Open Heart Surgery Procedures

What Are The Alternatives To Bypass Surgery

There are a few less-invasive procedures your doctor could try instead of bypass surgery.

Angioplasty. A surgeon threads a deflated balloon attached to a special tube up to your coronary arteries. Once it’s there, they inflate the balloon to widen your blocked areas. Most times, it happens in combination with the installation of something called a stent, a wire mesh tube that props your artery open.

There’s also a version of angioplasty that, instead of a balloon, uses a laser to eliminate the plaque that clogs your arteries.

Minimally invasive heart surgery. A surgeon makes small incisions in your chest. Then, they attach veins from your leg or arteries from your chest to your heart, much like a traditional bypass surgery. In this case, though, your surgeon will put the instruments through the small incisions and use a video monitor as a guide to do the work. Unlike bypass surgery, your heart is still beating during this procedure.

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Coronary Artery Bypass Surgery

Once your doctor has opened the chest, he or she will stabilize the area around the artery to be bypassed with a special instrument.

The rest of the heart will continue to function and pump blood through the body.

The heart-lung bypass machine and the person who runs it may be kept on stand-by just in case the procedure need to be completed on bypass.

The doctor will do the bypass graft procedure by sewing one end of a section of vein over a tiny opening made in the aorta, and the other end over a tiny opening made in the coronary artery just below the blockage.

You may have more than one bypass graft done, depending on how many blockages you have and where they are located.

Before the chest is closed, the doctor will closely examine the grafts to make sure they are working.

What Are The Risks Of Coronary Artery Bypass Surgery

Possible risks of coronary artery bypass graft surgery include:

• Bleeding during or after the surgery

• Blood clots that can cause heart attack, stroke, or lung problems

• Infection at the incision site

• Failure of the graft

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.

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Here For You Before During And After Surgery

Whether youve had a heart attack or youre recovering from a heart procedure or surgery, PeaceHealth gives you the power to heal better and faster with cardiac rehabilitation. Programs include medical oversight, education and guidance on exercise and nutrition to help you lead a heart-healthy lifestyle.

What Are The Risks Of Heart Bypass Surgery

All surgeries come with the chance of problems. Some include:

• Blood clots that can raise your chances of a stroke, a heart attack, or lung problems
• Problems breathing

Many things affect these risks, including your age, how many bypasses you get, and any other medical conditions you may have. You and your surgeon will discuss these before your operation.

Once youâve recovered, your symptoms of angina will be gone or much better. Youâll be able to be more active, and youâll have a lower risk of getting a heart attack. Best of all, the surgery can add years to your life.

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Why Might I Need Coronary Artery Bypass Surgery

Your doctor uses coronary artery bypass graft surgery to treat a blockage or narrowing of one or more of the coronary arteries to restore the blood supply to your heart muscle.

Symptoms of coronary artery disease may include:

• Swelling in the hands and feet

Unfortunately, you may not have any symptoms in early coronary artery disease, yet the disease will continue to progress until theres enough artery blockage to cause symptoms and problems. If the blood supply to your heart muscle continues to decrease as a result of increasing blockage of a coronary artery, you may have a heart attack. If the blood flow cant be restored to the particular area of the heart muscle affected, the tissue dies.

There may be other reasons for your doctor to recommend CABG surgery.

What Medications Will I Take After Heart Bypass Surgery

Your doctor will give you medications to help manage your pain, such as ibuprofen or acetaminophen . You may also receive a narcotic for extreme pain.

Your doctor will also give you medications to help you throughout your recovery process. These will include antiplatelet drugs and other drugs prescribed by your doctor.

Talk to your doctor about what medication plans are best for you. This is especially important if you have existing conditions such as diabetes or conditions affecting the stomach or liver.

Type of drug

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What To Expect On The Day Of Surgery

Prepping you for surgery will involve several steps, including checking your vitals, placing an IV in your hand, arm, or neck to deliver fluids and medications during surgery, and placing an arterial line to monitor your blood pressure.

Once you are in the operating room, an anesthesiologist will give you medications to put you to sleep and a breathing tube will be inserted. This tube is connected to a ventilator to assist with breathing during surgery.

A Foley catheter will also be placed at this time to drain urine. In select cases, the surgeon may place a thin tube called a Swan-Ganz catheter in a vein in your neck. This catheter measures pressures in and around the heart and is used for monitoring purposes during and right after surgery.

The precise steps of your open heart surgery depend on what exactly is being done and what technique is being used.

That said, here is a general breakdown of a traditional open heart surgery:

You will be wheeled into a post-anesthesia care unit where you will wake up from anesthesia.

The duration of open heart surgery depends on the specific operation being performed. For example, a CABG takes approximately three to five hours. A heart transplant surgery, on the other hand, may take up to eight hours.

