~ Written by Elkan Rodricks
Open heart surgery, also known as traditional heart surgery is the type of surgery where the chest is cut open and the heart muscles, valves, or any part of the heart is operated on by cardiothoracic surgeons. Open heart surgery is resorted to when there is a requirement to repair damaged valves, treat abnormal heartbeat, carry out heart transplantation, and treat other conditions concerned with the heart. While the surgery is intensive and can prolong for up to six hours, the risk of fatalities is fairly low. However, the life expectancy of a patient after undergoing open-heart surgery is projected to be significantly shortened, especially in older patients.
Preparation for the surgery occurs days before the operation, where routine tests are carried out on the patient such as Electrocardiogram (ECG), vein mapping, X-rays, and blood tests, to ensure that there are no procedural infringements on the day of the surgery. Additionally, patients are recommended to not consume anything post-midnight on the day of the operation. During surgery, patients are dosed with general anesthesia to make sure that they essentially undergo a painless experience. Breathing tubes are placed in the lungs of the patient by intubation through the throat. An incision is made by the surgeon down the center of the chest following which the breastbone is cut downwards to open the ribcage and access the heart. The functioning of the heart is temporarily paused for the duration of the surgery, which is why patients are connected to a heart-lung bypass machine. The heart-lung bypass machine carries out the heart’s functions for the length of the operation, additionally helping to shift blood away from the heart, thus enabling surgeons to perform on a beatless heart. Be it coronary artery bypass graft (CABG) or heart transplantation, the required procedures are carried out depending on the purpose of the surgery. The breastbone is then wound back together using a wire (which remains in the body), and the initial incision is then sealed up by stitching. Patients usually experience heart attacks during or briefly after open-heart surgery, which however doesn’t cause major complications since they are under the care of medical professionals.
After the strenuous surgery, patients spend a day or two in an Intensive Care Unit (ICU) to ensure stable recovery. During this time, vital signs such as blood pressure and heart rate are monitored to confirm that there are no complications, and that the patient is fit enough to go home. The patient is discharged from the hospital after approximately 3 to 4 days and can return home, however they need to make several alterations to their lifestyle. Frequent visits to the doctor are essential for continuous monitoring of cardiac activity so as to ensure its smooth functioning (this may be enhanced by any recommended medications such as blood thinners). Moreover, unhealthy habits such as smoking, consuming deleterious foods (such as sugar, trans fats, alcohol, etc.), and lack of exercise must be abolished. Lastly, it is imperative that patients take care of the stitched incision by keeping it clean in order to prevent it from getting infected.
Even though open heart surgery is a lifesaving option for many, many undesirable outcomes can come with it. For example, as iterated before, heart attacks and strokes are fairly common during or after open-heart surgery which can have long-term detriments to one’s health even if it is effectively contained. Additionally, conditions such as lung and kidney failure, chest pain and infection, blood clots, breathing difficulty, and memory loss have a high probability of surfacing after open-heart surgery.
The frequency of open-heart surgery is becoming increasingly prominent in today’s day and age due to an unfortunate surge of cardiac patients. It is a complicated procedure that requires formidable skill and demands immense preparation and effort.
Bibliography:
7. https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/surgery/cardiothoracic-surgery
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