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Open Heart Surgery

Alternate Names

  • intracardiac surgery

Definition

Open heart surgery describes any surgery that requires the heart to be cut open.

Who is a candidate for the procedure?

This type of surgery may be necessary for any of these conditions:
  • physical defects of the heart present at birth, known as congenital heart disease
  • damaged or diseased heart valves
  • severe heart disease requiring heart transplant
  • severe blockages of the arteries of the heart requiring heart bypass surgery.
A person must be healthy enough to withstand the stress of major surgery.

How is the procedure performed?

Open heart surgery is done with general anesthesia. This means that the person is put to sleep with medications and feels no pain during the surgery. He or she is put on an artificial breathing machine, a ventilator, during the first part of the surgery. The chest area is cleaned with an antibacterial soap.
Next, an incision is made into the chest. Usually, the incision is made through the breastbone (sternum) into the middle of the chest, exposing the heart. At this point, the heart is stopped, the lungs are deflated, the ventilator is turned off, and the person is placed on a heart-lung bypass machine. This device keeps the blood circulating through the body at the correct pressure and full of oxygen.
The surgeon can then fix the heart problem. This may involve repairing or replacing a valve, sewing a defect closed, or bypassing blocked arteries. When the repair is complete, the person is taken off the heart-lung machine, the heart is restarted with an electric pulse, and the ventilator is reconnected.
Once the surgeon verifies that the person's heart is working again to pump the blood, the chest incision can be closed. The person is taken off anesthesia and sent to the surgery recovery room.

Sources

Heart Disease, 1997, Braunwald et al.

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