Open-Heart Surgery - Risks, Procedure, and Preparation

Comprehensive Guide to Open-Heart Surgery: Procedure, and Possible Complications

Open-heart surgery is a major operation performed to correct heart conditions that pose a threat to life. Although medical technology has enhanced the success of this surgery, it still remains a severe operation with certain risks, preparation processes, and a lengthy recovery process.

Thus, it is essential to be aware of the risks and preparations that come with this surgery. This blog will discuss open-heart surgery in detail, including what it is, what is done to the patient, risks, and long-term effects. Keep reading for better insight.

What is Open Heart Surgery and How is it Different from Bypass Surgery?

During open-heart surgery, the chest is opened to allow direct access to the heart. The surgeon examines and operates on the valves, muscles, arteries, or other heart structures while the patient lies on a heart-lung bypass machine. Open-heart surgery is usually advised for:

• Valve replacement or repair as faulty valves may either block blood flow or cause leakage.

• Correction of congenital heart defects, such as septal defects, can be closed through surgery.

• Bypass surgery is performed to resume normal circulation when the coronary arteries are blocked.

Let's look at the difference between bypass and open heart surgery, discussed in the table below:

What Happens During the Open-Heart Surgery Procedure?

Having an idea of what will happen during the open-heart surgery can make the process less frightening. The actual surgery usually lasts 3 to 6 hours and is performed in a clean operating room by an experienced team of cardiothoracic surgeons, anesthesiologists, and nurses.

The open-heart surgery process can be complicated. However, it is approached in a rational order, involving the following:

● General Anaesthetic is Given

This ensures you remain unconscious and comfortable throughout the procedure.

● Making of an Incision

The breastbone (sternum) is incised down the middle, providing surgeons with direct visual access to the heart.

● The Patient is Connected to a Heart-Lung Machine

During the operation, the machine temporarily assumes the heart's pumping and lung functions, allowing the heart to remain still.

● The Surgeons Start Operating

The surgeons work on the required operation, which may involve valve replacement, closing a septal defect, or a quadruple bypass to divert the blood flow around plugged-up arteries.

● Closing Breastbone

The breastbone is secured with surgical wires, and the incision is closed. The wires are left in the body permanently, and the outside cut resolves for weeks.

Each surgery may vary slightly depending on the heart issue being addressed. Quadruple bypass surgery, for instance, is longer and more complex than single-vessel surgeries because there are more arteries involved.

What are the Risks and Possible Complications of Open Heart Surgery?

Despite its ability to save lives, open-heart surgery has numerous potential complications. These complications center around risks associated with the patient’s age, medical history, lifestyle, and surgical details. The most common risks and complications include:

● Infections

The incision sites and lungs are at high risk of developing infections like pneumonia, which may require treatment beyond antibiotics.  

● Excessive Bleeding

Patients may develop uncontrollable bleeding that requires re-operation or, in severe cases, blood transfusion.  

● Blood Clots

These blood disorders can give rise to stroke or pulmonary embolism.  

● Arrhythmias

During the operation, a patient’s heart may develop abnormal beating patterns, which will need treatment in the short or long run.  

● Lung Complications

Pre-existing conditions of the lungs and other respiratory failures can lead to difficulty breathing and pneumonia.

● Kidney Failure

This condition is rare among patients, but becomes likely if already dealing with weakened kidney function.  

● Cognitive Dysfunction

Patients can undergo periods of confusion and memory loss, amplified with the extended duration of surgery and anesthesia, also termed “pumphead.”  

● Heart or Brain Attacks

Though extremely rare, patients can suffer from damage to the heart or brain due to blood clots and low oxygen supply to the areas during surgery.

As much as possible, your surgical team will do their best to evaluate your risks before surgery and take a plethora of steps to minimize any possible complications.

How Does the Recovery Process of Open-Heart Surgery Work?

Open heart surgery recovery includes inpatient care following heart surgery and 5-7 days of in-house monitoring. In addition to age and general health condition, the specific type of surgery performed also determines the duration of full recovery, which can span several weeks to months.

Here’s what the open-heart surgery recovery process usually looks like:

• Post-surgery, full recovery includes timelines and an ICU recovery period of 1-2 days and an inpatient ward rehab room stay for 3 days (coupled with ICU monitoring)

• Patients are checked thoroughly within the ICU to monitor whether recovery allows moving to the general rehabilitation ward. Further observation is also conducted in the rehab department.

• Fluid and pus-filled lungs can be avoided by cough-inducing exercises and performing stretching movements with a spirometer.

• A period of 6-12 weeks of full rest is usually required. This is the standard duration that experts expect patients to limit strenuous activities.

What are the Lifestyle Changes Needed after Open-Heart Surgery?

Recovery from open heart surgery is a gradual process that goes beyond body recovery. It's also a phase in which one regains strength and creates long-term habits that protect the heart. Here are a few lifestyle modifications that need to be maintained:

● Hospital and Home Recovery

You will be hospitalized for a few days under close supervision before recovery at home for 6 to 12 weeks with usual symptoms ranging from weakness, moderate pain, and swelling in the vicinity of the open heart surgery scar.

● Scar Care

Keep the wound area clean and dry to avoid infection. Avoid sun exposure from the scar to prevent discoloration and speed up recovery.

● Gradual Physical Activity

You begin with light walking and move on to supervised exercises, like those in a cardiac rehab program, to rebuild heart strength step-by-step.

● Heart-Healthy Nutrition

Practice low-fat, low-sodium, high-fruit, vegetable, whole-grain, and lean-protein diet to assist with recovery and avoid additional heart complications.

● Stress Management

Employ relaxation skills such as deep breathing or meditation to reduce stress, which impacts heart health.

● Avoid Smoking

Avoiding smoking is crucial because it hastens recovery and reduces the risk of complications or later cardiac problems.

● Follow Up with a Physician Regularly

Attend your regular cardiologist to monitor recovery and rule out long-term side effects of open heart surgery for easy recovery.

Open heart surgery is a crucial surgery that requires long-term recovery and significant life alteration. You can support your recovery and improve your long-term heart health by taking care of your surgical scar and integrating beneficial habits, such as exercise, proper nutrition intake, and stress management.

However, open-heart surgery can be expensive, so it is essential always to have health insurance to secure your health and finances during critical times.

At Star Health, we offer extensive coverage for heart-related treatments under our Star Cardiac Care Insurance Policy. We provide hassle-free cashless claim settlements across over 14,000 network hospitals in India.