Blockage or narrowness of the heart’s coronary vessels can cause heart and blood vessel disease, which can lead to heart attack or infarction. Heart surgery is a branch of surgical science performed by a surgeon on the heart and large vessels. If you want to learn more about heart surgery, read this article from the Doctour website.
What Is Heart Surgery?
Heart surgery, also known as cardiac surgery, is a type of medical procedure that involves the heart or the blood vessels around it. It is performed to correct problems associated with the heart. The most common type of heart surgery for adults is coronary artery bypass grafting (CABG), where a healthy artery or vein from the body is grafted to the blocked coronary artery. This allows the grafted artery to bypass the blocked artery and bring fresh blood to the heart.
Heart surgery can treat complications of heart disease, correct congenital heart defects, treat valvular heart disease and control heart rhythm disturbances. It can also implant medical devices that help control the heartbeat or support heart function and blood flow and replace a damaged heart with a healthy one from a donor.
Open-heart surgery is when the chest is cut open and surgery is performed on the muscles, valves, or arteries of the heart. During this procedure, the heart may be stopped temporarily and the patient is connected to a heart-lung machine. This machine takes over the pumping action of the heart, supplying oxygen and removing carbon dioxide from the blood.
Despite its complexity, heart surgery has high success rates and helps millions of people live healthier, more active lives. Recovery from heart surgery can be a lengthy process, with initial recovery taking 6 to 8 weeks. However, most people can return to normal activities after this recovery period.
When is heart surgery needed?
Heart surgery is typically needed when less invasive treatments such as lifestyle changes, medication, or non-surgical procedures are not enough to manage heart disease or conditions. Here are some situations when heart surgery may be necessary:
Coronary Artery Disease (CAD): This is the most common type of heart disease. CAD occurs when the major blood vessels that supply the heart with blood, oxygen, and nutrients become damaged or diseased. If the blockage in the coronary arteries becomes severe, coronary artery bypass grafting (CABG) may be needed.
Valvular Heart Disease: Heart valves regulate blood flow through the heart. If one or more of the valves don’t open or close properly due to conditions like stenosis, regurgitation, or atresia, heart surgery may be required to repair or replace the affected valves.
Heart Failure: In some cases of heart failure, where the heart can’t pump enough blood to meet the body’s needs, a ventricular assist device (VAD) may be implanted to help the heart pump blood. In end-stage heart failure, a heart transplant may be considered.
Arrhythmias: These are abnormal heart rhythms. If they are severe or life-threatening, surgery may be needed to implant a pacemaker or an implantable cardioverter-defibrillator (ICD).
Aneurysm Repair: An aneurysm, a bulge in a blood vessel caused by a weak vessel wall, can occur in the heart. If it’s at risk of rupturing, surgical repair may be necessary.
Congenital Heart Defects: These are heart defects that a person is born with. Some of these defects, if serious, may require surgery right after birth or during childhood.
The decision to perform heart surgery takes into account various factors including the patient’s age, overall health, the specific nature of their heart problem, and the risks associated with surgery. The goal is always to improve the patient’s quality of life and extend life expectancy. It’s important to note that heart surgery is usually part of a comprehensive treatment plan that includes lifestyle changes to improve heart health.
What Should I Know about Heart Surgery?
Surgeries of this type are performed in the following cases: for the treatment of chronic ischemic heart disease (such as coronary artery bypass surgery, congenital heart defects, or for the treatment of heart valve disease). Heart transplantation can also be considered a type of heart surgery. If the blockages of coronary vessels cannot be resolved through stent or balloon Angioplasty, Open Heart Surgery will be performed to reach the blood to the heart through the transplanted vessel.
What happens before heart surgery?
Before heart surgery, several important steps are taken to ensure the patient is ready for the procedure. Here’s a general overview:
Medical Evaluation: The patient undergoes a thorough medical evaluation, which includes a complete medical history, physical examination, and diagnostic tests such as blood tests, chest X-rays, electrocardiogram (EKG), and echocardiogram. The purpose is to assess the patient’s overall health and the specific condition of their heart.
