Verified By: Dr.Sukhvinder Singh - A Certified Cardiologist in India MBBS, MD, DM (Cardiology) Experience:10 + years He Provides Cardiologist Consultations through Online (TeleMedicine)
Heart diseases are among the deadliest problems currently attacking the humankind. Open heart surgery, is one of the procedures followed to cure a particular abnormality or a condition of the heart. In India alone, around half a million heart surgeries are conducted annually to correct problems in adults as well as children.
Open heart surgery is suggested depending upon the condition of the patient. The final call is the heart specialist or the cardiologist who takes the decision after examining the patient, reports of tests and scanning.
In an open-heart surgery, the chest is cut opened for operating the heart or its surrounding arteries. More often, the cardiac surgeons opt to correct severe obstruction in the coronary arteries supplying blood to the heart (anginal heart disease or coronary artery disease). This procedure is called coronary artery bypass surgery (CABG)
The doctors may also take this decision if the patient is in need of heart valve repair or replacement of heart valves or for fixing structural heart defects like holes in the heart.
During this type of surgery, the heart of the patient is taken out and the patient is kept on the heart-lung bypass machine. The heart-lung machine performs the heart and lungs function for the body and provides oxygen-rich blood to the heart and body organs. The heart, when taken out, is stopped by using a solution (cardioplegia). It is high-potassium, cold solution that protects the heart muscles during the time when it is in the non-working state.
The heart is then opened and repair is carried out in a still, bloodless environment. In another variant of coronary artery bypass surgery (CABG), the heart is operated upon without keeping it on a cardiopulmonary bypass machine and is operated while still beating. Such a procedure is called off-pump CABG or CABG without the bypass or beating heart surgery. This kind of surgery has a lesser incidence of postoperative stroke as compared to traditional bypass surgery. More often, only a cut is required for the operation.
However, open heart surgeries can be complicated if the patient is suffering from complex defects requiring different possible approaches for either palliation or correction. Such complicated surgeries are carried out by the input of many experts. Irrespective of how good the pre-operative assessment has been, the anatomy of a heart is never really understood unless the surgeon gets to look at it. Hence, the course of the operation might change depending upon the intra-operative findings.
This type of surgery is advised for treating various types of heart conditions.
During the surgery, typically the mitral and the aortic valves are either repaired or replaced. The repairing or replacement is advised when these valves either get obstructed (stenotic) or start leaking severely. Sometimes the surgery is advised when the valves become regurgitant (leaky) leading to symptoms of heart failure necessitating heart surgery. In such a condition, the chest including the sternum or breastbone is opened with a cut to expose the heart. At times, the surgeon is able to perform surgeries using smaller incisions. These are called key-hole surgeries.
Sometimes a part of heart get massively enlarged and ballooned out after the heart attack, the surgeon may have to cut such a part and repair heart by open heart surgery.
An open-heart surgery is sometimes recommended for serious life-threatening arrhythmias.
Other conditions necessitating this type of surgery include septal defects in adults (holes of a heart), congenital lesions in children and aortic surgery for aneurysms. Although open-heart surgery is a serious operation, with the advancement of medical sciences, risks have been minimized. Today's doctors use highly scientific and evolved instruments and machines for performing the operation. Hence, most of the heart surgeries are successful, and there is no need to worry much about the outcome.
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