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Heart Surgery: A guide to the procedure, risks, and recovery
A surgical procedure that is performed to resolve a health concern related to the heart is called a heart surgery or a heart operation. A heart surgery may involve:
A heart surgery is performed to correct any abnormalities in heart functioning that cannot be cured through drugs and lifestyle changes. Any cardiac surgery is undertaken with the purpose of ensuring a steady heartbeat that is not too slow or too fast, and a pumping action that is strong enough to maintain the requisite blood pressure during all forms of bodily activity, as well as to ensure that the heart is able to supply oxygen and nutrients to all parts of the body.
Sometimes, a heart operation does this by clearing an arterial blockage, and other times, this is done by steadying erratic heartbeat. Different types of heart surgery are recommended by cardiologists based on the pathophysiology of the heart and the body's response to non-invasive corrective measures such as heart-specific drugs.
Any number of factors can weigh in on a recommendation for a heart surgery, including:
Angina, which is pain associated with reduced blood flow to the chest, shortness of breath without much physical exertion or arrhythmia, which is the irregular beating of the heart, are all indications that you must consult with a cardiologist or heart surgeon immediately.
Heart surgery is varied across patients depending on their symptoms and their underlying causes. Cardiac surgery performed has evolved to be specific to different heart concerns over the last few decades. The most commonly performed types of heart surgery are:
The most traditional form of heart surgery, open heart surgery involves an invasive procedure where the chest is cut open to expose the heart and its surrounding blood vessels, after which a surgical procedure corrects the concerns through various techniques.
Heart surgery may be performed directly on the heart muscle, or on one of the arteries or valves connecting to it. This process involves the connection of the patient to a heart-lung machine that substitutes as an artificial heart at the time of the heart surgery, and oxygenates the blood since the heart is being operated upon and has been stopped to allow precision. Heart valve surgery and correction of congenital heart defects such as a hole in the heart walls are the most common types of open heart surgeries.
Open heart surgery has been the reason to reduce heart disease related mortality across the world and has evolved to be a safe procedure for most patients. The fact that open heart surgery cost has gone down in recent times has also made it a more frequently performed procedure and helped make it one of the most relied-upon techniques to drive better patient outcomes.
It is one of the most common types of open heart surgeries where a graft is needed for the coronary artery which is affected by plaque build up or another kind of irreversible blockage. The grafted artery allows the heart to bypass the blockage while transporting blood, thus normalizing its functioning. Coronary artery disease (CAD) is the major indication for a bypass heart surgery, and most commonly occurs as the arteries harden over time due to fat build up inside them. This can result in shortness of breath, heaviness or tightness felt in the chest region, chest pain or a squeezing sensation. It also often precedes a heart attack. A timely diagnosis can help the doctor recommend a bypass heart surgery as a preventative measure.
It is a last resort in case of impending heart failure and is recommended only in the most severe of situations. In case of cardiomyopathy that cannot be corrected by minor procedures or implantation of a medical device, or in cases of irreparable birth defects of the heart, a heart transplant surgery is suggested by the doctor. This procedure requires a donor and heart recipient to match blood and tissue types, despite which the heart transplant surgery requires the use of anti-rejection drugs to ensure that the received heart is accepted by the recipient body.
They are safer and have a lower risk of complications that open heart surgeries. Another benefit is that the recovery period after a minimally invasive procedure is much less than an open heart surgery. A minimally invasive cardiac surgery requires the heart surgeon to make smaller incisions around the chest region, instead of opening up the heart cavity completely. Today, even a coronary arterial bypass heart surgery may be performed through a minimally invasive cardiac surgery procedure, resulting in reduced trauma to the body, overall.
It refers to heart surgery procedure that is performed on a child who may be born with heart defects, or at some stage, has acquired one. Pediatric cardiac surgery is an especially sensitive process in infants, but have become safer over time, offering a high rate of success. This may involve a heart transplant surgery, or sometimes a closed heart surgery (thoracotomy) where the rib cage does not need to be cut open, but an incision is made between the ribs.
It is performed when major arteries near the heart are clogged due to plaque build up. A stent heart surgery involves a stent, which is a small tube with a balloon attached at one end, that is inserted into the artery. This cardiac surgery procedure is very commonly used and helps restore blood flow despite the blockage. The balloon is inflated once the stent is in place, and causes the arterial wall to be pushed outward and essentially widening the blood vessel to aid normalized blood flow. A stent replacement procedure is done to replace an existing device in case it is worn out or otherwise defective.
