Open-Heart Surgery: Risks, Procedure, and Preparation

Cardiac Surgery | by Dr. Manoj Kumar Daga | Published on 28/02/2024

Introduction 

Open heart surgery is one of the groundbreaking clinical procedures that has effectively evolved the field of cardiac care. In this procedure, the surgeon involves accessing the heart and making an incision in the chest to evaluate several cardiovascular problems that range from coronary artery disease to congenital heart defects. 

Introduced in the mid-20th century, open heart surgery has efficiently emerged with technological, techniques, and patient care breakthroughs. If you have been recommended for open-heart surgery, you can book your appointment with the best cardiac surgeon in Kolkata at the BM Birla Heart Research Centre in Kolkata. You will find the best cardiac and open-heart surgeons, offering the best patient care. 

In this blog, we aim to delve into the complexities of open heart surgery that involve its procedures, risks, and benefits, delivering readers comprehensive information on this life-saving interference and its deep impact on modern medicine and patient outcomes. Kindly note that this write-up is for information purposes only and we do not construe the doctor’s consultation in any way. 

What is an open-heart surgery? 

Open-heart surgery is a complex medical procedure involving accessing the heart through an incision in the chest. The procedure is involved in assessing a range of cardiovascular problems that are difficult to manage through medication or less invasive interventions. These conditions usually include coronary artery disease, heart valve anomalies, congenital heart defects, or heart failure. During the procedure, the surgeon stops the heart temporarily, and a heart-lung bypass machine is connected to the patient to maintain circulation. 

When is open-heart surgery needed?

Open-heart surgery is needed when several cardiac conditions are hard to manage through medication or less invasive procedures. These conditions encompass coronary artery disease, heart valve disorders, congenital heart defects, and heart failure. 

Typically, the surgery addresses severe blockages in the coronary arteries, valve abnormalities impeding blood flow, or structural defects within the heart. Patients experiencing significant symptoms such as chest pain, shortness of breath, or fatigue, or those at risk of life-threatening complications, may be recommended for open-heart surgery. 

The decision for this intervention is meticulously made following a comprehensive evaluation by cardiologists and cardiac surgeons, considering the individual's overall health status and the severity of their cardiac condition.

How to prepare for open-heart surgery?

Here are some prerequisites that the patients need to follow before undergoing the following steps:

• Consultation: It is vital to get into a meeting with the surgical team to go through the preoperative tests, medications, anticipations, and the procedure itself.
• Medical evaluation: It involves comprehensive medical assessment like cardiac evaluations, imaging scans, and blood tests.
• Lifestyle modifications: The patient must ensure following pre-operative guidelines for medication administration, diet, exercise, and quitting smoking.
• Support system: One can form plans for at-home post-operative care and assistance like assistance with daily tasks.
• Mental ready: The patient must speak to the medical team about any anxiousness or apprehensions, and think about joining a support group or counseling service.

How is open-heart surgery performed?

While performing an open-heart surgery, here are steps that are followed for smoother outcomes: 

• General anesthesia is first given to confirm the patient's unconsciousness throughout the entire procedure. 
• A surgical incision is made in the chest to reach the heart often through the breastbone.
• A heart-lung bypass machine is utilized to replace the heart's pumping action once the chest cavity is offering the surgical team a bloodless and motionless operating area.
• The heart is momentarily stopped to perform any required repairs or corrections like bypassing clogged arteries, replacing or repairing heart valves, or correcting structural anomalies.
•  A variety of techniques are involved depending on the particular procedure such as sewing, grafting, or using prosthetic devices.
• The bypass machine is slowly removed after the repairs are done, permitting the heart to return to its normal function.
• The patient is closely monitored in the intensive care unit before moving into a regular hospital room during the recovery period once the chest incisions are closed with sutures or staples.
• Open heart surgery needs precision and attention to detail, cutting-edge medical equipment, and the surgical team's experience to ensure success and safety.

What are the risks of open-heart surgery?

Like any other surgical procedure, open-heart surgery also involves certain risks such as:

• Infection: Infection in the surgical area or in the chest cavity is a probability even after following safety measures.
• Bleeding: Bleeding is a possible risk during and after this major surgical procedure.
• Clots in the blood: Following surgery and being immobile leads to enhancing the risk of clots in the blood moving to the lungs or forming in the legs.
• Heart rhythm abnormalities: Post-surgery, the heart's rhythm might experience disturbance temporarily, and arrhythmias may occur.
• Kidney issues: During surgery, the heart-lung bypass machine leads to impairment of kidney functionality temporarily resulting in complications.
• Breathing issues: Ventilation support might be needed, and some patients might experience breathing issues as an outcome of the anesthesia's effects or the procedure itself following surgery.
• Response to anesthesia: Risks linked to anesthesia such as allergic reactions and damage to vital organs.
• Long-term complications: Patients can experience psychological effects, diminished stamina, or chronic pain in the long run.
• Mortality: Open heart surgery involves a risk of mortality even after the advancements in surgical techniques and perioperative care, specifically in patients with intricate medical conditions or advanced age.

What happens after open-heart surgery?

Once open-heart surgery is finished, here is what exactly often happens after the procedure: 

• Recovery room: The patient is kept under close observation in a recovery area.
• Intensive care: The patient might be asked to stay in the intensive care unit for some time for more rigorous monitoring, depending on the procedure and overall health.
• Pain management: Post-operative pain will be controlled with medication and other methods.
• Rehabilitation: Strength, mobility, and independence regaining will be assisted by physical and occupational therapy.
• Follow-up appointments: Regular assessments by your medical team will evaluate the patient’s recovery and help modify the treatment plan as required.
• Lifestyle changes: Long-term recovery and general well-being depend on adopting a heart-healthy lifestyle, which includes dietary and exercise adjustments.

Conclusion 

In conclusion, open heart surgery is usually needed to treat chronic cardiac conditions and enhance quality of life, even though it is a substantial medical intervention with inherent risks. Most patients benefit from positive and successful outcomes with longer lifespans, all thanks to advancements in surgical techniques and post-operative care. For the finest probability of recovery, the patient must decide with careful planning, a robust support system, and a dedication to following medical advice. By putting their physical and mental health first, accepting lifestyle changes, and staying in regular touch with medical professionals, it becomes easy to face the complexities of open-heart surgery with courage and optimism for a healthier future.

FAQ-

 

Can a heart valve be replaced without open heart surgery?

Yes, transcatheter aortic valve replacement is a minimally invasive option to open-heart surgery to replace heart valves. This method is appropriate for patients who are at high risk for traditional surgery. 

Is open heart surgery and bypass surgery the same?

Open-heart surgery and bypass surgery are interlinked to one another but are not identical surgeries. Open heart procedure involves several cardiac surgeries involving bypass, valve repair, and congenital defect repairs. On the other hand, bypass particularly encompasses rerouting blood flow across the blocked arteries to enhance blood flow. While bypass surgery is among the open-heart surgery types, not all open-heart surgeries are bypass surgeries. 

Is open heart surgery safe? 

Like any other traditional surgical procedure, open heart surgery involves risks like bleeding, infections, and anesthesia complications. However, with the latest advancements in clinical technology and surgical methods, this surgical procedure is usually safe for patients who are eligible as per their healthcare providers.