New Delhi: Open-heart surgery is often viewed as a daunting procedure, filled with complexity and risk. While it’s true that it’s a significant operation, many patients don’t fully understand what happens during this life-saving procedure. Dr. A. Nagesh, Consultant Cardiac Surgeon and Clinical Director of MICS & Heart Transplant, CARE Hospitals, Banjara Hills, in interaction with News9Live, shared 7 facts that reveal what goes on during open-heart surgery.
- The Heart Isn’t Always Stopped: One of the most common misconceptions about open-heart surgery is that the heart is always stopped during the procedure. However, not all heart surgeries require halting the heart’s natural rhythm. In procedures such as beating heart bypass surgery (also known as off-pump coronary artery bypass grafting or off-pump CABG), surgeons operate while the heart is still beating. To stabilise the targeted part of the heart, specialized tools are used. These devices hold the area of the heart being worked on steady, enabling the surgeons to bypass blocked arteries without stopping the heart. This technique reduces the need for a heart-lung machine and leads to quicker recovery times.
- Patients Are Kept Cool to Protect the Brain: In traditional open-heart surgery, especially in more complex cases like aortic surgery, patients are often cooled down to a lower body temperature through a technique called hypothermic circulatory arrest. Lowering the patient’s body temperature slows the metabolism and reduces oxygen demand, giving the heart and brain a reprieve. This precautionary measure protects vital organs, particularly the brain, by reducing the risk of neurological damage. Surgeons can then operate on the heart for longer periods without the organs becoming oxygen-deprived.
- The Heart-Lung Machine Does the Work: In many cases of open-heart surgery, such as valve replacements or coronary artery bypass grafting (CABG), a heart-lung machine temporarily takes over the heart’s and lungs’ functions. This machine pumps oxygenated blood throughout the patient’s body while the heart is stopped for surgery. The heart-lung machine performs the critical role of maintaining blood circulation, allowing surgeons to operate on the heart without any interruptions to the body’s oxygen supply. This technology has revolutionized the ability to perform complex cardiac surgeries while keeping the patient stable.
- A Tiny Incision Can Be Enough: Advancements in Minimally Invasive Cardiac Surgery (MICS) mean that open-heart surgery doesn’t always require a large incision down the chest. Surgeons can now perform certain heart surgeries through much smaller incisions, sometimes no more than a few inches. These innovations lead to faster recovery times, reduced pain, and minimal scarring. MICS techniques also decrease the risk of infection, allowing patients to experience a smoother and quicker recovery process compared to traditional open-heart surgery.
- The Sternum Is Temporarily Opened: For most open-heart surgeries, the sternum or breastbone needs to be divided to gain access to the heart. This is done carefully, and once the procedure is complete, the sternum is wired back together. Over time, it naturally heals as the body forms new bone tissue around the wire. While the thought of the sternum being cut might sound intimidating, it’s a routine part of the surgery, and the body can recover and repair itself effectively in a few months.
- Precision Is Key: Every Stitch Matters: Heart surgery requires an extraordinary level of precision. Surgeons use highly magnified tools, sometimes aided by robotic assistance, to ensure that each stitch is placed perfectly. Whether replacing heart valves or performing coronary artery bypass surgery, even the smallest mistake can have serious consequences. The heart is an intricate and delicate organ, so precise movements and accuracy are critical to the success of the procedure and the patient’s overall recovery.
- Recovery Begins Immediately: Many patients are surprised at how quickly their recovery begins after open-heart surgery. The recovery process starts as soon as the patient leaves the operating room. They are transferred to an advanced cardiac intensive care unit (ICU), where medical staff monitor their vital signs closely. Within hours, patients begin basic physical exercises like breathing exercises and gentle movements to help stimulate circulation and prevent complications like blood clots. For those undergoing Minimally Invasive Cardiac Surgery (MICS), the recovery time is even shorter, with many patients able to resume normal activities like driving or returning to work within just a few days or a week.
Open-heart surgery is a marvel of modern medicine, involving intricate procedures, advanced technology, and highly skilled surgeons. While the thought of undergoing heart surgery can be intimidating, understanding the science and expertise behind the operation can provide reassurance. With advancements in surgical techniques and faster recovery times, patients can now enjoy a higher quality of life post-surgery, often returning to their normal routines sooner than ever before.
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