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What is an open heart process?

What is an open heart process?

Open heart process

The open heart surgery is called traditional cardiothoracic surgery, a process in which the thoracic wall is opened to perform surgery on the heart muscles, valves or arteries. The surgeon cuts the cuticle or the upper part of it. Once the heart is reached, an artificial heart-lung device is inserted to replace the heart. The function is to pump blood to all parts of the body. This device allows the surgeon to perform the operation in the heart that is stopped working and the blood does not flow through it, and it is possible to perform this process through small cracks between the ribs of the rib cage instead of the big cleft Bone marrow, referred to as minor incision surgery, can be used in an artificial heart-lung machine in this type of surgery or dispensing with it, so the label of open heart surgery is sometimes inaccurate.

The doctor decides to perform the open heart surgery when the alternatives that may help the patient, such as medicines, and a healthy lifestyle, and other means, where the cardiologist evaluates the patient’s condition and need for the operation, and conducts medical analysis to determine the health of the patient and then discuss the subject of the operation with his patient And to show him how difficult and accurate and symptoms, and the patient needs a recovery period in order to begin to restore health and well-being.

Causes of open heart surgery

One of the reasons that a doctor resort to open heart surgery is the following:

  • Repair damaged parts of the heart.
  • Replace or repair a valve that does not work perfectly.
  • Cultivate a healthy heart from a donor and replace it with the old heart.
  • Cultivation of cardiac organs helps to control the heartbeat and regulate the flow of blood.
  • Treatment of heart failure and coronary heart disease.

Types of open heart surgery

Types of open heart surgery include the following:

  • Coronary artery traction: (CABG). This is the most common surgical procedure. This surgery improves the flow of blood to the heart to treat coronary heart disease, caused by the accumulation of cholesterol plaques within the coronary arteries, leading to constriction, thus reducing the amount of blood flowing This can cause severe pain in the chest (angina), and the explosion of these plaques can lead to large blood clots, thus stopping the blood flow completely through the coronary arteries (heart attack).
During this surgery, an artery or a healthy vein is attached to the closed coronary vessel so that it can restore the delivery of blood and oxygen to the heart muscle. This procedure can be performed in more than one closed coronary artery during the surgery.
  • Repair or replace heart valves: In order for the heart to function correctly, blood must flow in only one direction, and the heart valves operate in this function, opening and closing accurately during the blood pumping process. When the valve is damaged, it is severely constricted to prevent blood flow through it, or to close it completely, allowing blood to flow in the opposite direction. The open heart operation is performed to repair the damaged valve, replace it with a new artificial valve, or a biological valve (taken from the heart of the cow or human) .
  • Treatment of atrial fibrillation: It is the most common type of arrhythmias, where the ears contract irregularly or rapidly. A process called maze surgery involves the opening of new pathways for the electrical signal passing through the atria to regulate their contractions.
  • Heart transplantation: It is a process that involves removing the heart of the injured person and replacing it with a healthy heart from a deceased donor. Most heart transplantation is performed for patients with heart failure (the final stage of the disease at the failure of all treatments), a weakness of the heart or failure to pump enough blood to meet the needs of the body.
  • Cultivation of atrial fibrillation (VAD): This device is used to support the function of the heart, regulate the flow of blood in patients with weak heart muscle, or disease of heart failure, or during the patient waiting for the heart of a donor, which can be used temporarily for months or years depending on the patient’s condition.
  • Artificial heart transplantation (TAH): This device replaces the ventricles temporarily injured during the process of heart transplantation in cases of chronic heart failure.

Medical evaluation and diagnostic tests

The doctor will talk to the patient about the following:

  • The type of problem the heart experiences, and the symptoms it causes.
  • Previous treatments for heart disease problems involving its medications, operations and surgery.
  • Family history of heart disease.
  • Other health problems experienced by the patient, such as: diabetes, high blood pressure.
  • Age and general health status.
  • Some blood tests may be performed, such as: Full blood count, cholesterol test, and other tests as needed.

