Who Is In Theater For Open Heart Surgery
A team of doctors and other health professionals work together in the operating theater during open heart surgery.
The team is likely to include:
- the lead surgeon who will direct others surgeons who will assist during the operation
- the anesthesiologist, who is in charge of giving and anesthesia and monitoring vital signs
- the pump team, also known as perfusionists, operate the heart-lung machine and other technical equipment that supports open heart surgery
- nurses and technicians, who assist the surgical team and prepare the operating theater for surgery
What Happens During Coronary Artery Bypass
Coronary artery bypass graft surgery requires a stay in a hospital. Procedure may vary depending on your condition and your doctor’s practices.
Generally, CABG follows this process:
You will be asked to remove any jewelry or other objects that may interfere with the procedure.
You will change into a hospital gown and empty your bladder.
You will lie on your back on an operating table.
The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. Once you are sedated , a breathing tube will be put into your throat and you will be connected to a ventilator, which will breathe for you during the surgery.
A healthcare professional will insert an intravenous line in your arm or hand. Other catheters will be put in your neck and wrist to monitor your heart and blood pressure, as well as to take blood samples.
A catheter will be put into your bladder to drain urine.
The skin over the surgical site will be cleaned with an antiseptic solution.
Once all the tubes and monitors are in place, your doctor will make incisions in one or both of your legs or one of your wrists to access the blood vessel to be used for the grafts. He or she will remove the vessel and close those incision.
The doctor will make an incision below the Adam’s apple to just above the navel.
The doctor will cut the sternum in half lengthwise. He or she will separate the halves of the breastbone and spread them apart to expose your heart.
What Happens Before Heart Surgery
Preparation for your surgery can take weeks or months. Before your heart surgery is scheduled, your medical care team will evaluate your condition. Your care team will likely include your primary care doctor and cardiologist. Youll also consult with a cardiothoracic surgeon .
Your care team will give you a medical evaluation. This includes:
- Talking about your symptoms and how long theyve been going on.
- Talking about your medical history and your biological familys medical history.
- Blood tests to check your cholesterol and other important numbers.
Your team will also run some diagnostic tests. These tests provide a detailed picture of your heart function and any problems. They also help you and your care team decide if you need surgery and what type you need.
If you need surgery, your care team will tell you exactly how to prepare and what to expect. Its important to follow their recommendations about:
- When to stop taking any medications.
- When to begin fasting the day before your surgery.
- Quitting smoking or tobacco use and reducing alcohol consumption to lower your risk of complications.
Be sure to ask any questions you have, even if they seem small or you think you asked them already. Its better to double-check to make sure youre as prepared as possible for your surgery.
What to expect after youre admitted to the hospital
- Tests like an EKG or chest X-ray.
- Hair shaved from the spot where youll have your incision.
- Glasses and contact lenses.
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Do You Have To Make Any Dietary Changes After Heart Bypass Surgery
A heart smart diet is always a good choice, whether you have had surgery, or are simply trying to stay healthy and strong. The Mediterranean diet is a great option.
This eating plan is rich in:
This easy-to-follow diet has been proven to reduce heart attack risk and improve the health of the arteries. For some people, cutting back on salt is also important, since salt may contribute to high blood pressure and fluid buildup.
What Happens During Heart Surgery
What happens during your surgery depends on the type youre having. It also depends on the method your surgeon uses to perform the operation.
Surgeons use different methods for operating on your heart. These include open-heart surgery, off-pump bypass surgery and minimally invasive heart surgery. Your care team will discuss which method is best for you, and why.
Open-heart surgery
Open-heart surgery is what most people think of when they hear someone say heart surgery. Your surgeon makes a 6-to 8-inch long incision in the middle of your chest and spreads your ribcage to reach your heart. Youll be connected to a heart-lung bypass machine, so your heart wont be beating during the surgery.
The length of traditional open-heart surgery varies based on whats being fixed. CABG surgery takes about three to six hours.
Off-pump bypass surgery
Off-pump bypass surgery is also called beating heart surgery. Its similar to traditional open-heart surgery, but you wont be on a heart-lung bypass machine. This method can only be used for CABG surgery. And its most suitable when only one or two coronary arteries need to be bypassed.
Minimally invasive surgery
Minimally invasive heart surgery is also called a keyhole surgery. This means your surgeon makes smaller incisions to access your heart.
