Open heart surgery

Treatment for open heart surgery

Doctors perform open heart bypass surgery to restore normal blood flow to the heart muscle. This reduces the risk of a heart attack. Your doctor may recommend surgery if angioplasty and stenting aren’t the right choices for you.

The best treatment option may depend upon the:

• Number of blockages
• Severity of blockages
• Location of blockages in your coronary arteries
• Severity of your symptoms
• Success of previous angioplasty and stenting procedures

Heart bypass surgery is also an emergency treatment for a heart attack.

Types

There are two kinds of open heart bypass surgery:

• On-pump surgery uses a heart-lung machine to divert blood from the heart. Your surgeon operates on a still heart clear of blood.
• Off-pump surgery does not use a heart-lung machine. The heart will continue to beat throughout the procedure. This approach is slightly more complicated, but because the blood keeps moving through the muscle the entire time, off-pump heart bypass surgery lowers the chances of stroke in some patients who are at higher risk.

In addition, the grafts used in open heart surgery come in several forms.

Grafts can come from veins or arteries. You and your doctor will determine which kind will work best for you based on the following criteria:

• Location of your blockage
• Your age
• The extent of your blockage
• The size of your coronary arteries
• The availability of veins and arteries
• Any other medical complications you have

Vein grafts generally come from the saphenous veins in your legs. The surgery to retrieve them is minimally invasive, and recovery time is short. In the long term, however, vein grafts tend to fail.

Arterial grafts come from either the internal thoracic arteries (ITA) or the radial artery in your arm. ITA grafts are the most common type of graft used and have the best long-term results. These arteries are located in your chest and can usually be kept intact in their original position.

Radial arteries are taken from the arm, and the long-term success rates are not clear. The radial artery does not deliver blood to the arm (the ulnar does), so generally, there are no side effects for using this graft. This graft has good results but does require you to take calcium channel blockers to keep the artery open several months after surgery.

Other grafts may be used, though they are far less common. You and your doctor will decide together which graft will work best for you.

Preparation

Your doctor will give you instructions for pre-surgery preparation. In general:

• Stop taking aspirin or other blood thinners, as directed
• Check with your insurance company about your coverage
• Don’t eat for about eight hours before your surgery
• Make arrangements for help during your recovery

Recovery

Open heart bypass surgery can take up to six hours. You’ll spend several days in the hospital. Most people return to work within six weeks. Ask your doctor about returning to exercise and other activities.

As with any surgery, there are certain risks to be aware of beforehand. Complications are unusual but can include bleeding, infection, or blood clots.

Your doctor will let you know whether you’re a good candidate for this type of procedure based on your age, health history, and the severity of your arterial blockage. In many cases, the benefits of open heart surgery outweigh the risks. Talk with your doctor to learn which risks are relevant to your particular situation.

Cardiac rehabilitation will help you recover and return to your usual activities. Full recovery can take up to 12 weeks.

Open heart bypass surgery may not prevent future problems with your coronary arteries. However, lifestyle changes can reduce your risk:

• Be physically active
• Eat a heart-healthy diet
• Maintain a healthy weight
• Control high blood pressure, cholesterol, and diabetes
• Reduce stress
• Quit smoking

Results

There are actions that you can take to keep your heart healthy and avoid arterial disease or prevent another surgery:

• Avoid smoking
• Exercise
• Manage stress levels
• Maintain a healthy weight
• Eat a healthy diet

Additionally, taking prescribed medications to lower blood pressure and cholesterol, control diabetes, and prevent blood clots will keep your heart healthy in the long term and lead to a positive outcome post-surgery.

At Dignity Health, we routinely perform open heart bypass surgery, with compassion. Find a Doctor to learn more or connect with one of our expert cardiology specialists.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.