If you have loved ones in the waiting room, a hospital staff member or member of the surgical team will provide them with updates during the surgery.

How Do I Prepare For Open Heart Surgery

Tell your healthcare provider about any drugs you are taking, even over-the-counter medications, vitamins, and herbs. Inform them also of any illnesses, including cold, flu, or fever.

In the two weeks before the surgery, your healthcare provider may ask you to quit smoking and to stop taking blood-thinning medications ,

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 any other detailed instructions when you arrive at the hospital for surgery.

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Why Do I Need Heart Bypass Surgery

Bypass surgery treats symptoms of coronary artery disease. That happens when a waxy substance called plaque builds up inside the arteries in your heart and blocks blood and oxygen from reaching it.

Your doctor may suggest heart bypass surgery if:

• You have severe chest pain that your doctor thinks happens because several of the arteries that supply blood to your heart are blocked.
• At least one of your coronary arteries has disease that’s causing your left ventricle — the chamber that does most of your heart’s blood pumping — to not work as well as it should.
• There’s a blockage in your left main coronary artery, which gives your left ventricle most of its blood.
• You’ve had other procedures, and either they haven’t worked or your artery is narrow again.
• You have new blockages.

Coronary artery disease can lead to a heart attack. It can cause a blood clot to form and cut off blood flow. Bypass surgery can give your ticker a big health boost.

If I Need Heart Surgery What Are My Next Steps

If you think or have been told you need heart surgery, your next step should be to get an evaluation or second opinion from a cardiac surgeon. Our surgeons can help you decide if surgery is truly necessary, and if so, which type of approach makes the most sense for you and your particular condition.

To get started, call 305-2633 or use ourappointment request form.

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What Is Minimally Invasive Heart Surgery

In minimally-invasive heart surgery, special surgical instruments , are inserted through tiny incisions in the chest or rib cage. The number and location of incisions will depend on the specific disease process and patient anatomy. People who qualify for minimally invasive options typically have faster recovery, reduced risk of infection, and a better cosmetic outcome.

Corrective Surgery For A Heart Defect Present At Birth

Congenital heart disease is caused by defects in the heart and great vessel structures. They are the most common types of birth defects. Babies born with one or more heart defects have CHD. CHDs can affect the structure of a babys heart, the way it works, and how blood flows through the heart and out to the rest of the body. Corrective surgery can treat a heart defect that a child is born with. The number of surgeries to repair the heart or blood vessels depends on the type and severity of the defect. The most common surgery is to close holes between the heart chambers.

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When Should I Call The Doctor

You should call your healthcare provider if you experience:

• Chest pain other than normal discomfort at the incision.
• Signs of infection at the surgical site, such as oozing and redness.
• Slurred speech or other signs of stroke.

A note from Cleveland Clinic

Open-heart surgery is a life-saving procedure. But it is also a major surgery. Recovery can be long. When possible, you should take steps to improve your health like exercising, losing weight and quitting smoking before surgery. These actions may make recovery easier. Its normal to have concerns before undergoing a heart procedure. Dont hesitate to share questions and concerns with your healthcare provider.

Last reviewed by a Cleveland Clinic medical professional on 03/25/2021.

References

How Do You Prepare For Bypass Surgery

Before your surgery, youâll get blood tests, chest X-rays, and an electrocardiogram . Your doctor may also do an X-ray procedure called a coronary angiogram. It uses a special dye to show how the blood moves through your arteries.

Your doctor will also let you know if you need to make any changes to your diet or lifestyle before the surgery and make any changes to medicines you take. Also tell your doctor about any vitamins and supplements you take, even if they are natural, in case they could affect your risk of bleeding.

Youâll also need to make plans for recovery after your surgery.

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What Is An Open Aortic Valve Replacement

An open, invasive aortic valve replacement is a surgery to replace a poorly working aortic valve with an artificial valve. The aortic valve is one of the hearts 4 valves. These valves help blood flow through the heart and out to the body. Under certain circumstances, your valve can stop working well. Your surgeon will use an artificial valve to replace your poorly working valve. This will ensure that your blood can exit the heart and flow out to the body normally. The surgery is called “open” because it uses a traditional type of incision to expose your heart. This incision is larger than those in minimally invasive types of aortic valve replacement surgery.

How Do I Manage Post

A cardiac anesthesiologist is also a pain management specialist for conditions related to surgery. Your anesthesiologist will talk to you about your options for managing post-operative pain. Before your surgery, the anesthesiologist may ask about your pain tolerance to help gauge how best to manage your post-operative pain, guiding decisions such as the proper narcotics dosage, the feasibility of nonnarcotic pain medication options, and the need for nerve blocks.

