What Is Heart Surgery ?
Heart surgery is used to correct heart problems in children and adults. This article discusses heart surgeries for adults.
The most common type of heart surgery for adults is coronary artery bypass grafting (CABG). During CABG, surgeons use healthy arteries or veins taken from another part of the body to bypass (that is, go around) blocked arteries. CABG relieves chest pain and reduces the risk of heart attack.
Heart surgery also is done to : -
* Repair or replace valves that control blood flow through the heart
* Repair abnormal or damaged structures in the heart
* Implant medical devices that regulate heart rhythms or blood flow
* Replace a damaged heart with a healthy heart from a donor (heart transplant)
Traditional heart surgery, often called “open heart surgery,” is done by opening the chest wall to operate on the heart. Almost always, the chest is opened by cutting through a patient’s breastbone. Once the heart is exposed, the patient is connected to a heart-lung bypass machine. The machine takes over the pumping action of the heart. This allows surgeons to operate on a still heart..
Types of Heart Surgery
Different types of heart surgery are used to fix different heart problems. : -
Coronary Artery Bypass Grafting :
Coronary artery bypass grafting (CABG) is the most common type of heart surgery. More than 500,000 of these surgeries are done each year in India. CABG improves blood flow to the heart. It’s used for people with severe coronary artery disease (CAD)…
Transmyocardial Laser Revascularization : >>
Transmyocardial laser revascularization or TLR, is a surgery used to treat angina when no other treatments work. For example, if you’ve already had one CABG procedure and can’t have another one, TLR may be an option. This type of heart surgery isn’t common.
During TLR, the surgeon uses lasers to make channels in the heart muscle. These channels allow oxygen-rich blood to flow from a heart chamber directly into the heart muscle.
Valve Repair or Replacement : >>
For the heart to work right, blood must flow in only one direction. The heart’s valves make this possible. Healthy valves open and close in a precise way as the heart pumps blood.
Each valve has a set of flaps called leaflets. The leaflets open to allow blood to pass from the heart chambers into the arteries. Then the leaflets close tightly to stop blood from flowing back into the chambers…
Arrhythmia Treatment : >>
An arrhythmia is a problem with the speed or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm.
Most arrhythmias are harmless, but some can be serious or even life threatening. When the heart rate is abnormal, the heart may not be able to pump enough blood to the body. Lack of blood flow can damage the brain, heart, and other organs. Arrhythmias are usually treated with medicine first. If medicines don’t work well enough, you may need surgery. For example, your doctor may use surgery to give you a pacemaker or an implantable cardioverter defibrillator (ICD)…
Aneurysm Repair : >>
Heart Transplant : >>
A heart transplant is surgery in which a diseased heart is replaced with a healthy heart from a deceased donor. Heart transplants are done on patients whose hearts are so damaged or weak that they can’t pump enough blood to meet the body’s needs..
Open-Heart Surgery : >>
Open-heart surgery is any kind of surgery where the chest wall is opened and surgeons operate on the heart. “Open” refers to the chest, not the heart. Depending on the type of surgery, the heart may be opened too. Open-heart surgery is used to bypass blocked arteries in the heart, repair or replace heart valves, fix atrial fibrillation, and transplant hearts..
Minimally Invasive Heart Surgery : >>
For minimally invasive heart surgery, a surgeon doesn’t make a large incision (cut) down the center of the chest to open the rib cage. Instead, he or she makes small incisions in the side of the chest between the ribs. A heart-lung bypass machine is used in some types of minimally invasive heart surgery, but not others. This newer heart surgery is used for some CABG and Maze procedures. It’s also used to repair or replace heart valves and insert pacemakers..
Who Needs Heart Surgery ?
Heart surgery is used to treat people who have severe heart diseases and conditions. If other treatments, such as lifestyle changes, medicines, and medical procedures, haven’t worked or can’t be used, heart surgery may be an option…
Medical Evaluation
Your doctors will talk with you about : -
* The kind of heart problem you have, the symptoms it’s causing, and how long you have had symptoms
* Your history and past treatment for heart problems, including surgeries, procedures, and medicines
* Your family’s history of heart problems
* Your history of other health problems and conditions, such as diabetes or high blood pressure
* Your age and general health
The doctors also may do blood tests, such as a complete blood count, a cholesterol test, and other tests as needed.