A heart valve may become defective due to several factors, and would then require either correction or replacement. A valve replacement surgery addresses one of the four major valves near the heart, namely:
Each of these valves allows blood to flow in a single direction between chambers in the heart, or out of the heart to the body and vice versa, preventing oxygenated and deoxygenated blood from mixing. Heart surgery types involving these valves are annuloplasty which address a concern where a ring around the valve becomes loose, or valvuloplasty, wherein the valve flaps stiffen or fuse with each other.
A candidate for cardiac surgery needs to satisfy a few criteria to be considered for undergoing the procedure. Depending upon many factors such as age, attitude, overall health, the severity of the heart condition and symptoms of heart disease.
While considering the patient's recovery, a heart doctor will necessarily consider such concerns such as their willingness to make lifestyle changes such as quitting smoking and reduction in alcohol consumption. It is also understood that octogenarian patients may not fare as well as younger patients after cardiac surgery, and may show more severe trauma symptoms during the recovery period.
If you have an underlying heart disease and suffer from frequent fainting spells, momentary blackouts, chest pain, shortness of breath and / or recurring fatigue and palpitations, you may be a candidate for one of the types of heart surgery. It is best to clarify all questions and concerns with your doctor relating to recovery and required lifestyle changes if you are to undergo an open heart surgery and continue to live an active lifestyle.
A life-changing event, a heart surgery can free you from limiting circumstances of health and heart conditions, and allows most patients to enjoy a better quality of life. Preparing for a heart surgery requires a few changes, a major one being that of appointing a caregiver who is present throughout the recovery time which can be a length of several months for some patients. In case an episode of loss of consciousness or an acute shortness of breath occurs, it is best to have a person contact the doctor while performing emergency measures.
Other changes include quitting smoking two to three weeks prior to surgery, light exercises to regularize blood circulation and blood pressure as much as possible prior to cardiac surgery, and a generally healthier lifestyle. It also includes stopping certain medication that may interfere with the heart operation or the anaesthesia that is administered during the procedure. This helps the body prepare itself for a heart surgery which is an invasive procedure that is quite straining on the body.
Complications are possible after a heart surgery is carried out, and the risk of heart surgery complications vary from patient to patient.
The side effects of open heart surgery include:
Infections: This is rare but possible, and may occur in patients who have undergone heart surgery in a hospital environment that is not sterile, or may be due to contagion.
Angina: Chest pain is a usual symptom that necessitates cardiac surgery, but may also show up as a side effect. It may happen due to venous thrombosis and will be resolved by doctors if happening when the patient is under observation after surgery.
Blood clots: Clots in veins can arise after surgery due to several reasons, and these can cause angina, and in severe cases, myocardial infarction. The risk of such an incident is rare today, but observation of a patient after heart surgery is recommended to monitor occurrence of such symptoms.
Internal bleeding: In case of incorrect placement of a stent or a different medical device during a cardiac surgery, bleeding near the heart region might occur and may be either as a hematoma that forms clots, or a haemorrhage which is active bleeding and needs to be stemmed to prevent blood leaking into surrounding tissue. Hematomas chances can increase for patients receiving anticoagulation drugs prior to heart surgery.
Organ failure: In case of older patients, trying to stimulate the heart can cause failure in the kidneys. Susceptibility to such may also be due to factors unrelated to age, and have been seen during coronary bypass heart surgeries.
Over the last two decades, open heart surgery as well as closed heart surgery have grown significantly more sophisticated, and continuous monitoring of all vital signs, as well as non-vital health related symptoms allow preparedness for eventualities such as severe side effects. Heart surgery has become safer and is now commonly offered by some of the top heart surgeons in India and abroad as a more or less mainstream solution for heart trouble.
Open heart surgery recovery time can be a stressful period, overall recovery will take a few weeks to a few months, based on care provided post-operation, genetic preclusion of heart disease, post-operative stresses in life that might hamper open heart surgery recovery by countering its benefits, and consistent care towards lifestyle and overall well being.
The following recommendations are provided by the best cardiac surgeons in India on our medical staff:
Quit smoking: It is hard to wean a patient off a particular long term habit such as smoking, and it is necessary that this change is made to their lifestyle even prior to heart surgery.
Incision care: The skin around the incisions during surgery may become swollen, red, itchy and even open up or ooze fluid, making it very necessary to continue to monitor the area after the procedure.
Pain management: Open heart surgery may cause pain during the healing time for some patients, and efficient medication aids in less stressful recovery and quicker healing.
General lifestyle changes: Open heart surgery recovery time may be reduced if a diet causing lower inflammation levels in the body and light exercises that aid blood pressure and circulatory balance are incorporated as part of daily life.
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