For diagnostic tests, they are conducted to obtain information about the heart problem and the general health of the patient. These tests help the doctor determine the procedure, determine its type, and the time needed to perform the tests. These tests may include:

  • ECG: To determine the electrical activity of the heart (determine the speed and regularity of the heart rate).
  • Stress Test: The patient’s heart is examined while practicing exercises that the doctor is required to perform. Diagnosis of some heart problems is easier during the operation of the heart with a greater effort than normal.
  • Echocardiography: This test uses ultrasound technique, where the shape and size of the heart, the body of the valve, and the strength of its work is recognized.
  • Coronary angiography: This test uses a special dye and x-ray to visualize the coronary arteries, which helps the doctor to know the health of blood flow through the heart and blood vessels.
  • Vascular imaging of the aorta.
  • Chest X Ray: Used to shoot chest, heart, lung and blood vessels. This examination is done to determine the size and shape of the heart.
  • Magnetic resonance imaging (MRI): This is done to determine the exact details of the cardiovascular structure.

How to prepare for the process

The patient is prepared in advance for the operation of the operation before several days of the operation to follow the pressure, and make some of the diagnostic tests mentioned above, and choose the appropriate time to conduct the process, where the patient is given a special soap solution wash to reduce the risk of infection caused by bacteria and microbes, and then the nurse haircut From the chest area where the opening will take place, and gives the patient some drugs intravenously to be entered into the operating room and anesthetized fully to conduct the operation.

During open heart surgery

The process of the open heart goes through the following:

  • The doctor examines the patient’s heartbeat, blood pressure, oxygen levels, and breathing during surgery.
  • A breathing tube is placed in the lungs through the throat. This tube is attached to an artificial ventilator (a device that supports the patient’s breathing).
  • The center of the chest opens (6-8 inches), then cuts the shear bone and opens the thoracic cage until the heart is reached. Then a heart-lung device connects the blood to all parts of the body away from the heart. .
  • After the procedure, the surgeon returns the blood flow through the heart, and then the heart returns to work automatically, but sometimes it may use mild electrical shocks to restart the heart, and then a heart-lung device.
  • Special and permanent wires are used to close the shear, close the chest skin with stitches, and remove the breathing tube.

After open heart surgery

The patient is placed in the intensive care unit for a day or more depending on the patient’s health condition until he gets out of the anesthetic and starts moving. The patient is gradually given fluids through a needle in the blood vessels in the arm or chest. A medical team provides the patient with additional oxygen through a mask When the patient is discharged from the intensive care unit and stays in the hospital for several days before returning home. During this period, the patient’s heart rate, blood pressure, and breathing are checked. The patient will regain his health gradually, and is advised not to visit the patient during the first week of the process, where the body of the patient is sensitive to any type of bacteria and microbes that may cause infection and some complications, which may affect the success of the process.

The patient’s response to the operation varies depending on the type of heart problem and the procedure being performed. After surgery, the doctor may be told how to take care of the wound, identify the symptoms of infection and inflammation, and how to deal with the aftermath and complications of the operation.

The patient needs a recovery period to recover his health and health. The patient may have some symptoms and complications after the procedure, including: muscle and chest pain, swelling of the foot after coronary artery bypass, depression, sadness, pessimism, nervousness, loss of appetite, During eating, anxiety at night and lack of desire to sleep, urine retention, constipation. All of these symptoms are normal and gradually begin to diminish, as the patient returns to full health and begins to recover significantly after the first months of the operation. The doctor determines according to the patient’s health status when a person can practice his normal life, such as returning to work, driving, No impediments.

Patient care continues through periodic medical checkups to monitor post-operative heart function. The patient may require changes in his lifestyle, such as quitting smoking, changing his diet, exercising, and reducing stress and stress.

Risk of open heart surgery

Despite excellent surgical results, heart surgery may cause some of the risks and complications that improve within 6-12 months of surgery:

  • Bleeding.
  • Infection and infections.
  • Side effects of anesthesia.
  • Arrhythmia.
  • Damage to the heart, lung, kidney and liver tissues.
  • brain attack.
  • Death (especially in serious and emergency cases before surgery).
  • In some patients, loss of memory affects the elderly, women and other diseases such as diabetes. Diabetes may prevent wound healing and healing, and the patient may experience several infections.
  • Kidney and lung diseases.
  • Peripheral artery disease more than other cases.

An important factor in the success of the process is the patient’s strong will, his understanding of the process and the results of the operation. This helps the patient recover quickly and recover his health faster. Some patients believe that open-heart surgery will negatively affect human health, life and exercise for daily work, although many of those who have performed the operation are naturally and much better than before.