Heart Surgery
Heart Surgery

Heart Surgery What to Expect During Surgery

Heart surgeries are done in hospitals. Typically, heart surgeries are performed by highly trained doctors called cardiothoracic surgeons. A team of healthcare providers including your surgeon, imaging specialists, anesthesiologists, and nurses will care for you during your hospital stay.

Depending on many factors including your heart condition and overall health, your surgeon may perform minimally invasive heart surgery, off-pump surgery, or open-heart surgery. For example, coronary artery bypass graft surgery (CABG) can be performed using any of these methods. Your provider will work with you to decide which one is best based on how serious your heart problem is and any factors that may put you at risk for complications.

What to expect during open-heart surgery

Open-heart surgery is any kind of surgery in which a surgeon makes a large incision (cut) in the chest to open the rib cage and operate on the heart. For this type of surgery, you'll be given anesthesia, a medicine to make you unconscious and unaware of pain.

Your surgeon will make a 6- to 8-inch incision down the center of your chest wall. Then, they 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. Your surgeon will connect a heart-lung bypass machine to your heart. The machine will take over your heart's pumping action and move blood away from your heart. This is done because surgeons can better perform some procedures on a heart that isn't beating and doesn't have blood flowing through it.

Heart-lung bypass machine
Heart-lung bypass machine. The image shows how a heart-lung bypass machine works during surgery. 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 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, they 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.

Procedures that may use open-heart surgery

What to expect during off-pump heart surgery

Surgeons often use off-pump, or beating heart, surgery to perform CABG. This approach is similar to open-heart surgery because the breastbone 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 in order to operate on it. Your heart will continue to pump blood to your body during the surgery.

Off-pump heart surgery isn't right for all people. Your provider will carefully consider your heart problem, age, overall health, and other factors that may affect the surgery to decide whether this type of surgery will work for you.

What to expect during minimally invasive heart surgery

To perform minimally invasive heart surgery, a surgeon makes small incisions (cuts) in the side of the chest between the ribs. They do not cut through the breastbone to open the chest as is done in open-heart surgery. During the procedure, your surgeon will insert a tool with a small video camera at the tip. This tool will allow the surgeon to see and operate on your heart using small tools inserted through the incisions in the side of your chest.

Another type of minimally invasive heart surgery called robotic-assisted surgery is becoming more common. With this method, the surgeon uses a computer that controls small robotic arms inserted through incisions to perform heart surgery while watching a high-definition video of your heart and the inside of your chest. This method allows the surgeon to perform precise, controlled movements.

Compared to open-heart surgery, you may have a shorter recovery time and lower pain levels after minimally invasive surgery. Many heart conditions can be treated using minimally invasive surgery, though it isn’t right for everyone. Your provider will discuss whether you are eligible depending on the severity of your heart problem and your overall health.

Procedures that may use minimally invasive heart surgery

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