Heart Surgery

Heart surgery can correct problems with the heart if other treatments haven’t worked or can’t be used.

Having to undergo major heart surgery is a huge shock to many. You’ll be experiencing many feelings as you await the day of surgery:

  • guilt about being a burden – ‘If only I’d looked after myself better’
  • grief – disbelief, shock, denial, anger
  • fear of complications during the operation
  • negative self-image (including anxiety about scars)
  • fear of the future
  • fear of dying.

Information about heart surgery can be quite daunting and difficult to understand. Here are some handy tips from a heart patient that could be hepful:

  • Find out exactly what is wrong, write down all your questions, digest what the doctors are telling you, discuss it with family, and put your trust in medical science and the doctors.
  • Choose to have a positive attitude and rid your life of negative thoughts, people and situations.
  • Go gently as you recover. If I wake in the night, I listen to how beautiful the silence is. I love sitting in the garden with a book, or watching the birds, the warmth of the sun, the wind in the trees, flowers.
  • Enjoy the simple things. I eagerly look forward to visits with my family, and especially my grandson. Hugs. Many things motivate and inspire me throughout the day.
  • Cardiac rehab is absolutely essential. Look at making changes in your life: weight, diet, exercise, and your spiritual well-being.
  • It’s not the end of the world to have had a heart procedure it’s a new beginning. Live your life as gloriously as you can.
DIFFERENT TYPES OF PROCEDURES

CORONARY ARTERY BYPASS

The aim of a coronary artery bypass is to restore blood flow to the heart muscle. The surgery does not remove the blockages but provides a ‘detour’ around the blockage – a bypass. 

What is involved?
A blood vessel from the leg, the arm or inside the chest can be used as a bypass graft. The surgeon will decide which to use at the time of the operation.When a suitable graft has been found, one end of it is sewn onto the aorta (the main artery coming out of the heart), or another major artery within the chest.The other end is sewn onto the coronary artery below the blockage. This results in a better blood supply to the heart muscle.The procedure will vary from patient to patient. Your doctor can explain it to you and answer any questions.

Procedure
At the start of the operation the surgeon makes a cut along the middle of your breastbone, in order to reach your heart. This is called a sternotomy.

The bypass operation can then be done in one of two ways:

Heart–lung machine
You are connected to a heart–lung machine, which maintains the blood flow to your body during the procedure. Your body temperature is lowered to protect vital organs such as the brain and kidneys. A special fluid then stops the heart while the coronary artery grafting is done.

The heart is not taken out of the chest for the operation. When the grafts are complete, you are warmed back to normal temperature. The heart starts beating again, and the heart-lung machine is removed.

Off-pump surgery
The other way to do the operation is without using the heart-lung machine. The heart is operated on while it is still beating. This is called ‘off-pump’ or ‘beating-heart’ surgery. The coronary arteries are held still, one at a time, using a stabilising device. The grafting is then performed in exactly the same way as before, except that your body is kept warm.

After surgery
Regardless of which method is used, at the end of the operation the breastbone is closed with stainless steel wires, and you are taken to intensive care. When you arrive there, your skin may feel cool to the touch because some heat is lost during transport. 

HEART VALVE SURGERY

There are four valves in the heart. Two are most often involved in heart surgery, but sometimes a third valve might be involved.

The two most commonly involved valves are on the left side of the heart:

  • the aortic valve – located between the heart and the aorta (the main artery of the body)
  • the mitral valve – located between the chambers of the heart.

Procedure

The procedure for heart valve surgery is very similar to that for coronary artery bypass operations. The heart is stopped before the valve is repaired, or removed and replaced.

TRANSMYOCARDIAL RAVASCULARIZATION (TMR)

Procedure
An incision is made on the left breast to expose the heart. Then, a laser is used to drill a series of holes from the outside of the heart into the heart’s pumping chamber. In some patients TMR is combined with bypass surgery. In those cases an incision through the breastbone is used for the bypass. Usually requires a hospital stay.

Reason for the Procedure

  • Used to relieve severe chest pain (angina) in very ill patients who aren’t candidates for bypass surgery or angioplasty.
CARDIOMYOPLASTY

Procedure
An experimental procedure in which skeletal muscles are taken from a patient’s back or abdomen. Then they’re wrapped around an ailing heart. This added muscle, aided by ongoing stimulation from a device similar to a pacemaker, may boost the heart’s pumping motion.

Reason for the Procedure

  • Increases the pumping motion of the heart.
HEART TRANSPLANT

Procedure
Removes a diseased heart and replaces it with a healthy human heart when a heart is irreversibly damaged. Uses hearts from organ donation.

Reason for the Procedure

  • Recognized as a proven procedure to restore heart health in appropriately selected patients.
COMPLICATIONS WITH SURGERY

Complications may occur with any surgery. With heart surgery, they can include:

  • Arrhythmias – irregular heart beat
  • Bleeding – which may require re-operation
  • Stroke – particularly in the elderly
  • Wound infections – although uncommon, an infection may occur in the sternum, leg or arm wounds.

These complications will be discussed with you further, by your surgeon or registrar before surgery.