Consultation: The patient meets with the cardiac surgeon to discuss the procedure in detail. The surgeon explains the benefits, risks, and alternatives to the surgery. This is an opportunity for the patient to ask questions and express any concerns.
Preoperative Instructions: The patient receives specific instructions to prepare for the surgery. These may include guidelines on eating, drinking, and medication use. For instance, the patient may be asked to fast for a certain number of hours before the surgery.
Pre-Anesthesia Check-Up (PAC): The patient meets with the anesthesiologist for a pre-anesthesia check-up. The anesthesiologist reviews the patient’s medical history and explains the anesthesia process.
Admission to the Hospital: The patient is usually admitted to the hospital a day before the surgery. The patient’s vital signs are checked, and the surgical area is cleaned and shaved if necessary.
Consent Form: The patient or their legal representative signs a consent form that confirms their understanding of the surgery and its risks.
Medications: The patient may receive medications to help them relax and prepare their body for surgery. These could include antibiotics to prevent infection and blood thinners to prevent clots.
Cardiovascular Surgery
Also referred to as cardiac surgery or heart surgery, describes any surgical procedure that involves the heart or the blood vessels that carry blood to and from the heart. If a person has symptoms of a heart condition, their physician may refer them to a cardiologist. Symptoms that can indicate a heart problem include:
Shortness of breath
Dizziness
Chest pains
Changes in heart rate or rhythm
High blood pressure
A cardiologistcan carry out tests for a heart murmur or an abnormal heart rhythm. Their patients often are people who’ve had a heart attack, heart failure, or other heart problems. You may need to see a cardiologist even without symptoms if you have a family history of heart disease or high cholesterol if you are or have been a smoker, have diabetes, or are starting a new exercise program.
What are some types of heart surgery?
Coronary artery bypass grafting (CABG)
The surgeon takes a healthy artery or vein from elsewhere in your body and connects it to supply blood past the blocked coronary artery. The grafted artery or vein bypasses the blocked portion of the coronary artery, creating a new path for blood to flow to the heart muscle. Often, this is done for more than one coronary artery during the same surgery. CABG is sometimes referred to as heart bypass or coronary artery bypass surgery.
An Open Heart bypass surgery is performed under general anesthesia through the following process:
First, a vein will be harvested from one or both legs and in some cases from the chest or arms to become the graft.
Second, the chest is opened by making an incision along the sternum, or breastbone.
Third, the heart and vessel system will be attached to an artificial heart-lung machine and the heart will rest while the surgeon is transplanting the harvested vein to the heart artery.
Heart valve repair or replacement
Surgeons either repair the valve or replace it with an artificial valve or with a biological valve made from pig, cow, or human heart tissue. One repair option is to insert a catheter through a large blood vessel, guide it to the heart, and inflate and deflate a small balloon at the tip of the catheter to widen a narrow valve.
Insertion of a pacemaker or an implantable cardioverter-defibrillator (ICD)
Medicine is usually the first treatment option for arrhythmia, a condition in which the heart beats too fast, too slow, or with an irregular rhythm. If medication does not work, a surgeon may implant a pacemaker under the skin of the chest or abdomen, with wires that connect it to the heart chambers. The device uses electrical pulses to control the heart rhythm when a sensor detects that it is abnormal. An ICD works similarly, but it sends an electric shock to restore a normal rhythm when it detects a dangerous arrhythmia.
Maze surgery
The surgeon creates a pattern of scar tissue within the upper chambers of the heart to redirect electrical signals along a controlled path to the lower heart chambers. The surgery blocks the stray electrical signals that cause atrial fibrillation — the most common type of serious arrhythmia.
Aneurysm repair
A weak section of the artery or heart wall is replaced with a patch or graft to repair a balloon-like bulge in the artery or wall of the heart muscle.
Heart transplant
The diseased heart is removed and replaced with a healthy heart from a deceased donor.
Insertion of a ventricular assist device (VAD) or total artificial heart (TAH)
A VAD is a mechanical pump that supports heart function and blood flow. A TAH replaces the two lower chambers of the heart.
