Open heart surgery tends to be thought of as one procedure. However, it actually references any cardiac surgery that requires opening up the chest. An incision about eight to ten inches long is made through both skin and breastbone to allow the surgeon to perform the necessary procedure.
More and more medical advances allow for many surgeries that were traditionally open heart to be performed through robotic assistance or other minimally invasive measures. This makes for a blurry line when saying “This surgery is open heart, this surgery is not.” Bearing that in mind, these are some of the more common reasons for open heart surgery.
One of the most obvious reasons open heart surgery is necessary is to replace the heart entirely. This is also one of the most difficult types of surgery to think about, because it requires finding a heart from someone who has died and was willing to be an organ donor. The heart is taken from its original place and transplanted into the person in need. Heart failure, abnormalities, defects, and even beats or rhythms that are totally out of sync with what they should be can’t always be fixed through more conservative surgeries or with medications. In this case, the patient must simply wait for an appropriate donor. However, there are still many risks associated with a heart transplant.
Coronary Artery Bypass Graft (CABG)
CABG tends to be the surgery most commonly thought of when someone says “open heart surgery,” even if it isn’t exactly clear what that means. When arteries in the heart become too blocked up (from poor diet, a sedentary lifestyle, or a myriad other factors), the blood simply can’t flow the way it’s supposed to. In this case, a blood vessel is taken from another part of the body and grafted to create an alternate route of blood flow, allowing the heart to function the way it’s supposed to. A patient may undergo CABG multiple times, but it’s not something that can keep going on forever, which means a change in lifestyle is often required along with a bypass surgery.
Aortic or Mitral Valve Surgery
The aortic valve is responsible for opening up, so that blood can leave the heart, and then closing, so that same blood doesn’t rush back in where it doesn’t belong. Similarly, the mitral valve allows blood from the left atrium to the left ventricle. While the specific surgeries for repairing these valves are different, the idea is the same: open heart surgery is necessary for doctors to get in and repair the valves. In some cases, it isn’t possible to repair them, in which case they must be replaced instead.
Congenital Defect Corrective Surgery
Babies, unfortunately, are sometimes born with a heart defect. Luckily, open heart surgery is available to them as well. Fetuses have an additional blood vessel that usually closes up once they come into the world, but in some cases, it doesn’t. Doctors are able to go in and close off the additional blood vessel manually. There are other alternatives to open heart surgery, as well as medications that may be helpful, but sometimes corrective surgery is the best or only option for these very young patients.