Definition Open heart surgery describes any surgery that requires the heart to be cut open.
Who is a candidate for the procedure? Anyone who has heart disease requiring surgery is a candidate for open heart surgery. This type of surgery may be necessary for any of these conditions:
severe blockages of the arteries of the heart requiring heart bypass surgery. Although the heart is not technically cut open for most bypass procedures, many experts consider this a form of open heart surgery.
A person must be healthy enough to withstand the stress of major surgery.
How is the procedure performed? Open heart surgery is done with general anaesthesia. This means that the person is put to sleep with medications and feels no pain during the surgery. He or she is put on an artificial breathing machine, or ventilator, during the surgery.
The chest area is first cleaned with an antibacterial soap. Next, an incision is made into the chest. Usually, the incision is made into the breastbone, or sternum. The heart is exposed.
The person must then be put on a heart-lung bypass machine. This involves special tubes that move blood around, or bypass, the heart. The blood is sent into a special machine that keeps the blood circulating and full of oxygen.
Once the person is connected to the bypass machine, the heart is cut open. The surgeon can then fix the heart problem. This may involve repairing a valve, sewing a defect closed, or bypassing blocked arteries.
When the problem is repaired, the heart is sewn shut. The person is taken off the heart-lung machine. Once the person's heart is working again to pump the blood, the chest incision can be closed. The person is taken off anaesthesia and sent to the surgery recovery room.
What happens right after the procedure? After the surgery, the person generally will spend at least an hour in the recovery room until the anaesthesia has worn off. Occasionally, the person is taken right to the intensive care unit for recovery from anaesthesia. Once a person can breathe on his or her own, the ventilator is turned off. The person then must stay in the hospital usually for seven days. Analgesics are given to relieve pain. The person will be assisted out of bed for increasingly longer periods, beginning 24-48 hours after surgery. This early activity helps to prevent post operative problems such as deep venous thrombosis and pneumonia.
What happens later at home? Full recovery may take months because this is a major operation. People are usually be told to:
Other care depends on the procedure that was performed.
What are the potential complications after the procedure? The risks of any major surgery include:
bleeding
infection
death
Chest pain may persist for months. Some numbness in the skin near the incision may also occur, but often gets better with time. Specific risks depend on the procedure that is performed and should be discussed with the surgeon.
Author: Adam Brochert, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 12/06/2005 Contributors Potential conflict of interest information for reviewers available on request