Diagnostic Tests
Medical tests are done to find out more about your heart problem and your general health. This helps your doctors decide whether you need heart surgery, what type of surgery you need, and when to do it.
EKG (Electrocardiogram) : -
An EKG is a simple and painless test that records the electrical activity of your heart. This test is used to help detect and locate the source of heart problems. A technician attaches sticky patches, called electrodes, to the skin of your chest, arms, and legs. The electrodes are attached with wires to a machine that records your heart’s electrical signals.An EKG shows how fast your heart is beating and whether its rhythm is steady or irregular. It also shows where in your heart the electrical activity starts, and whether it’s traveling through your heart in a normal way.
Stress Test : -
Some heart problems are easier to diagnose when your heart is working harder and beating faster than when it’s at rest. During stress testing, you exercise (or are given medicine if you’re unable to exercise) to make your heart work hard and beat fast. During the stress test, your blood pressure is checked and an EKG is done. Other heart tests also may be performed.
Echocardiography : -
Echocardiography is a painless, noninvasive test. “Noninvasive” means that no surgery is done and no instruments are inserted into your body.
This test uses sound waves to create a moving picture of your heart. Echocardiography provides information about the size and shape of your heart and how well your heart chambers and valves are working. The test also can show areas of poor blood flow to your heart, areas of heart muscle that aren’t contracting normally, and previous injury to your heart muscle caused by poor blood flow.
Coronary Angiography : -
Coronary angiography (an-jee-OG-ra-fee) uses a special dye to show the insides of your coronary arteries on x-ray pictures. An angiogram shows the location and severity of blockages in blood vessels. To get the dye to your coronary arteries, a procedure called cardiac catheterization is used. Cardiologists usually do cardiac catheterizations in a hospital. You’re awake during the procedure, and it usually causes little to no pain.
During this procedure, a catheter (a thin, flexible tube) is passed through an artery in your leg or arm and threaded to your heart. The dye is injected into your bloodstream through the tip of the catheter.
Aortogram : -
An aortogram is an angiogram of the aorta. The aorta is the main artery that carries blood from your heart to your body. An aortogram may show the location and size of an aortic aneurysm and the arteries that are involved.
Chest X Ray : -
A chest x ray provides a picture of the organs and structures inside your chest, including the heart, lungs, and blood vessels. This test gives your doctor information about the size and shape of your heart. A chest x ray also shows the position and shape of the large arteries around your heart.
Cardiac Computed Tomography Scan : -
A cardiac computed tomography (CT) scan provides computer-generated, x-ray images of your internal organs. A liquid dye that can be seen on an x ray is injected into a vein in your arm. The dye outlines arteries and veins in your heart on the CT scan. A cardiac CT scan can show whether plaque is narrowing your coronary arteries or whether you have an aneurysm. A CT scan also can find problems with heart function and heart valves.
Cardiac Magnetic Resonance Imaging : -
Cardiac magnetic resonance imaging (MRI) is a safe and noninvasive test that uses magnets and radio waves to create images of the inside of your body. Cardiac MRI uses a computer to create images of your heart as it’s beating. The computer makes both still and moving pictures of your heart and major blood vessels.
Cardiac MRI shows the structure and function of your heart. This test is very accurate at finding aneurysms and determining their size and exact location.
Off-Pump Heart Surgery
This type of surgery is the same as traditional open-heart surgery, except you aren’t connected to a heart-lung bypass machine. Instead, your heart is steadied with a mechanical device while the surgeon works on it. Your heart continues to pump blood to your body.
The advantages of off-pump heart surgery are : -
* No complications related to using a heart-lung bypass machine
* Faster recovery from the surgery
Minimally Invasive Heart Surgery
For this type of heart surgery, the surgeon makes small incisions in the side of your chest between the ribs. These incisions can be as small as 2 to 3 inches. Then the surgeon inserts surgical tools through these small incisions. A tool with a small video camera at the tip also is inserted through an incision. This allows the surgeon to see inside the body.
Some types of minimally invasive heart surgery use a heart-lung bypass machine; other types don’t.
The advantages of minimally invasive heart surgery are : -
* Less bleeding during surgery and a lower chance of needing a blood transfusion
* Lower risk of infection
* Less pain
* Smaller incisions and scars
* A shorter hospital stay and faster recovery
Patients who don’t need the heart-lung bypass machine aren’t at risk for the complications that the machine may cause.
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