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Open Heart Surgery

Open Heart Surgery in Anderson, SC


Earlier medical interventions and pharmaceutical advances mean fewer open heart surgeries are performed nationwide each year. AnMed Health performs about 250 open heart surgeries a year and our outcomes are ranked among the top 10 percent in the nation according to the CMS/Premier Hospital Quality Incentive Demonstration Project



What is Open Heart Surgery? 


During open heart surgery, a surgeon cuts open the chest in order to operate on the heart’s muscles, valves, or arteries. Open heart surgery patients are connected to a bypass pump (heart-lung bypass device) during this surgery. When the surgeon must stop the heart to perform a procedure, the bypass pump steps in to function as the patient's lungs and heart. Heart-lung bypass machines maintain sufficient oxygen levels in the bloodstream, keep blood circulating through the body, and eliminate carbon dioxide from the bloodstream.


Heart bypass machines have two basic functions: to oxygenate blood flowing through veins and then pump this blood back into the arteries during coronary artery bypass surgery. While under general anesthesia, open heart surgery patients will have blood entering their heart diverted to the bypass machine before blood flow is returned to arterial circulation.


Some types of heart surgery may not require continual use of a heart-lung bypass machine. Off pump heart surgery doesn’t require the patient to be connected to a heart-lung machine. Instead of stopping the heart, surgeons utilize medical equipment that stabilizes parts of the heart without stopping the heart. Off pump bypass surgery allows surgeons to bypass blocked arteries and repair damage, while the heart continues pumping blood throughout the body.


Cardiothoracic Surgeons in Anderson


Cardiothoracic surgeons specialize in operating on the lungs and heart, as well as the tissues and bones comprising the chest cavity. Common surgical procedures performed by a cardiothoracic surgeon include the repair of heart valve blockages, leaking heart valves, atrial fibrillation, coronary heart disease, and most lung diseases.


Alternately, a cardiologist is someone who diagnoses and treats heart problems non-surgically. Cardiologists perform minimally invasive procedures such as balloon angioplasties, ablation and insertion of stents or pacemakers. If you need open heart surgery in Anderson, you will have a board-certified cardiothoracic surgeon performing the surgery.

 

Open Heart Surgery at AnMed Health

Two of the most commonly performed open heart surgeries performed at AnMed Health are heart valve surgery and coronary artery bypass surgery. 


Heart valve surgery repairs a damaged heart valve. The heart contains four valves, which let blood flow in and out of the heart. If damaged, valves do not open and close as they should. As a result, blood is sometimes blocked or allowed to leak backward. When this happens, the heart has to work harder to pump blood to the body. 


Coronary artery bypass surgery is performed when one or more arteries around the heart become blocked. To correct the problem, the surgeon takes part of a blood vessel from the patient's leg or chest and attaches it to the coronary artery above and below the blockage. By "bypassing" the blockage in the artery, the surgeon is able to restore the flow of blood to the heart.


When is Open Heart Surgery Needed? 


Blocked Coronary Artery

The National Heart, Lung, and Blood Institute reports that coronary artery bypass grafting (CABG) is the most commonly performed open heart surgery in the United States. Individuals need CABG procedures when they have a blocked artery and require grafting of a healthy artery to the blocked artery. The grafted heart artery bypasses the blocked artery so that heart can receive sufficient amounts of oxygenated blood.

Atherosclerosis with Multiple Blocked Arteries

People who have had a heart attack or suffer from angina typically need open heart surgery involving several bypass procedures. When arteries harden and narrow enough to inhibit blood flow, the lack of blood flow can cause strokes, peripheral vascular disease, and heart attacks. Atherosclerosis often presents no symptoms as the disease progresses. The first symptom of atherosclerosis is usually a heart attack or severe chest pain resembling a heart attack.

Valvular Heart Disease

The blockage of mitral or aortic valves is called valvular disease. Open heart valve surgery is done to repair or replace these damaged heart valves. Causes of valvular heart disease include endocarditis (infection of the heart's inner lining), rheumatic disease, and sustained high blood pressure that resists treatment.

Does Having a Heart Attack Mean You Will Need Open Heart Surgery?

