World Heart Day: What to Expect from a Cardiac Surgery?
While the mortality rate due to cardiovascular diseases (CVDs) declined in the last 15 years by 41 percent in the United States, it rose by 34 percent in India, according to a recent study published in the Journal of the American College of Cardiology.
This trend is attributable to the increasing incidence of hypertension, diabetes, deranged blood lipids, smoking, physical inactivity and obesity, all of which are contributing factors towards heart disease.
Heart disease can be controlled to a significant extent by correcting adverse lifestyles and making simple changes in what you eat, how often you exercise, how much you weigh and how you best manage stress.
However, once the disease develops, suitable treatment customised to the needs of the patient is required.
Heart surgery is often required for certain patients with coronary heart disease. It is also needed to treat many patients with congenital heart disease, valvular heart disease (disease involving one or more of the heart), heart failure and to implant devices to regulate heartbeat.
What Happens In Cardiac Surgery?
Cardiac surgery is a procedure in which the patient’s chest is cut open and surgery is performed on the muscles, valves, or arteries of the heart. The heart is connected to a heart-lung bypass machine or bypass pump. The machine takes over the functioning of heart and lungs.
A healthy artery or vein is then used to make a new path around the blocked artery. The incision site is thereafter stitched.
The newer modification for coronary artery surgery is called Off Pump Bypass surgery, which does not require the heart to be stopped and Heart Lung Bypass machine is not needed.
This avoids many potential complications and is offered in certain centres with surgeons who are experienced in this technique.
Coronary Artery Bypass Graft (CABG) is the most common open-heart surgery. It is prescribed for removing blockages in the coronary arteries.
Is the Surgery Risky?
While CABG is known to be a safe procedure, certain risks associated with the surgery include infection, organ damage, stroke, kidney failure and pneumonia. Patients with advanced heart disease face a higher risk of complications during and after surgery. But in experienced hands, the incidence of complications is very low.
Preparing for the Surgery
A person undergoing open heart surgery has a hospital stay of about a week to 10 days.
Prior to the surgery, a detailed physical examination is done and various tests are done to look for any co-morbid conditions including kidney, liver and brain functions. Diabetes, high blood pressure or any other associated disease is controlled before performing surgery. These steps are taken to ensure an uncomplicated surgery and a smooth post-operative course.
Open heart surgery requires close monitoring and immediate post-operative support. The patient is kept in the intensive care unit (ICU) for a couple of days under continuous monitoring till the cardiovascular and respiratory functions normalise. Once the condition stabilises, the patient is shifted to a regular room.
Post discharge, the surgical wound should be well cared for and one must immediately consult their doctor if they notice any signs of infection around the wound, characterized by redness or discharge. The incision site must be kept dry.
Recovery post-surgery is gradual, and one must be patient. It may take a few months to get back to normal life. Minor physical exertion and routine chores may lead to fatigue and pain over the surgical sites.
Apart from muscles, one may also experience pain in the throat. Mild pain medication is prescribed for such conditions. Physiotherapy aids post-surgical recovery. Regular blood tests, heart scans and stress tests are recommended to monitor the short and long-term health status.
To aid smooth recovery from open heart surgery, following are recommended:
- Balanced, healthy diet
- Limited consumption of foods high on salt, fat and sugar
- Regular exercise
- Smoking cessation
- Limited alcohol consumption
- Blood pressure and cholesterol control
Observing these precautions ensures a smooth recovery and a gradual return to an active and productive life.
(Dr Naresh Trehan is Chairman and Managing Director at Medanta, Heart Institute.)