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Some patients with cardiovascular disease have to undergo a significant operation known as an open heart surgery. This article outlines everything you need to know about open heart surgery.

Open heart surgery is conducted as a treatment to fix a variety of heart-related issues including problems with the heart’s valves, problems with arteries that supply blood to the heart, and aneurysms (an outward bulge) in the main blood vessel known as the aorta.

Open heart surgery is a significant operation that requires patients to stay at the hospital for at least one week if not longer. In fact, many people end up spending some time in the intensive care unit (ICU) right after surgery. Despite the fact that open heart surgery is quite intensive, the risk of mortality is very low. In fact, one study found that the in-hospital mortality rate for patients who undergo open heart surgery was only 2.9 percent. Thus, open-heart surgery has an excellent survival rate.

Common types of open heart surgery

The most common type of open heart surgery is called a coronary artery bypass, which is conducted when the coronary arteries (the blood vessels that supply the heart with oxygenated blood) become blocked or narrowed, putting patients at a risk of having a heart attack. The surgery involves taking a blood vessel from one part of the body and then using it to reroute blood from the area of blockage.

Other common types of open heart surgery are valve replacements, which are conducted to replace a damaged heart valve, and surgery to repair aortic aneurysms.

How long should I expect to be at the hospital if I am undergoing open heart surgery?

You will need to be at the hospital for seven to 10 days and you will likely be in the ICU for at least one day right after the operation.

How do I prepare for surgery?

You need to start preparing for your open heart surgery the night before. You can have dinner as usual but should not eat or drink anything after midnight. Here are some tips to help you prepare for open heart surgery surgery:

  • Wear loose and comfortable clothes that don’t restrict your movements right after surgery.
  • Keep all your medical information handy, including a list of medicines, any recent illnesses and insurance information.
  • If you feel anxious, make sure to seek comfort from the healthcare team.
  • If you have hair on your chest area, then be prepared for the doctor to ask a member of your healthcare team to shave it.
  • Keep in mind that doctors may run tests on you prior to surgery and you will get an intravenous (IV) line to deliver fluids.

What happens during the operation?

If you are undergoing a coronary bypass, that will take approximately three to six hours to complete. The surgeon will make a six to eight inch cut in the middle of the chest. In some cases, the surgical team will use a heart-lung bypass machine, which takes over the heart's function including removing carbon dioxide from the blood, adding oxygen and bringing it back to the body. In other cases, the surgeon may not use the pump but instead use another device to steady the heart while the procedure is being performed.

The team that conducts your surgery will consist of a lead surgeon who will direct the other surgeons, an anesthesiologist who administers anesthesia and monitors your vital signs, the pump team that operates the heart-lung machine and other machinery, and finally the nurses that help the surgical team prepare the theater for surgery.

How do you recover after open heart surgery?

Patients who have just undergone open heart surgery will usually remain in the ICU for a few days immediately after the surgery. You will be closely monitored and receive the post-operative support you need.

After the operation, you will have a breathing tube to assist you with your breathing as well as an IV live that provides pain relief medications. You may also be attached to some other monitoring equipment.

Once you leave the ICU, you will likely stay in the hospital for a week and once you are home, recovery takes about four to six weeks. Your healthcare team will teach you how to rehabilitate and give you advice on the medications you need to take and what kind of restrictions you have to follow. Here are some tips for your recovery:

  • Understand that it is normal to feel tired and experience some pain.
  • You need to closely follow the advice of your medical team and look for signs of infection around your wound.
  • If you find any signs of infection, such as a fever, issues breathing, or excessive sweating, go to the emergency department or call an ambulance.
  • You need to be patient as it can take a long time (weeks to months) to go back to your normal activities.
  • Take advantage of rehabilitation programs that are offered by your doctor.

What are the risks involved with open heart surgery?

All types of surgeries, including open heart surgery, come with risks. The severity of these risks depends on the patient as those that are of advanced condition generally have a higher risk of complications both during and after the operation. Risks associated with surgery include being under anesthesia, contracting an infection, damage to organs and having a stroke.

  • Hannan, E. L., Kilburn, H., O'Donnell, J. F., Lukacik, G., & Shields, E. P. (1990). Adult open heart surgery in New York State: an analysis of risk factors and hospital mortality rates. Jama, 264(21), 2768-2774.
  • Pons, J. M., Granados, A., Espinas, J. A., Borras, J. M., Martin, I., & Moreno, V. (1997). Assessing open heart surgery mortality in Catalonia (Spain) through a predictive risk model. European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery, 11(3), 415-423.
  • Abram, H. S. (1965). Adaptation to open heart surgery: A psychiatric study of response to the threat of death. American Journal of Psychiatry, 122(6), 659-668.
  • Photo courtesy of SteadyHealth

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