A partial sternotomy involves a 3- to 4-inch incision through part of your sternum . A mini-thoracotomy avoids your breastbone and instead uses small cuts between your ribs.
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Helping Your Loved Ones In Managing Their Emotions During Bypass Surgery Recovery Period
The caregiver can help their loved ones in managing their emotions during bypass surgery recovery period. Feeling sad or cold after a surgery is a common symptom, but it should pass after a few weeks. The person who is taking care of the patient should encourage their loved one to:
There are a few precautions for bypass surgery that can be taken to reduce the risk of getting heart problems in the future.
The First 24 To 48 Hours After Surgery
A heart bypass procedure usually takes approximately four to six hours to complete. After your surgical procedure is complete, you will be transferred to the cardiac intensive care unit or intensive care unit . Most people are transferred out of the CICU unit, to a lower level of care in one to three days.
On the day of surgery, most people who have undergone heart bypass surgery:
- Begin drinking clear liquids: You will also start eating easy-to-digest solids once your body can tolerate it. You’ll stay away from food that are fried, greasy, processed or spicy.
- Are asked to sit up: Your healthcare team will encourage you to move your body by sitting up on the side of the bed.
- Are coached to cough and do deep breathing exercises frequently: This is to prevent lung complications such as pneumonia.
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Caring For Your Wound
The metal wires holding your breastbone together are permanent.
But the stitches closing your skin will gradually dissolve over the weeks following surgery as your skin heals.
While you’re recovering in hospital, you’ll be told about how to care for your wounds at home.
It’s important to keep the wounds clean and protect them from the sun while they’re healing.
You’ll have a scar where the surgeon cut down your chest, as well as where the grafted blood vessel was taken from.
These will be red at first, but will gradually fade over time.
When Should I See My Healthcare Provider
- Signs of infection by your incision, like oozing or redness.
- Slurred speech or other signs of a stroke.
It may be hard to know when a symptom is just a part of recovery, or when its a sign of a complication. When in doubt, pick up the phone and call your care team. Its better to get checked out and learn nothings wrong than to ignore a problem that needs medical care.
A note from Cleveland Clinic
Heart surgery is a life-changing event for you and your loved ones. Take the time to learn more about your condition and the surgery that you need. Talk with your healthcare provider and ask any question that comes to mind. Keep your support system close during this journey, and dont be afraid to ask for help when you need it. If you dont have family and friends nearby, talk with your provider about available resources and support groups.
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How Long Can You Live After Heart Surgery
You can live for many years or decades after heart surgery. Many factors affect how long you live, including other health conditions and risk factors. Heart surgery can make you healthier and stronger. But its important to keep doing whatever you can to lower your risks for future problems. Things you can do include:
- Make lifestyle changes recommended by your healthcare provider.
- Take your medications as prescribed.
- Keep all your medical appointments and follow-ups.
Heart surgery is like a bicycle that can carry you down a long road when youre tired of walking, but you still have to push the pedals.
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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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 Happens After Heart Surgery
After your heart surgery is done, youll be moved to the intensive care unit . Youll recover in the ICU for at least one day. Youll then move to a regular hospital room for continued rest and care.
How long you stay in the hospital depends on the surgery you had and how your body responds to it. Each persons recovery is different. Your hospital team will keep a close eye on you and make sure youre healing as you should. Theyre also prepared to notice and respond to any problems that come up.
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How Long Does It Take To Recover From Heart Bypass Surgery
Heart bypass surgery is the most common type of heart surgery performed on adults. Doctors recommend heart bypass surgery when one or more of the blood vessels that transport blood to the heart muscles become partially blocked.
Heart bypass surgery is a complicated procedure that involves a significant amount of preparation and recovery time. Occasionally, someone must undergo emergency heart bypass surgery, but most of the time the operation is planned.
Heart bypass surgery is a relatively safe and effective procedure that reduces the risk of heart attack and death. The procedure might also ease symptoms of coronary artery disease, such as chest pain.
How Long Does It Take To Recover From Heart Surgery
Recovery depends on the type of surgery and other factors like your overall health. Most people need six to 12 weeks to recover from open-heart surgery. Some people need even more time.
Follow your care teams instructions on when you can drive, go back to work, lift heavy objects or do other activities. Your care team will also offer advice on how to care for your incision. Its important to take things slow and give your body time to heal.
As you recover, you may feel:
- A clicking sensation in your chest. This should go away after a week or two. If it doesnt, call your surgeon.
