What is open heart surgery?

Open heart surgery is any surgery in which the surgeon cuts open the chest to operate on the heart. Open heart surgery can treat a variety of diseases and conditions of the heart. Conditions commonly treated with open heart surgery include heart valve disease, birth defects of the heart, and coronary artery disease. Coronary artery disease is the leading cause of heart attack.

Your heart is made of specialized muscle tissue (myocardium) that pumps blood through your body. Blood moves through the four chambers of the heart in a precise manner controlled by electrical signals. Valves help coordinate the movement of blood through the heart. The coronary arteries are blood vessels that supply your heart muscle with blood.

Open heart surgery is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all your treatment choices before having open heart surgery. 

Types of open heart surgery

The types of open heart surgery procedures include:

  • On-pump surgery uses a heart-lung machine (cardiopulmonary bypass). This machine temporarily takes over the heart’s job of pumping oxygen-rich blood to the organs and tissues. This is the traditional type of open heart surgery. It allows your surgeon to operate on a heart that is not beating and has no blood traveling through it.
  • Beating heart or off-pump surgery does not use a heart-lung machine and your surgeon operates on an actively beating heart. However, your surgeon will slow your heart rate with medication or a device. This type of open heart surgery is limited to a few specific procedures.
  • Robot-assisted surgery allows your surgeon to use a special computer to control robotic arms that perform the surgery. The surgeon sees a three-dimensional view of the surgery on the computer. This type of surgery is very precise. However, it also is limited to a few specific procedures.

Why is open heart surgery performed? 

Your doctor may recommend open heart surgery to treat a variety of diseases and conditions of the heart. Your doctor may only consider open heart surgery for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on open heart surgery.

Your doctor may recommend open heart surgery for: 

  • Congenital defect repair, which is done to correct a variety of heart problems that are present at birth
  • Coronary artery bypass graft (CABG), commonly called heart bypass surgery. CABG provides a new route around diseased coronary arteries with healthy vessels taken from other places in your body. This is the most common heart surgery in adults.
  • Heart transplant to remove a severely damaged heart and replace it with a donor heart
  • Heart valve repair or replacement when a heart valve does not function properly. Heart valves control the flow of blood into and out of the heart.
  • Implantation of medical devices to help control your heartbeat or support proper heart function
  • Transmyocardial laser revascularization when coronary artery bypass is not an option. The surgeon uses lasers to make channels directly in the heart muscle to supply it with blood.
  • Maze procedure, which is the creation of scar tissue to block irregular electrical signals through the heart. The Maze procedure is used to treat atrial fibrillation or an irregular heartbeat that is not amenable to medications or less invasive methods. It is often performed with another procedure, such as CABG or valve repair.  

Who performs open heart surgery?

The following specialists perform open heart surgery:

  • Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. Cardiac surgeons may also be known as cardiothoracic surgeons.
  • Congenital cardiac surgeons specialize in the surgical treatment of heart defects present at birth.
  • Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.