عمل قلب باز چیست؟ When is open heart surgery necessary? How is open heart surgery performed? Is open heart surgery dangerous? Open heart surgery is one of the best solutions for heart problems, which requires the removal of the breastbone. In this article, while answering all your questions about open heart surgery, we will investigate more about this and recommend that you stay with us until the end.

What is open heart surgery?

Open heart surgery is one of the important and sensitive methods for treating heart problems and provides a way for surgeons to access the patient's heart. In this type of surgery, the chest wall is opened so that the surgeon can access the heart. To perform open heart surgery, the surgeon cuts the sternum or breastbone and opens the ribs. Open heart surgery will be a safe method that if the patient is strong enough, it can be a very suitable solution for treating heart diseases.

Types of open heart surgery

Of the types of open heart surgery, we can mention the following:

• Open heart coronary artery bypass surgery (CABG)

Coronary artery bypass grafting (CABG) or heart bypass surgery is a procedure to restore blood flow to areas of the heart. Since the blockage of the artery can cut off the blood flow and lead to heart attacks or similar symptoms, this surgery will bring great advantage. This surgery creates a detour around the blockage through the blood vessels of other parts of the body and circulates the blood using this method. It should be noted that open heart surgery for heart artery blockage has saved many lives.

In other words, in coronary artery bypass surgery, a part of the leg artery or vein is removed and replaced by the blocked coronary artery. This improves blood supply to the heart. In fact, the surgeon tries to improve the amount of oxygen that the heart needs. This situation helps to improve the activity and performance of the heart.

• Mitral valve replacement open heart operation

In open heart surgery, through mitral valve replacement, an artificial mitral valve replaces the weak mitral valve in the body. As you know, the mitral valve consists of 4 heart valves that allow blood to flow from the heart to other parts of the body. In fact, the mitral valve is located between the left atrium and the left ventricle.

• Open heart surgery for aortic valve replacement

In this type of open heart surgery, an artificial aortic valve replaces the weakened aortic valve. As you know, the aortic valve is one of the 4 heart valves. It should be noted that these valves have the duty to flow blood through the heart and help it flow in the body.

• Open heart surgery with laser

Another type of open heart operation is called vascular reconstruction with laser. In this type of open heart surgery, which is also known as transmyocardial laser revascularization, a small incision is made on the left side of the chest. In open heart surgery with a laser, small channels are created inside the open heart muscle and the heart continues to beat during the operation. In this type of open heart surgery with a laser, there will be no need for a heart-lung bypass device.

• Open heart surgery without anesthesia

Open heart surgery without anesthesia is another type of open heart surgery. In this open heart surgery method, TAVR is used and a new valve is created to the heart using a catheter.

• Multiple Bypass Operation

In bypass surgery and open heart surgery, the number of bypasses for coronary arteries will be of great importance. Due to the difference in the number of blocked arteries in different patients, coronary artery grafting can be done in single, double, triple and quadruple ways. Therefore, during surgery, it is necessary to use the bypass device according to the number of vessels taken.

Multiple bypass operation for heart surgery is not dangerous and it takes 2-6 hours to perform open heart surgery for coronary artery bypass grafting. It should be noted that the greater the number of surgical bypasses, the longer the duration of surgery.

• Heart transplant surgery

Open heart surgery may be performed as a heart transplant. If the heart failure is severe and the heart structure is severely damaged, a heart failure specialist in Isfahan recommends heart transplant surgery. This surgery is performed when none of the restorative methods have any effect on improving the patient's condition. A surgeon and doctor specializing in heart transplant surgery replaces the patient's heart with a donated heart from another person. It should be noted that the conditions of transplant surgery with open heart surgery are very special and the care before and after it has a significant impact on the surgery.

When is open heart surgery necessary?

Open heart surgery may be performed for coronary artery bypass grafting (CABG), which is usually necessary for people with coronary artery disease. As we explained earlier, coronary artery disease or heart attack occurs when the blood vessels that supply blood and oxygen to the heart muscle become narrow and stiff. This is called "hardening of the arteries".

Hardening of the arteries occurs when fatty substances form a plaque on the wall of the coronary arteries. By narrowing the arteries, this plaque makes it difficult for blood flow to pass. As a result, when the blood cannot flow properly to the heart, it can cause a heart attack.

Doctors and specialists recommend the method of open heart surgery in order to treat all kinds of heart diseases, the reason for open heart surgery can be different. In the following, we mention some of the reasons for the need for open heart surgery:

• Repair or replacement of heart valves with artificial heart valves (heart valve disease)
• repairing damaged or abnormal areas of the heart
• Implantation of medical devices that help the heart beat properly
• Replacing the damaged heart with a donated heart (heart transplant)
• Heart arrhythmia, including atrial fibrillation
• Treatment of congenital heart defects, such as atrial septal defect (hole in the heart) or hypoplastic left heart syndrome (underdeveloped heart structures)
Coronary artery disease
• Treatment of heart failure
Thoracic aortic aneurysm

At what age is open heart surgery performed?

