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Open heart surgery

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Open heart surgery with the doctors hand inside the patient

Open heart surgery is a second chance at life because of a medical condition or poor life choices that leave a body in less than perfect condition. It is an operation that can make a person stay after the surgery for a week or longer. The person will traditionally end up in an intensive care unit after the surgery to recover. There is good news with open heart surgeries since, studies show that there is only a in-hospital mortality rate of 2.94% [1]. It is typically found that people with obesity and bad eating habits put stress on their heart which can lead them to need an open heart surgery. The body was not made to be sitting around, the body was made to be active, so when people do not take good care of their body, this is one of many problems that can occur. Better choices and a healthy meal plan including exercise can be the difference between health problems that result inline or death surgery. Surgeries should be a last resort and not a plan for being unhealthy. If one can workout or take better care of their body to avoid a surgery they should. Anything can happen in a surgery and the body usually never fully heals to 100%

Reasons for needing open heart surgery

Clogged vein from fatty deposits in the vein.

Open heart surgery is done to repair a damaged or fault heart. The heart problems that need open heart surgeries could be problems with the arteries supplying the heart with blood, the valves, or aneurysms [1]. Open heart surgeries are also necessary when the arteries become blocked or narrowed because of the heart disease a person is found to have a higher chance of getting a heart attack [1]. Surgeons can also use open heart surgery to repair aneurysms(a bulge in the main artery which leaves the heart). Open heart surgery is also done to bypass a blocked area or even to replace an artery like the aortic artery. Arteries can also end up hardening, which results in worse blood flow to the body.[2]. This is called coronary heart disease, and it is common. The condition occurs when fatty material forms and builds up a plaque on the walls of the coronary arteries [2] The plaque causes the arteries to narrow, making the blood flow worsen. If the condition is serious enough, the blood will not flow properly and a heart attack could occur [2] Typically open heart surgery is done for four general reasons: Repair or replace heart valves, which allows blood to travel through the heart, repair damaged or abnormal areas of the heart, implant medical devices that help the heart beat properly, and replace a damaged heart with a donated heart, known as a heart transplantation. While there are benefits to open heart surgery it is also important to note the potential dangers in an open heart surgery. One of the risks is a chest wound infection, these are more common with patients that have diabetes or obesity, it can also however be found with those who have had a CABG before [2]. Another risk would be a heart attack or stroke. Another underlying problem could be an irregular heartbeat. The other problems are the chances for lung or kidney failure. Another present problem could be chest pains and a low fever. One could also experience a feeling of memory loss or "fuzziness". There are also the problems with blood clots or blood loss. People have had signs of breathing difficulties and problems. One of these breathing problems includes pneumonia. A study was done at the Heart and Vascular Center at the University of Chicago Medicine, showing that the heart-lung bypass machine can be found to cause increased risks of strokes and neurological problems [2]. There can also be underlying problems with the prescription drugs that could be taken by the individual.[2]

Open heart surgery procedure

Heart being stitched up after surgery

To preform this operation the surgeon cuts open the chest and accesses the heart. The most common heart surgery procedure was found to be a coronary artery bypass. These coronary arteries deliver blood to the heart. The operation requires a healthy blood vessel be taken from somewhere else in the body. This vessel is then used to bypass the blocked area. There are other operations however, one of these would be a procedure where a aortic valve is replaced because it is faulty. This heart valve, when working properly, prevents the blood from flowing back into the heart after the heart has pumped the blood out. After open heart surgery the person is kept for 7 to 10 days and at least one day in a intensive care unit [1]. Usually before any open heart surgery the person is told to eat an evening meal but to not eat or drink after midnight. It is also suggested for those getting the surgery to wear loose clothes and have any and all personal medical information with them. The person can commonly feel anxious before an anesthetic too and they can seek a healthcare team. The doctor will give an anesthetic to start the procedures. It is also common to make sure that the heart is the problem before they start cutting into the body. They will typically test the blood and heart, and put put a line into a vein. While times vary for surgeries heavily, the National Heart, Lung and Blood Institution say that a coronary artery bypass takes 3 to 6 hours [1]. To access the heart the surgeon will make a 6 to 8 inch incision along the middle of the chest. This incision cuts through the breastbone. Sometimes the medical team will use a heart-lung bypass during the surgery. They do this to stop the heart from beating, and the machine takes the hearts place while they are preforming the surgery [1]. The machine mimics a heart beat and removes blood from the heart by tubes, which the machine then removes the carbon dioxide from the blood, adds oxygen, and finally returns the blood to the body. This type of surgery is called a "on-pump" surgery. It can also be found however that while some times a machine is used, other times for surgeries they are not. This is true for "off-pump" surgeries, his this surgery the heart keeps pumping and the surgical team used a device to keep the heart steady during the procedure. There is still debate on which surgery technique is safer. However, it was found that both surgery techniques have a success rate of about 96-97 percent [1]. A team for this process would be typically: a lead surgeon, who directs other surgeons during the operation, an anesthesiologist who is in charge of giving anesthesia and monitoring vital signs, the pump team, or perfusionists, who operate the heart-lung machine and other equipment that supports the surgery, then finally there are nurses and technicians who assist the surgical team and prepare the operating theater for surgeries [1].

Video

A video showing open heart surgery at St. Luke's

Cardiovascular diseases

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 MacGille, Gerhard. [1] Medical News Today. Web. May 19, 2019. (accessed.)
  2. 2.0 2.1 2.2 2.3 2.4 2.5 Luo, Elaine. [2] Healthline. Web. May 19, 2019. (accessed.)