What to expect after you’re admitted to the hospital
After being admitted to the hospital for heart surgery, patients can expect a series of steps to ensure their recovery and health:
Post-Surgery Care: Immediately after the surgery, the patient is moved to the Intensive Care Unit (ICU) for close monitoring. Medical staff will monitor vital signs, including heart rate, blood pressure, oxygen levels, and more.
Pain Management: It’s normal to feel some pain after surgery. The medical team will administer pain relief medications and monitor the patient’s comfort level closely.
Physical Activity: As soon as the patient is stable, they will be encouraged to move around. This can start with simple activities like sitting up in bed, standing, and eventually walking. This helps prevent complications such as blood clots and pneumonia.
Nutrition: The patient will initially be on a liquid diet, gradually moving to solid foods as their body recovers. A balanced diet helps in healing and recovery.
Rehabilitation: Cardiac rehabilitation is a crucial part of recovery. It includes exercises, education about heart-healthy living, and often emotional support.
Follow-Up Appointments: After discharge, follow-up appointments are scheduled with the cardiac surgeon and cardiologist. These visits allow the healthcare team to check the patient’s progress and make any necessary adjustments to the treatment plan.
Medication: Patients are usually prescribed several medications after heart surgery. These may include pain relievers, blood thinners, anti-arrhythmic drugs, and others. It’s important to take all medications as directed by the doctor.
Emotional Health: It’s common to experience a range of emotions after heart surgery. Support from a mental health professional, support groups, family, and friends can be very helpful.
Lifestyle Changes: To protect heart health, patients are often advised to adopt a heart-healthy lifestyle. This can include quitting smoking, eating a balanced diet, getting regular exercise, and managing stress.
Remember, every patient’s recovery process is unique and depends on various factors including the type of surgery, overall health, age, and more. Always follow the specific instructions given by the healthcare team.
What happens during heart surgery?
During heart surgery, a series of carefully orchestrated steps are followed to ensure the safety and success of the procedure. Here’s a general overview:
Anesthesia: The first step in heart surgery is administering anesthesia to make the patient unconscious and pain-free during the operation. An anesthesiologist monitors the patient’s vital signs and adjusts the anesthesia as needed throughout the surgery.
Preparation: The chest area is cleaned and shaved to reduce the risk of infection. The surgeon makes an incision in the chest. For open-heart surgery, the incision is usually down the middle of the chest.
Accessing the Heart: In open-heart surgery, the breastbone is split to access the heart. The patient is connected to a heart-lung bypass machine, which takes over the function of the heart and lungs during the surgery.
The Procedure: The specific steps of the procedure depend on the type of heart surgery. For example, in a coronary artery bypass graft (CABG), a healthy blood vessel from another part of the body is attached to the blocked artery, bypassing the blocked area to improve blood flow to the heart.
Closing Up: Once the procedure is complete, the surgeon closes the incision. The breastbone is rejoined with wires, and the skin incision is stitched or stapled.
Recovery: The patient is taken off the bypass machine, and the heart is restarted. The patient is then moved to the intensive care unit (ICU) for close monitoring during the initial recovery period.
Risks and Benefits of Heart Surgery
Heart surgery, while often life-saving, carries inherent risks that must be carefully considered. It is a major operation that involves opening the chest, stopping the heart, and using a heart-lung machine to maintain blood flow and oxygenation. While heart surgery can provide significant benefits, it is not without risks; Some of these risks & benefits include:
Heart Surgery Risks
Infection: One of the most immediate risks that can occur at the surgical site or in the lungs, leading to pneumonia. Despite stringent sterilization protocols, the risk of infection cannot be completely eliminated.
Bleeding: While some blood loss is expected during surgery, excessive bleeding can lead to complications. In some cases, a blood transfusion may be required, which carries its own risks, including allergic reactions and transmission of infections.
Heart-lung machine complications: For instance, it can cause damage to blood cells and lead to clot formation. These clots can travel to the brain, causing a stroke.
Kidney damage: As the kidneys can be sensitive to changes in blood flow and pressure during surgery. In severe cases, this can lead to acute kidney injury or chronic kidney disease.
Psychological impacts: Such as depression and anxiety. The stress of surgery and the recovery process can take a toll on mental health.
