, writing: “I can only assume didn’t ask the company.”

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Potential Complications During And After

Some of the more common complications of heart surgery are routinely dealt with during the hours and days of recovery in the hospital. The patient is closely monitored for these complications by staff and through lab tests.

  • Bleeding: May occur at the incision site or from the area of the heart where surgery is performed
  • Abnormal Heart Rhythm: In rare cases, a temporary external, or permanent internal pacemaker may be necessary to correct this problem.
  • Ischemic Heart Damage: Damage to heart tissue caused by a lack of blood flow to the heart
  • Death: The risk of death is increased in surgeries where the heart is stopped for the procedure.
  • Blood Clots: Clots may form in and around the heart or travel through the bloodstream.
  • Stroke: Often caused by clots that form in the blood after surgery
  • Blood Loss: In some cases, a transfusion may be necessary.
  • Emergency Surgery: If a problem is discovered after surgery, emergency surgery may be necessary to repair any problems.
  • Cardiac Tamponade : A life-threatening condition where the pericardium, the sac surrounding the heart, fills with blood. This makes it difficult, or impossible, for the heart to fully function.
  • : Separation of the sternum may slow the healing process of the bone. Sternal precautions help prevent this as well as excessive pulling on the surgical incision.

This Team Is On The Verge Of Creating A Beating Band

Tips For Preparing For Open Heart Surgery

He considers it telling that off-pump coronary bypass surgeries in the U.S. dropped from 23 percent in 2002 to 17 percent in 2012.

The vast majority of cardiac surgeons dont want to hurt their patients, and while they want to be innovative, I think when they stop doing this operation, you know that theres got to be a problem, he said.

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How Is Yale Medicine Unique In Its Approach To Cardiac Surgery

Yale Medicine Cardiac Surgery has a team of world-class heart surgeons who are highly skilled in treating the full range of cardiac diseases and conditions, using a variety of approaches and techniques, from minimally invasive robotic surgeries to complex open surgeries. Yale New Haven Hospitals Heart & Vascular Center is one of the few cardiac centers in the country where cardiac surgery outcomes for procedures such as CABG and mitral and aortic valve replacement consistently exceed national and regional norms.

Yale is a major referral center for a number of cardiac surgeries. Yale Medicine has the largest volume of aortic cases in Connecticut and is in the top 3 percent of aortic surgical volume nationally. We are one of the highest volume centers in New England for mitral valve repairs, which our surgeons can often perform with a minimally invasive approach that may include use of a highly advanced robotic surgical tool. We also are nationally recognized for excellence in TAVR and are a designated training center for this technique.

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An Invasive Surgery That Requires Removing A Portion Of The Skull To Inspect The Brain

Imagine a an operation to drill through a portion of the skull to reach the brain. The removed portion is not replaced immediately leaving the brain vulnerable to damage if it is not protected properly. The permanent damage can include loss of vision, mobility, speech, memory and co-ordination. There is also the chance of excessive build up of fluid in the brain which could result in side-affects as serious as a stroke, seizures, spinal fluid leakage, swelling of the brain, making it one of the riskiest surgeries.

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Coronary Artery Bypass Grafting

When arteries that feed oxygen to the heart are blocked, the heart muscle is at risk for damage called a heart attack and even death. In an operation known as coronary artery bypass grafting , an artery or vein from another part of the body is used to reroute blood flow around the blockage. Surgeons use chest wall arteries and segments of the patients own veins to construct new pathways for blood and oxygen to reach the heart. The veins used for this reconstruction are usually taken from the patients legs, using a minimally invasive technique that leaves only a few tiny incisions. By restoring blood flow to the heart, CABG can relieve symptoms and potentially prevent a heart attack. Coronary bypass operations are performed half a million times a year with an overall success rate of almost 98 percent.

There are two types of CABG operations currently available: on-pump and off-pump surgery. On-pump procedures require the surgeon to open the chest bone , stop the patient’s heart, and place the patient on a heart-lung machine. This machine takes over the function of the patient’s heartdelivering oxygenated blood through out the body and brainwhile the bypass is performed.

What To Expect After The Triple Bypass Surgery

Life in the OR â Open Heart Surgery

After the triple bypass surgery operation is done, the patient is allowed to wake naturally from the anaesthesia. Thus it takes around four to six hours for the patient to wake up and become alert. The patient will be kept in a cardiac care unit or ICU on the first day after the surgery for observation. Within 12 hours of the surgery, the patient not only wakes up but is asked to slowly walk few steps and sit on a chair at least once. This process is aimed to reduce the risks of serious complications like blood clots and pneumonia. It takes about few weeks for the patient to recover from triple bypass surgery.

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Infections Rare But Deadly

One of those deaths was Sheila Hagan-Bloxham’s husband of 52 years, John Bloxham.

“John was not a person who had a vengeful bone in his body. He would not like the idea of being involved in a lawsuit,” said Hagan-Bloxham. “But he would be adamant that he did not want this to happen to anybody else.”

Bloxham had surgery for an aortic valve replacement in April 2016 at the Mazankowski. He died as a result of M. chimaera infection in January 2018, two months after doctors confirmed he’d been infected. By then, it had spread to his bone marrow and his brain.

WATCH | Sheila Hagan-Bloxham recounts some of her final moments with her husband:

About Coronary Artery Bypass Surgery

An estimated 170,000 Americans undergo coronary artery bypass surgery each year. This operation, once considered a difficult achievement, is now almost routine in many medical centers.

Studies have conclusively demonstrated that the operation prolongs life in patients who have severe blockages in the three major coronary arteries, in severe disease, in patients with low ejection fraction, and in patients with diabetes. There is less agreement about when it is appropriate for other patients. In general, it is recommended for people with disabling angina that cannot be controlled by conventional therapy and who are also good candidates for surgery.

The operation itself is relatively simple. For “on-pump” procedures, circulation is maintained by a heart-lung machine. In an “off-pump” operation, the surgeon operates directly on the beating heart. Most people who undergo the operation report feeling vastly better afterward. Very often, the patient may have suffered from disabling angina or other cardiac limitations before the operation. With an increased blood supply to the heart muscle, these problems should be eliminated or minimized.

The skill and experience of the surgical and recovery teams also are important considerations. Patients considering coronary bypass surgery always should determine whether the surgeon performs this particular operation regularly and whether there is a skilled recovery team and a special recovery unit.

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Why Would You Need Heart Reoperation Surgery

There are several reasons why you may need a second heart operation.

1. Its been awhile since your first surgery

If you had coronary artery bypass, you may find that you need a second surgery later in life because of new disease in your own vessels or disease that has developed in your bypass grafts. How long a coronary artery bypass lasts depends on a number of things, including:

  • Type of bypass used
  • Quality of the coronary arteries being bypassed
  • Risk factors
  • Genetic tendencies

2. A valve repair or replacement fails

If you had a heart valve repair or replacement, the operation sometimes needs to be repeated. Repairs are typically chosen over replacement because of the prospect for longer durability.

Depending on the reason for the first repair, sometimes the valve itself will still degenerate over time. Similarly, tissue replacement valves are known to wear out over time and even mechanical valves can develop later problems that may require a reoperation.

For example, the valve might start to leak or allow blood to flow backwards . This impairs your heart function. We can often repair the valve again to achieve the outcomes that we hoped for in the first surgery, or we can replace the valve.

3. Complications develop

If you develop an infection or other complications from your initial surgery, you may need a second heart surgery. These reoperations are particularly difficult and should be addressed by a team familiar with the safest techniques for successful treatment.

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