Although most heart surgeries are major surgeries, they are typically not a source of long-term pain. Even in the short term, the pain may be less severe than with operations on other areas of the body. Opioids are used when necessary, but there are many other pain management options, including:

• Lidocaine infusion

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What Are The Risks Of An Open Aortic Valve Replacement

There are certain risks with any type of surgery. Your particular risks will vary based on your particular medical condition, your age, and other factors. Be sure to talk with your doctor about any concerns that you have.

Most people who have open aortic valve replacement will have a successful outcome. However, there are some possible risks. These include:

What Are The Risks

Most heart surgeries are major surgeries. Although often successful, they do entail risks. The National Heart, Lung, and Blood Institute identifies some of these risks as:

• Damage to tissues in the heart, kidneys, liver, and lungs
• Death, especially for someone who is already very sick before surgery

The risk is higher if you have other diseases or conditions, such as diabetes, peripheral artery disease, or kidney or lung disease.

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Heart Procedures And Surgeries

If you’ve had a heart attack, you may have already had certain procedures to help you survive your heart attack and diagnose your condition. For example, many heart attack patients have undergone thrombolysis, a procedure that involves injecting a clot-dissolving agent to restore blood flow in a coronary artery. This procedure is administered within a few hours of a heart attack. If this treatment isn’t done immediately after a heart attack, many patients will need to undergo coronary angioplasty or coronary artery bypass graft surgery later to improve blood supply to the heart muscle.

See diagnostic tests and procedures to better understand the tests you may have to undergo to find out if you had a heart attack, how much damage was done and what degree of coronary artery disease you have.

Your Heart Is In Experienced Hands At The Dmc

The Detroit Medical Centers open-heart surgery program is made up of cardiovascular surgeons, critical care specialists, physician assistants, cardiac nurses, nurse practitioners and technicians.

When it comes to your heart, you need someone you can trust. The Heart and Vascular Institute at the DMC has delivered advanced cardiac care to our community for more than three decades. DMC Harper University Hospital is proud to be ranked by U.S. News and World Report for 2022-2023 as High Performing in Chronic Obstructive Pulmonary Disease, Heart Attack and Heart Failure.

Our range of services includes a comprehensive spectrum of diagnostic testing, which allows us to pinpoint a variety of conditions. We provide advanced cardiac care, including interventional cardiology procedures and open-heart surgery. Our care extends to the post-surgical period where we supervise cardiovascular rehabilitation and continue to monitor your heart health.

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What Happens During An Open Aortic Valve Replacement

Check with your doctor about the details of your procedure. In general, during your open aortic valve replacement:

• You will be given anesthesia before the surgery starts. This will cause you to sleep deeply and painlessly during the operation. Afterwards you wont remember it.
• The operation will take several hours. Family and friends should stay in the waiting room, so the surgeon can update them.
• Your doctor will make an incision down the middle of your chest. To access your heart, your doctor will separate your breastbone.
• The surgery team will connect you to a heart-lung machine. This machine will act as your heart and lungs during the procedure.
• Your surgeon will remove your current heart valve and replace it with a new valve.
• The surgery team will remove the heart-lung machine.
• The team will wire your breastbone back together.
• The team will then sew or staple the incision in your skin back together.

What To Expect During Open

Open-heart surgery is any kind of surgery in which a surgeon makes a large incision in the chest to open the rib cage and operate on the heart. For this type of surgery, you’ll be given anesthesia, a medicine to make you unconscious and unaware of pain.

Your surgeon will make a 6- to 8-inch incision down the center of your chest wall. Then, they will cut your breastbone and open your rib cage to reach your heart. During the surgery, you’ll receive medicine to thin your blood and keep it from clotting. Your surgeon will connect a heart-lung bypass machine to your heart. The machine will take over your heart’s pumping action and move blood away from your heart. This is done because surgeons can better perform some procedures on a heart that isn’t beating and doesn’t have blood flowing through it.

Heart-lung bypass machine. The image shows how a heart-lung bypass machine works during surgery. You’ll be given medicine to stop your heartbeat once you’re connected to the heart-lung bypass machine. A tube will be placed in your heart to drain blood to the machine. The machine will remove carbon dioxide from your blood, add oxygen to your blood, and then pump the blood back into your body. Your surgeon will insert tubes into your chest to drain fluid.

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What Are The Types Of Open

There are two ways to perform open-heart surgery:

• On-pump: A heart-lung bypass machine connects to the heart and temporarily takes over for the heart and lungs. It circulates blood through the body while moving blood away from the heart. The surgeon then operates on a heart that isnt beating and doesnt have blood flow. After surgery, the surgeon disconnects the device and the heart starts to work again.
• Off-pump:Off-pump bypass surgery takes place on a heart that continues to beat on its own. This approach only works for coronary artery bypass grafting surgery . Your surgeon may call this beating-heart surgery.