Open heart surgery is any type of surgery in which the chest is opened and surgery is performed on the heart muscles, valves or arteries.
According to the National Heart, Lung, and Blood Institute (NHLBI)Trusted Source, coronary artery bypass grafting (CABG) is the most common type of heart surgery performed on adults. During this surgery, a healthy artery or vein is grafted (connected) to a blocked coronary artery. This allows the grafted artery to bypass the blocked artery and bring fresh blood into the heart.
Open heart surgery is sometimes called traditional heart surgery. Today, many new cardiac procedures can be performed with only small incisions, not wide openings. Therefore, the term "open heart surgery" can be misleading.
When is open heart surgery necessary?
Open heart surgery may be performed for CABG. A coronary artery bypass graft may be necessary for people with coronary artery disease.
Coronary heart disease occurs when the blood vessels that supply blood and oxygen to the heart muscle narrow. This is called "atherosclerosis".
Atheroma occurs when fatty matter forms plaque on the walls of coronary arteries. This plaque narrows the arteries, making it difficult for blood to pass through them. When blood does not flow properly to the heart, a heart attack can occur.
Open heart surgery is also done for:
Repair or replace the heart valves that allow blood to pass through the heart
Repair damaged or abnormal areas of the heart
Implantation of medical devices that help the heart beat properly
Replacing a damaged heart with a donor heart (heart transplantation)
How is open heart surgery performed?
According to the authoritative National Institutes of Health, CABG surgery takes anywhere from three to six hours. This is usually done by following these basic steps
The patient is under general anesthesia. This ensures that they will be asleep and pain-free during the entire surgery.
The surgeon makes an 8- to 10-inch cut in the chest.
The surgeon cuts all or part of the breastbone to expose the heart.
Once the heart is visible, the patient can be connected to a heart-lung machine. The machine moves blood away from the heart so the surgeon can operate. Some newer procedures do not use this device.
The surgeon uses a healthy vein or artery to create a new path around the blocked artery.
The surgeon closes the breastbone with wires, leaving the wire inside the body.
The original pieces are stitched.
Sometimes sternum flaps are done in people who are at high risk, such as those who have had multiple surgeries or the elderly. The sternal endothelium is when the breastbone is reattached with small titanium plates after surgery.