- Bruising or minor swelling at your incision site.
- Difficulty falling asleep or staying asleep.
- Less hungry. You may even feel nauseated around food for a couple of weeks. This is normal and common.
- Pain or tightness in your shoulders and upper back.
- Sad, depressed or moody.
These are normal responses to surgery. But that doesnt mean you have to face them alone. Tell your family or friends how youre feeling. If the pain feels severe or medication doesnt help, call your care team.
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Managing Pain After Open Heart Surgery
Managing your pain is an important part of your recovery after heart surgery. In addition to keeping you comfortable, pain control can help speed your recovery and reduce your risk of developing certain complications after surgery, like pneumonia and blood clots. Your pain level should be managed to the point that youre able to get up, walk around, cough and take deep breaths after surgery.
After heart surgery, you need to be able to move with some degree of comfort to aid the healing process, Dr. Tong says. Keeping your pain level manageable will help make sure your recovery stays on track.
You may leave the hospital with a prescription for pain medication and detailed instructions on how to use those medications to manage your pain.
People are often apprehensive about taking narcotic pain medications because of the risk of addiction, Dr. Tong notes. That is a healthy and very reasonable fear and an important conversation to have with your doctor. There are safeguards in place to stem opioid abuse and protect you from abusing medications. When it comes to prescription pain medication, for most people, its a matter of listening to your body. If you need it, take it. If you dont, dont.
If you have concerns about bringing narcotics into your home, or if you have a history of substance use disorder, be honest with your doctor. Theyll be able to discuss your options with you and determine a pain control plan with you.
What Are The Most Common Heart Surgeries
Coronary artery bypass grafting is the most common heart surgery. In 2018, about 200,000 CABG procedures were performed in the U.S.
The second most common heart surgery is valve replacement and repair. About 110,000 valve surgeries were performed in the U.S. in 2018. This number doesnt include endovascular repair methods, which dont require open surgery.
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Your Eating Habits May Change
You may notice that youve lost your appetite or you just feel too tired to eat. This is common, so be patient. Your appetite will soon be back to normal.
We suggest you try eating frequent, small meals throughout the day. You need proper nutrition to enable your body to heal and get stronger.
We recommend a diet low in fat, cholesterol and sodium and high in protein. Good sources of protein include fish, eggs, dairy, beans and nuts. Limit the amount of salt in your diet to 2,000 milligrams a day. Foods known to be high in salt include restaurant food, soups, pizza, bacon and other processed meats.
Stay Active Before Surgery
Dr. Bolman: Some degree of physical fitness definitely helps recovery. If you are inactive for a few days, your muscle tone will quickly disappear, leaving you feeling vulnerable, debilitated, and discouraged.
Dr. Rawn: Fitness is particularly critical in people with marginal conditioning, since the stress of surgery and immobility can be profoundly deconditioning. You don’t have to be immobilized long before it’s a struggle to get out of bed. Before surgery, walk up the stairs, walk for a miledo whatever you can within reason, and it should speed your recovery.
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What Conditions Are Treated With Heart Surgery
Heart surgery treats a range of conditions that affect your heart and the blood vessels connected to your heart.
Aneurysms
An aneurysm is a bulge in your artery wall or heart muscle. One type of aneurysm is an aortic aneurysm. This occurs in your aorta, which is the large artery that carries blood out of your heart to the rest of your body. Aortic aneurysms may form in your belly . Less often, they form in your chest .
Aneurysms can also form in your heart muscle, usually in your left ventricle. This is the chamber of your heart responsible for pumping blood through your aorta.
Arrhythmias
An arrhythmia is an abnormal heartbeat. Your heart might beat too fast or too slow . Or, your heart may have an irregular rhythm. Atrial fibrillation is the most common type of irregular rhythm.
Over time, an arrhythmia can weaken your heart and lead to serious problems.
Congenital heart disease
Some congenital heart defects need to be repaired soon after birth. Other defects may not show symptoms right away. So, congenital heart disease can affect adults who never knew they had a problem. This often happens with atrial septal defects, which may not show symptoms until middle age.
Coronary artery disease
CAD may cause no symptoms. In some cases, it causes chest pain . If untreated, CAD can lead to a heart attack.
CAD is the most common form of heart disease, affecting about 18 million adults in the U.S.
Heart failure
Heart valve disease
- Stiff and narrow .