Heart attacks occur mainly because arteries have been narrowed by plaque buildup (atherosclerosis). Arterial plaque consists of cholesterol, fat, calcium, and cellular waste. As plaque accumulates, artery wall cells begin secreting chemicals that worsen the narrowing and the hardening of the arteries. In addition, plaque may cause a rupture of a heart artery, which can result in a blood clot. The combination of atherosclerosis and blood clots leads to a complete blockage of blood flow to and from the heart. When this happens, a heart attack essentially "stops" the heart from beating. Some heart attacks are mild and may not need surgery to repair damage. The amount of heart muscle damage done during a heart attack depends on how long an artery is blocked.

An Anderson open heart surgeon will discuss surgical or nonsurgical options with you following a heart attack. Mild heart attacks are clinically called "non-ST elevation myocardial infarctions." This indicates an artery was partially – rather than completely – blocked, and it can still pump normally. In some cases, you may need a stent to further open the artery.

 

Open Heart Surgery Risks 


Heart bypass surgery, like all other major surgeries, comes with certain risks, especially if the patient already has a chronic health problem like diabetes, hypertension, or kidney disease. Complications associated with open heart surgery include:


  • Infection of surgical incision

  • Blood clots

  • Excessive loss of blood during surgery that may require a transfusion

  • Breathing problems after surgery

  • Arrhythmia (irregular heart rate) while recovering

  • Kidney or lung failure (rare)

  • Cognitive issues affecting short-term memory and concentration


If you are scheduled for open heart surgery, Anderson medical personnel and your surgeon will discuss the benefits and risks associated with the surgery with you before you consent to the surgery. When previously undiagnosed chronic health issues are discovered during a patient's preoperative examination, your surgeon may delay the operation until the health issue is addressed and properly managed by your primary care physician.


What are Risks Associated with General Anesthesia?


General anesthesia is considered "very safe" by the Mayo Clinic. However, if you are older or have a serious medical issue, you may be at risk for experiencing more postoperative disorientation or pneumonia while recovering. Make sure to inform your Anderson open heart surgeon about any prior problems you have had with general anesthesia. 

It is normal to have the following side effects after awakening from general anesthesia:

  • Nausea/vomiting

  • Muscle aches

  • Dry mouth

  • Hoarse voice

  • Shivering

  • General body itchiness

These side effects of general anesthesia should diminish within 12 to 24 hours after your surgery.

Success Rates of Open Heart Surgery 


The majority of open heart surgery patients enjoy a good prognosis following recovery, and they often live a decade or more without experiencing symptoms of heart disease. However, success rates of open heart surgery depend largely on how well the patient adopts and maintains lifestyle changes meant to improve their health after surgery. These may include getting enough exercise, eating lean meat and fresh vegetables, and not smoking.


One study found that survival rates for most open heart surgery patients who recover one month following surgery have the same survival rates as the general population. Another cohort study involving over 1,800 coronary artery bypass graft (CABG) patients over age 65 reported their survival rate as "excellent" and also comparable to people in their age group in the general population.

If you would like more information about success rates of open heart surgery, our Anderson health professionals would be happy to answer your questions regarding our medical center's open heart surgery program. 

Preparing for Open Heart Surgery


Once you learn you are going to have open heart surgery, you can start preparing for the procedure by doing the following:


  • If you smoke, try to stop smoking at least two weeks before the day of surgery. Chemicals in cigarette smoke can interfere with postsurgical healing and recovery.

  • Stop taking ibuprofen, aspirin, and other over-the-counter, blood-thinning medications two weeks before surgery. If you take prescription blood thinners, your surgeon may advise you when you should stop taking them.

  • Stop drinking alcohol at least one week before surgery. Alcohol may impair functioning of your immune system and delay blood coagulation.

  • Visit your dentist before having open heart surgery if you haven't recently. Get a dental cleaning and have your dentist check for cavities or signs of gingivitis. Patients who have a history of oral disease may be asked by their surgeon to see a dentist for treatment of possible inflammation or infection.

  • Do not eat or drink the night before surgery. You can take medications with small sips of water if necessary. Having food in your stomach before surgery will make you feel more nauseous upon regaining consciousness.


Be sure to read all of the informational sheets and booklets that your heart surgeon gives you. Knowing exactly what will happen before, during and after on-pump heart surgery will help ease your fears and concerns about the surgery. The Anderson medical staff is always available to assist you as you begin preparing for your surgery.


