Open Heart Surgery

Open heart surgery is one of the procedures used by cardiothoracic surgeons to repair some disorders that may affect the valves, arteries or myocardium. Recently, the open-heart surgery has been replaced by catheterization surgeries; the surgeon makes small incisions in the chest rather than a large incision that penetrates the bones and muscles.

Coronary artery bypass surgery is one of the most common procedures that performed by open heart surgery, and the recovery period following an open heart surgery is often longer than the patient spends after catheterization surgeries.

Treatment in Jordan takes approximately "12 days".

A cardiothoracic surgeon can decide to perform an open heart surgery because of one of the following:

• Coronary arteries bypass as a result of blockage within arteries which obstruct blood flow supplying the heart muscle.
• Repair some damaged or abnormal areas of the heart, such as birth defects in the heart.
• Repair or replace heart valves.
• Heart transplantation.
• Implantation of a pacemaker.

After an open heart surgery is scheduled, the patient undergoes a series of tests to check whether he ready for the surgery. These tests include:

• Clinical examination of the patient.
• X-ray examination of the chest area.
• Echocardiogram.
• Examination of carotid arteries using ultrasound.
• Electrocardiogram (EKG).
• Blood tests to check liver and kidney function.
• Dental examination to check for any bacterial infections; that oral bacteria are one of the leading causes of artificial valve inflammation in the heart.

The patient may experience complications and risks as a result of an open heart surgery, including:

• Irregular heartbeat.
• Heart problems.
• Infection.
• Bleeding.
• Blood clots.
• Heart attack.
• Chest pain accompanied by a mild fever.
• Breathing difficulties.
• Stroke.
• Memory loss.
• Liver or lung failure.
• Nervous problems.

This surgery consists of three main stages:

• Preparing the patient: 

Once the open heart surgery is approved, the patient is prepared by the assistant medical team, but before that, he must go to the hospital to confirm the date of admission and complete the procedures, the doctor sits with the patient before starting the preparation and discusses with him all the reasons for surgery and the patient is informed of all the risks clearly and explicitly, the patient agrees to the surgery and the risks involved by signing the consent form.

The cardiac surgeon asks the patient to stop taking certain medications about two weeks before the surgery, such as blood thinners (ibuprofen, etc.), to refrain from smoking, to stop taking any herbs or vitamins. It is important to inform the surgeon of any allergies the patient has to certain substances or medications. The patient begins to abstain from food and drink from midnight before the surgery.

• During the surgery:

1. The patient receives anesthesia (general anesthetic).
2. Making an incision in the chest (the middle of the breastbone) about 6 to 8 inches.
3. The patient is connected to the heart-lung machine, so that the medical team can stop the heart, where this machine works instead of the heart by continuing to pump blood to the body and remove carbon dioxide and add oxygen.
4. Repair the defect, whether in the heart muscle, arteries or valves.
5. Restore the heart to work again, and close the incision and cover it.

The open heart operation takes approximately 3 to 6 hours, depending on the purpose of the surgery and the patient's condition.

• After the surgery:

The patient is moved to the intensive care unit once the surgery is completed and remains until he regain his health by closely monitoring his vital functions. The patient remains connected with a set of tubes in the chest to drain fluids and accumulated blood around the heart throughout the hospital stay.

The patient spends about 7 days in the hospital before returning home, where he begins the recovery period to recover from the open heart surgery and return to normal activities, the recovery period may take about 4 to 6 weeks depending on the patient's body response to treatments, the patient during this period feels some fatigue and pain which is normal, so the surgeon may prescribe some painkillers.

However, it is important to follow some tips during the period following the open heart surgery to promote the chances of recovery, the most important of which is full attention and carefully monitor of the wound to avoid any inflammations that may occur and keep it dry and warm and avoid touching it beforehand sterilization. It is also advised to rest during this period and try to take plenty of sleep and avoid stimuli that may cause insomnia such as those containing caffeine.