What is open heart surgery?
Open heart surgery is any surgical procedure in which the surgeon cuts open the chest for surgery on the heart. Open heart surgery can treat a variety of diseases and conditions of the heart. Conditions commonly treated with open heart surgery include heart valve disease, birth defects of the heart, and coronary artery disease. Coronary artery disease is the leading cause of heart attack.
Your heart is made of specialized muscle tissue (myocardium) that pumps blood through your body. Blood moves through the four chambers of the heart in a precise manner controlled by electrical signals. Valves help coordinate the movement of blood through the heart. The coronary arteries are blood vessels that supply your heart muscle with blood.
Open heart surgery is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options. You should consider getting a second opinion about all your treatment options before having open heart surgery.
Types of open heart surgery
The types of open heart surgery procedures include:
- On-pump surgery uses a heart-lung machine (cardiopulmonary bypass). This machine temporarily takes over the heart’s job of pumping oxygen-rich blood to the organs and tissues. This is the traditional type of open heart surgery. It allows your surgeon to operate on a heart that is not beating and has no blood traveling through it.
- Beating heart or off-pump surgery does not use a heart-lung machine and your surgeon operates on an actively beating heart. However, your surgeon will slow your heart rate with medication or a device. This type of open heart surgery is limited to a few specific procedures.
Your doctor may recommend open heart surgery for:
- Congenital defect repair, which is done to correct a variety of heart problems that are present at birth
- Coronary artery bypass graft (CABG), commonly called heart bypass surgery. CABG provides a new route around diseased coronary arteries with healthy vessels taken from other places in your body. This is the most common heart surgery in adults.
- Heart transplant to remove a severely damaged heart and replace it with a donor heart
- Heart valve repair or replacement when a heart valve does not function properly. Heart valves control the flow of blood into and out of the heart.
- Implantation of medical devices to help control your heartbeat or support proper heart function
- Transmyocardial laser revascularization when coronary artery bypass is not an option. The surgeon uses lasers to make channels directly in the heart muscle to supply it with blood.
- Maze procedure, which is the creation of scar tissue to block irregular electrical signals through the heart. The Maze procedure is used to treat atrial fibrillationor an irregular heartbeat that is not amenable to medications or less invasive methods. It is often performed with another procedure, such as CABG or valve repair.
Why is open heart surgery performed?
Open heart surgery is a major surgical procedure that your doctor may recommend to treat a variety of diseases and conditions of the heart. Your doctor may only consider open heart surgery for youif other treatment options that are less invasive have been ineffective. Talk with your doctor about all of your treatment options and consider getting a second opinion.
Open-heart surgery is most commonly performed on patients with blocked heart vessels or patients who have malfunctioning or inappropriately functioning heart valves.
The critical questions that determine whether someone needs open-heart surgery are: Are the blood vessels to the heart blocked? Is there damage to the heart valves?
“If there are severe blockages, such as more than 70 percent on every blood vessel, then the patient is best served by having open-heart surgery,” Mihaljevic says.
How is open heart surgery performed?
Your open heart surgery will be performed by a surgical team led by a cardiovascular surgeon. A cardiovascular surgeon is a physician who specializes in surgery of the heart and blood vessels.
Open heart surgery requires a large incision in your chest and through your breastbone (sternum). Open surgery allows your surgeon to directly view and access the surgical area. If you are having on-pump surgery, your surgical team will stop your heart with medicine and the heart-lung machine will pump blood to the body. When the surgery is complete, your surgeon will take your heart off the machine.