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Open Heart Surgery

What is open-heart surgery?

An open-heart surgery involves cutting through the breastbone to access the heart. Sometimes, open-heart surgery is also called traditional heart surgery. Currently, many new heart procedures can be done with only small cuts/incisions, without wide openings. Therefore, the term “open-heart surgery” can be misleading.

CABG (bypass surgery), heart transplantation, and valve replacement are all examples of open-heart surgery. In addition, heart failure, congenital heart defects, and coronary artery disease may be treated with open-heart procedures.

Also Read About: Transcatheter Aortic Valve Replacement

Why or when an open-heart surgery is required?

Patients with coronary heart disease may require open-heart surgery for a coronary artery bypass graft. Coronary heart disease is the result of narrowing and hardening of the coronary arteries that supply blood and oxygen to the heart muscle. When fatty material develops a plaque on the walls of the coronary arteries, it is called hardening. This buildup restricts the arteries, making it difficult for blood to flow, increasing the chances of a heart attack when blood supply to the heart is obstructed.

Open heart surgery is also done for other reasons, such as: 

  • Heart valves that allow blood to flow through the heart are to be repaired or replaced.
  • To heal any regions of the heart that are damaged or abnormal.
  • To implant medical gadgets that help the heartbeat properly
  • To replace the damaged heart with a donated heart, also called heart transplantation.

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What are the types of open-heart surgery used in CABG?

There are two types of open-heart surgery that can be done in CABG, and they are:

  • On-pump – A heart-lung bypass device is attached to the heart and takes over the heart and lungs for a short period. It moves blood away from the heart so that the surgeon can perform surgery on a heart that is not beating and has no blood supply. After surgery, the surgeon disconnects the device, and the heart begins to function normally again.
  • Off-pump – Off-pump bypass surgery is performed on a heart that keeps beating normally. This method is only effective in the case of coronary artery bypass grafting (CABG) surgery.

What can one expect from open-heart surgery?

Before the surgery

Before open-heart surgery, a person can expect to have: 

  • Chest X-ray, Electrocardiogram, Echocardiogram as well as other diagnostic procedures to assist the surgeon in planning the treatment.
  • The chest is to be shaved.
  • Antimicrobial (bacteria-killing) soap is used to sterilize the surgical area.
  • An intravenous line (IV) tube runs into the arm and delivers fluids and drugs.

During the surgery

Heart surgery is a complex procedure and can take up to six hours. The patient will be given an anesthetic during the procedure for pain management. Next, the surgeon makes an 8- to 10-inch cut in the chest. The surgeon slices through all or part of the patient’s breastbone to expose the heart. The surgeon can now repair the heart and using a healthy vein or artery, the surgeon builds a new route around the clogged artery.

Once the heart’s blood flow is restored, the heart begins to beat independently. A little electrical shock may be required to restart the heart. The heart-lung bypass machine if used can now be turned off. The surgeon uses wires or sutures to close the breastbone or other wounds and closes the skin incision using stitches.

After the surgery

The patient may need to spend a day or more in the hospital’s intensive care unit (ICU) based on the surgery. They will be moved to a regular hospital room when ready and may experience the following post-surgery: 

  • Constipation is a common complaint among people (a common side effect of strong pain relievers)
  • Mood swings or depression
  • Insomnia or sleeping problems
  • Appetite loss
  • Memory issues 
  • Muscle soreness in the chest
  • Pain, bruising, and slight swelling in the incision site

How can a person take care of themselves at home after open-heart surgery?

Incision care 

It is always important to look after the incision. Maintain a warm, dry environment around the incision site, and wash hands before and after touching it. You can shower if the incision is healing correctly and there is no drainage. Showering for less than 10 minutes with warm (not hot) water is recommended.

Pain management 

Pain treatment is crucial, as it can speed up the recovery. Muscle pain, throat pain, pain at incision sites, and pain from chest tubes are all possible.

Adequate sleep 

Although some people have difficulty sleeping following open-heart surgery, it is critical to obtain as much rest as possible. One can improve sleep by: 

  • Taking a pain reliever half an hour before bedtime
  • By properly arranging pillows to reduce muscle tension
  • Avoiding caffeine at night

Rehabilitation 

A planned, thorough rehabilitation program is beneficial to most people who have had a CABG. This is generally done as an outpatient procedure with multiple visits each week. Exercise, lowering risk factors and coping with stress, anxiety, and depression are all part of the treatment.

Conclusion

Open-heart surgery always has a slow but steady recovery. It could take up to six weeks before one starts feeling better, and it could take up to six months to fully benefit from the procedure. One can keep one’s heart healthy by doing the following: 

  • Consuming a nutritious diet 
  • Limiting high-salt, high-fat, and high-sugar foods 
  • Adopting a more active way of life 
  • Avoiding smoking
  • Managing high blood pressure and cholesterol
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