The Process of Open-Heart Surgery
Written by Aditi Avunuri
Open-heart surgery is one of the most complex and life-saving surgical operations in modern medical practice. As intimidating a procedure as it is, having a familiarity with the process in detail can make both family and patient less nervous about it. From first incision to last stitch, each aspect in the surgical room is planned out in detail to produce the best result.
The first part of the procedure involves sedating the patient with general anesthetic, putting them asleep and insensate during intervention. Once asleep, surgical professionals shave and disinfect the chest and then make an opening down the center of the chest, approximately 6 to 8 inches long. To gain access to the heart, the surgeon saws through the breastbone (the sternum) and spreads apart gently with care, opening a direct view and access to the heart and big blood vessels.
The heart can temporarily stop beating, and a heart-lung bypass device takes over its function, pumping blood full of oxygen through the body during work with a motionless heart. Known as "called on-pump surgery," it is a routine practice for complex operations such as heart valve and coronary artery bypass graft (CABG) operations. In a few operations, such as bypass operations, off-pump, or "beating heart" surgery, is performed, and the surgeon works with a beating heart, but with a little less access and a lot less blood in the surgical field.
Once the heart is accessible, whatever work is to be done is completed—repairing a failed valve, bypassing an obstruction with a new artery, even a full heart transplantation. Every move is executed with care, sometimes employing microscopic sutures to reconnect fragile blood vessels. Once repaired, replaced, and restarted, sometimes with a mild electrical stimulation when a stimulation is necessitated, the heart takes over its function naturally. When a heart-lung bypass device is utilized, it is removed and replaced with a return to a heart function naturally taking over its function.
Lastly, with care, the surgeon closes the chest, wiring together a breastbone, allowing it to fuse over a span of several years. The incision is sewed shut, and the patient is wheeled off to intensive care for observation. As long a healing period takes, actual surgery is a precisely coordinated exercise that, for many, brings a new chance at life.
Sources:
https://www.ynhh.org/articles/open-heart-surgery-recovery
https://www.nhlbi.nih.gov/health/heart-surgery/during
https://my.clevelandclinic.org/health/procedures/21502-open-heart-surgery
Written by Aditi Avunuri from MEDILOQUY