At what age open heart surgery should be done, it will be different depending on the cause of the disease and the emergency situation of the patient. Therefore, it is the responsibility of the surgeon to determine the patient's competence to perform surgery. Normally, the average age of open heart surgery in the world is 55 years; But from the medical point of view, this operation can be done at any age.

How is open heart surgery performed?

cardiologist in Isfahan uses two methods to perform open heart surgery, which are:

• On-pump

In this method, the heart-lung bypass device is connected to the heart and temporarily performs the function of the heart and lungs. This device takes blood away from the heart and circulates it around the body. This allows the surgeon to operate on a heart that is not beating and has no blood flow. After the surgery, the bypass device is disconnected and the heart starts beating again.

• Off-pump

In this heart surgery procedure, off-pump bypass surgery is performed on a heart that continues to beat during surgery. It should be noted that off-pump surgery is performed only for coronary artery bypass surgery (CABG).

care before and after open heart surgery

The heart pacemaker doctor in Isfahan states that before the surgery, you should be in contact with the best heart surgeon and the best heart hospital so that you can feel at ease about the doctor's decision and his skill. Before open heart surgery, you need to do a series of tests and imaging, which include:

• Blood, urine tests
• Coronary angiography to determine the condition of heart vessels
• Ultrasound examination of the heart and neck vessels to determine the condition of the heart valves, its contraction and the nature of damage to the carotid vessels
• Electrocardiography
• X-ray of chest organs
• in some cases examination of esophagus, stomach and DPC (FGDS)

Be aware that it is normal to feel confused before open heart surgery. We recommend that you get good information about this method before performing open heart surgery.

Care before open heart surgery

Before the surgery, you need to observe a number of things, which we will mention below.

• Before performing open heart surgery, the specialist doctor may recommend that you stop taking some medicines, food supplements or herbal products for one to two weeks. Usually, the specialist doctor recommends that you avoid blood thinners (aspirin, warfarin or other drugs that prevent blood clots and strokes) and non-steroidal anti-inflammatory drugs (NSAIDs). It should be noted that these drugs increase the risk of bleeding.
• You need to fast before performing open heart surgery, and the expert doctor will probably remind you of this point. Therefore, avoid eating or drinking liquids before surgery. It should be noted that unconsciousness will be safer with an empty stomach.
• We recommend that you stop smoking and avoid drinking alcoholic beverages before performing open heart surgery. These cases may reduce the speed of recovery or aggravate complications caused by surgery.
• It is better to wash your upper body with antibacterial soap before performing open heart surgery to reduce the risk of infection after surgery.

care after open heart surgery

Open heart surgery is considered a very important surgery and will require close monitoring and immediate support after the operation. Therefore, after open heart surgery it is normal to stay in the intensive care unit for the first few days. After leaving the intensive care unit, you will stay in the hospital for about a week, and recovery at home after discharge from the hospital will take between 4 and 6 weeks.

Feeling a little tired and sore during recovery is normal and nothing to worry about. It is also necessary to observe some points in order to get through this period more easily, which we will mention below:

• Be sure to take care of your wound according to the doctor's instructions, and if there are signs of infection around it, such as redness or discharge, talk to your doctor.
• If you experience serious symptoms of infection such as difficulty breathing, fever, or excessive sweating, be sure to seek emergency treatment.
• After open heart surgery be patient and take time to recover. Because your recovery may take weeks or months before you can return to your normal activities.

Complications after open heart surgery

open heart surgery is performed under anesthesia and does not cause any pain to the patient. However, after surgery, some short-term or long-term complications may arise for the patient due to various reasons. Among these complications, the following can be mentioned:

• Bleeding
• stroke
• kidney problems
• Create a blood clot
• chest infection
• Heartbeat
• Atrial fibrillation
• Loss of hearing or feeling of heaviness in the chest, head or ears
• Delirium
• Illness and nausea
Cognitive dysfunction

Certainly, the attending physician and specialist will give you the necessary recommendations to prevent the complications of open heart surgery, and you will feel at ease about this.

Conclusion

In this article, we mentioned that open heart surgery is one of the suitable solutions for the treatment of heart diseases, which are performed in different ways. Considering that open heart surgery is very sensitive and difficult, so it is necessary to go to the best cardiovascular surgeon or cardiologist to perform it. بدین منظور می‌توانید با کارشناسان دکتر حکمت ارتباط برقرار نمایید.