What to Expect with Open Heart Surgery


Upon Arrival


After being admitted and shown to your room, you can choose to keep personal items like eyeglasses, contact lenses, or hearing aids in your room or have family members hold onto them until after your surgery. Family can stay with you until you are taken to the operating room. Before surgery, you will be fitted with an IV and given a medication to help you relax. Some people experience dryness of the throat and mouth with this medication. Ice chips are provided to ease dryness.


In the Operating Room

A licensed anesthesiologist will administer general anesthesia via your IV. General anesthesia may be administered in gas form in some cases. General anesthesia places you in a deep sleep where you are not aware of anything happening around you. You won't feel any pain and discomfort during your surgery. Occasionally, surgeons may choose to combine general anesthesia with a peripheral nerve block infusion that provides a continuous drip of anesthetic into your IV. Peripheral nerve blocks are helpful for managing pain after surgery.

Waking Up After Open Heart Surgery

Most open heart surgeries take between three to four hours to complete. When your surgeon is done repairing your heart, you will be taken to the intensive care unit where nurses monitor your condition. It may take several hours to awaken from general anesthesia. The time it takes for patients to awaken varies and depends on your age, your current health, and other factors.

When you regain consciousness, expect to be hooked up to a ventilator that helps you take deep breaths necessary for replenishing your blood cells with oxygen. You will also have a stomach tube inserted to reduce nausea and bloating. Patients report stomach tubes are painless but that their noses drip from having the tube extending through their nasal passages. The irritation is minor and disappears after the tube is removed.

You will be catheterized so that nurses can monitor your urine output. Checking urine output is necessary to determine if your kidneys are functioning normally and removing excess fluid from the body. Chest tubes are also inserted immediately after surgery to drain fluid from your chest cavity. Once drainage has stopped, chest tubes will be removed. Your blood pressure is constantly checked using an arterial line inserted into an artery in either of your arms. Blood samples may be drawn from this line if necessary.

Recovering from Open Heart Surgery

 

The day after your open heart surgery, you can start drinking water and eating, as long as you can tolerate chewing and keeping down solid foods. Some patients will be able to sit up, while others will need another day of lying in bed to regain strength. Also on the first day, you may be shown coughing and breathing exercises that will help you reduce the risk of pneumonia or other lung complications. Most patients move out of ICU by the end of the first day to their room. Before you are transferred, you will be given a telemetry monitor to wear that keeps track of your heart rate.


Difficulty falling and staying asleep is a common problem reported by heart surgery patients. This is due to anesthesia effects, general discomfort, abrupt changes to daily routines, and anxiety. After you are discharged from the hospital and can sleep in your bed, you should notice sleeping patterns return to normal within two to three weeks. If you continue having trouble sleeping, talk to your primary care physician.


Remember, you have just undergone major surgery so don't be surprised if the simple act of walking from your bed to the bathroom wears you out. Do a little more each day, but don't overdo it. Prepare to have someone drive you to follow-up appointments until your doctor allows you to drive. The best things you can do to promote a healthy recovery is to get dressed every day, eat small meals instead of three large meals, get exercise by walking every day (within doctor's limits), and maintain contact with family and friends.

 

Life After Open Heart Surgery


Your open heart surgeon in Anderson may recommend that you begin cardiac rehabilitation during your recovery. Cardiac rehab programs involve therapeutic exercises that are tailored to address your specific health needs. You will also collaborate with your rehab therapist about adopting new lifestyle choices conducive to your recovery.


Most on-pump heart surgery or off-pump heart surgery patients resume more vigorous activities three to four months into their recovery, such as jogging, golfing, or even playing a game of tennis. Everyone differs in their recovery timeline. Always follow guidelines set by your heart surgeon and primary care doctor. People with chronic health problems will naturally take longer to fully recover and should not attempt to do more than recommended by their doctor.


The American Heart Association provides online support groups for open heart surgery patients who wish to talk about their experience with other heart patients. The nonprofit organization Mended Hearts also helps open heart surgery patients navigate their recovery with resources to educate and inspire.

 AnMed Health Open Heart Surgeons


AnMed Health performs about 250 open heart surgeries a year and our outcomes are ranked among the top 10 percent in the nation according to the CMS/Premier Hospital Quality Incentive Demonstration Project. Our cardiothoracic surgeons are among the most experienced in the Upstate and are part of our comprehensive heart and vascular care program.