Open heart surgery is a scary but often necessary procedure, and being as prepared as possible before the surgery occurs can help alleviate some of the anxiety associated with such a major procedure.
According to WebMD, the number of open heart surgeries performed since 2008 has actually decreased as many less invasive procedures have arisen that offer less trauma for the patient than actually cutting open his or her chest.
But if it's necessary to perform a coronary artery bypass graft, commonly referred to as a bypass, or one of several other procedures, the doctor may schedule open heart surgery.
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Here are nine things you should know about open heart surgery:
1. The most frequently performed open heart surgery is the coronary artery bypass graft, the CABG (referred to as the "cabbage"), which is a procedure to open blocked arteries in the heart. According to the National Institutes of Health, one study found about 80 percent of patients who had CABG were angina-free five years after surgery. Angina is chest pain related to the heart.
2. While many hospitals don't share data on open heart surgeries, others do and organizations like
Consumer Reports carry ratings on the procedures. See if your hospital and/or surgeon is listed there or with the Society of Thoracic Surgeons to learn about the number of procedures performed and any outcome statistics. It may make a difference in your choice of provider.
3. To perform the surgery, a surgeon will make an incision in your breastbone, typically 2 to 5 inches long, separating the muscles to provide access to your heart.
4. You will be hooked up to a heart-lung machine during a bypass procedure. This machine continues to push blood through your body so that your doctor can stop your heart from beating to perform the surgery.
"Once the bypass(es) are complete, your surgeon will close your breastbone with special sternal wires and your incision with special internal and/or external stitches,"
according to Norton Heart Care. "The surgeon will use electrical shocks to restart your heart, and you will be removed from the heart-lung bypass machine."
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5. When you wake up from surgery, you will have several tubes remaining in your body, possibly including one down your throat. The Norton Heart Care says typically, those may include pacing wires and a chest tube to drain fluid, as well as a temporary pacemaker.
6. Ask your doctor how he or she plans to do the graft and where the vein will be taken from. Historically, grafts were repaired with the saphenous vein, taken from the patient's leg. But over time, surgeons determined they could use the vein from the internal chest wall, called the internal thoracic artery or the internal mammary artery, more effectively,
according to The Society of Thoracic Surgeons.
The selection of a vein for the graft will make a difference in your recovery — if the leg vein is not used, that's one less surgical site to consider. You'll typically have swelling in the leg if the vein is taken from there and may have to wear support hose, according to WebMD.
7. You'll be in the ICU when you waken, or possibly in a special cardiology ICU. You'll be in there one to two days after the surgery and you will stay in the hospital, in a usual situation, three to eight days after the surgery.
8. When you get home, it will usually take 6 to 8 weeks to recover from the surgery, and the doctor and hospital will continue to counsel you on diet, exercise, and it’s often recommended that you enroll in a cardiac rehab program, according to WebMD.
9. Some people report heightened emotions for up to a year after surgery, including a tendency to cry, reports WebMD.
The Cleveland Clinic said it is common for patients to feel depressed after heart surgery, with about 20 percent of CABG patients experiencing major depression.
"In one landmark study, the continued presence of depression after recovery increased the risk of death (mortality) to 17 percent within six months after a heart attack (versus 3 percent mortality in heart attack patients who didn't have depression)," reports The Cleveland Clinic.
Be aware of the possibility and communicate with healthcare providers because early detection can help tremendously. Depression also can significantly slow recovery and healing.
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