Risk of death: Although the risk is low, it is a possibility that must be acknowledged. The risk is higher in older patients, those with other medical conditions, and those undergoing emergency or complex procedures.
Heart Surgery Benefits
Relief from symptoms: Conditions such as angina (chest pain), shortness of breath, palpitations, and fatigue can be significantly improved or even eliminated. This can lead to a dramatic improvement in the patient’s quality of life, allowing them to return to activities they enjoy and live a more normal life.
Increased lifespan: Many heart conditions, if left untreated, can lead to life-threatening complications such as heart failure or heart attack. Heart surgery can treat these conditions, reducing the risk of these complications and potentially extending the patient’s life.
Improve heart function: Procedures such as valve repair or replacement, coronary artery bypass grafting (CABG), or heart transplant can restore normal blood flow, improve the efficiency of the heart, and prevent further damage to the heart muscle.
In conclusion, heart surgery offers significant benefits for patients with certain heart conditions, but it also carries risks. The decision to undergo heart surgery should be made after a thorough discussion with the healthcare team about the potential benefits, risks, and alternatives.
What is the recovery time for heart surgery?
Recovery time depends on the type of surgery you have, but for most types of heart surgery, you are likely to spend a day or more in the hospital’s intensive care unit. Then you will be moved to another part of the hospital for several days until you go home. Recovery after heart surgery:
Stop any activity that causes shortness of breath, irregularity of heartbeat heart arrhythmia, chest pain, or dizziness; take a rest until these symptoms are resolved.
The best workout after surgery is walking as it will increase blood circulation through the whole body and heart muscles and will lower your cholesterol level and blood sugar. Walking can also help you to lose some weight and it will also reduce your desire to smoke.
You can go upstairs but slowly.
Do your activities with break intervals.
Avoid driving cars, motorcycles, or bicycles for 4-6 weeks after surgery.
Do not lift, push, or pull the things that weigh more than 2 kilograms six weeks after your surgery.
You can return to work about 6-8 weeks after surgery but this may differ for different jobs.
A healthy diet limits your fat intake and avoids using conserved foods. Reduce your pepper, salt, and caffeine intakes like tea and coffee.
Do not smoke cigarettes.
How long can you live after heart surgery?
The lifespan after heart surgery can vary greatly and depends on a multitude of factors including the type of surgery, the patient’s overall health, age, the presence of other medical conditions, and lifestyle choices post-surgery.
It’s important to note that heart surgery is not a cure for heart disease. Even after successful surgery, patients must continue to manage their condition with medication, lifestyle changes, and regular follow-up care. Without these measures, the underlying disease can progress, and symptoms may return.
Age and overall health play a significant role in life expectancy after heart surgery. Older patients or those with other serious medical conditions, such as diabetes or kidney disease, may have a shorter life expectancy. On the other hand, younger patients and those without other major health issues often have a longer life expectancy.
Lifestyle choices post-surgery also significantly impact life expectancy. Patients who adhere to a heart-healthy lifestyle, including a balanced diet, regular exercise, maintaining a healthy weight, not smoking, and managing stress, often have a better prognosis.
Therefore, patients need to have a thorough discussion with their healthcare provider to understand their specific prognosis and what they can do to improve their health and longevity post-surgery.
Conclusion
In conclusion, heart surgery is a critical intervention that can significantly improve the quality of life and extend the lifespan of patients with heart disease. It offers immediate relief from symptoms, improves heart function, and can halt or slow the progression of heart disease. However, it is not without risks, including infection, bleeding, stroke, kidney damage, and even death. Furthermore, heart surgery is not a cure for heart disease. Post-surgery, patients must continue to manage their condition with medication, lifestyle changes, and regular follow-up care. Therefore, the decision to undergo heart surgery should be made after a thorough discussion with the healthcare team about the potential benefits, risks, and alternatives, ensuring that the treatment aligns with the patient’s health status, preferences, and goals of care. Always consult with a healthcare professional for accurate information. Heart surgery, when performed for the right reasons and followed by a healthy lifestyle, can offer a renewed chance at life.
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