Heart surgery is done in a hospital, and a team of experts is involved. Cardiothoracic surgeons perform the surgery with other doctors and nurses who help.
How long the surgery takes will depend on the type of surgery you're having. CABG, the most common type of heart surgery, takes about 3–6 hours.
For this type of surgery, you'll be given medicine to help you fall asleep. A doctor will check your heartbeat, blood pressure, oxygen levels, and breathing during the surgery.
A breathing tube will be placed in your lungs through your throat. The tube will connect to a ventilator (a machine that supports breathing).
Your surgeon will make a 6- to 8-inch incision (cut) down the center of your chest wall. Then, he or she will cut your breastbone and open your rib cage to reach your heart.
During the surgery, you'll receive medicine to thin your blood and keep it from clotting. A heart-lung bypass machine will be connected to your heart. The machine will take over your heart's pumping action and move blood away from your heart.
A specialist will oversee the heart-lung bypass machine. The machine will allow the surgeon to operate on a heart that isn't beating and that doesn't have blood flowing through it.
You'll be given medicine to stop your heartbeat once you're connected to the heart-lung bypass machine. A tube will be placed in your heart to drain blood to the machine.
The machine will remove carbon dioxide (a waste product) from your blood, add oxygen to your blood, and then pump the blood back into your body. Your surgeon will insert tubes into your chest to drain fluid.
Once the bypass machine starts to work, the surgeon will repair your heart problem. After the surgery is done, he or she will restore blood flow to your heart. Usually, your heart will start beating again on its own. Sometimes mild electric shocks are used to restart the heart.
Once your heart has started beating again, your surgeon will remove the tubes and stop the heart-lung bypass machine. You'll be given medicine to allow your blood to clot again.
The surgeon will use wires to close your breastbone. The wires will stay in your body permanently. After your breastbone heals, it will be as strong as it was before the surgery.
Stitches or staples will be used to close the skin incision. Your breathing tube will be removed when you're able to breathe without it.
Off-pump heart surgery is like traditional open-heart surgery because the chest bone is opened to access the heart. However, the heart isn't stopped, and a heart-lung bypass machine isn't used.
Instead, your surgeon will steady your heart with a mechanical device so he or she can work on it. Your heart will continue to pump blood to your body.
For this type of heart surgery, your surgeon will make small incisions in the side of your chest between the ribs. These cuts can be as small as 2–3 inches. The surgeon will insert surgical tools through these small cuts.
A tool with a small video camera at the tip also will be inserted through an incision. This tool will allow the surgeon to see inside your body.
Some types of minimally invasive heart surgery use a heart-lung bypass machine and others don't.
Clinical trials are research studies that explore whether a medical strategy, treatment, or device is safe and effective for humans. To find clinical trials that are currently underway for Heart Surgery, visit www.clinicaltrials.gov.
November 20, 2013
Gary H. Gibbons
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