Open heart surgery just means that the kind of procedure you’re getting is going to require your surgeon to cut your chest open by about ten inches, separate the breastbone, and then when it’s all over, wire the breastbone back together and stitch your chest back up.
It can take days of hospitalization and weeks of recovery before you start to feel like yourself—not to mention months before you really feel the effects of the surgery. But what do all those other terms your cardiologist is bandying about mean?
Coronary Heart Disease: Given time, plaque, which is a sort of waxy substance made up of all the stuff that gets stuck in the arteries, can completely block the arteries—specifically the coronary arteries that supply new blood full of oxygen to the heart. It’s a leading cause of death in the United States, and may require a coronary artery bypass graft.
Graft: During a bypass surgery, the goal is to get around a blocked artery. So, surgeons take veins and arteries from elsewhere around the body and graft them into a new location so the blood can go around the blocked artery.
Aortic or Mitral Valve Surgery: The heart is made of many different parts. Some of these include valves, whose job it is to open and close to allow blood to flow through, and then prevent it from flowing back into the heart. In some cases, these valves stop working. Surgery must then be performed to correct or replace the valves.
Chest Wound Infection: The incision site following open heart surgery can become infected, just as with any other sort of surgery. However, the chance of infection is much more serious, because it is so closely connected to the heart. Any signs of green pus, odor, redness, or a hot, painful, and changing spot around or in the chest incision means you need to call your doctor immediately.
Heart Lung Bypass Machine: It can be difficult to perform surgery on a heart that’s not only beating and moving around, but also shooting out blood every time the doctor tries to do something. To get around this, a special machine is used to send blood and oxygen to the brain and the rest of the body during heart surgery. Effectively, the machine bypasses the heart and does its job for it until the surgery is over and it can resume operations properly.
Sternal Plating: While most patients have their breastbone put back together with wire, which will remain there, high risk patients need sternal plating. In the case of those who are older or who have had multiple open heart surgeries, titanium plates are used to put the breastbone back together.
Congenital Defect: Not all heart conditions come because of poor eating habits or old age. Sometimes, patients are born with them, which is what makes a “congenital" defect. This doesn’t mean they can’t be fixed! For example, all babies have an additional blood vessel that closes up once they’re born. Sometimes, that vessel sticks around, and so doctors must go in and close it up themselves.
Endoscopic Surgery: This is not an option for all surgeries, but medical advances have to lead to less invasive methods of repairing heart problems. Rather than making a large cut down the chest, small cuts are made. An endoscope, a small tube with a camera on the end, is sent through one hole, and special instruments are used through the other holes to perform the surgery. Recovery time is often quicker, and the chances of infection smaller because there is so much less of the interior open to external forces.
Robotic Assisted Surgery: This type of surgery works very similarly to endoscopic surgery, except robotic instruments go into the incisions rather than those in the doctor’s hands. The surgery is done by watching a 3D image on a computer screen. While it makes for very precise movements, experts suggest it has yet to be proven any more effective than traditional methods.
Ventricular Assist Device Or Total Artificial Heart: In some cases, it is necessary to give the heart an assistance device. Both VADs and TAHs must be put in through open heart surgery. While VAD helps weak hearts pump blood to parts of the body, TAH replaces the lower ventricles, usually in the last stages of heart failure.