Open Heart Surgery

Some heart surgeries, such as coronary artery bypass surgery and valve repair and replacement that are traditionally performed with a large incision can now be performed at certain medical centers using minimally invasive techniques. Minimally invasive procedures use smaller incisions instead of the larger incision made in open surgery. The surgeon uses special instruments with an attached camera to see the surgical area on a video screen. Minimally invasive surgery, as compared to an open procedure, generally entails a faster recovery time, less pain, and a lower risk of some complications, such as infection.

Your doctor will determine which type and method of surgery is best for you and how long you need to stay in the hospital or surgical center based on certain factors. These include your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different open heart surgery procedures and ask why your doctor will use a particular type of procedure for you.

Types of anesthesia that may be used

Your surgeon will perform open heart surgery using either general anesthesia or regional anesthesia.

• General anesthesia is a combination of intravenous (IV) medications and gases that put you in a special type of sleep. During general anesthesia, you are unaware of the procedure and do not feel any pain. In some cases, you may receive a peripheral nerve block infusion in addition to general anesthesia. In a peripheral nerve block infusion, a liquid anesthetic is injected or flows through a tiny tube inserted near your surgical site to control pain during and/or after surgery.
• A nerve block, also known as regional anesthesia, epidural or spinal anesthesia, may be used in some cases. For regional anesthesia, your anesthesiologist will inject an anesthetic medication around certain nerves in the spine to numb the surgical area. During regional anesthesia, you will be awake during the procedure.

What to expect the day of your open heart surgery

Your surgeon may admit you to the hospital the day before your open heart surgery. For your surgery you can generally expect to:

• Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will respect your privacy and give you blankets for modesty and warmth in the surgical suite.
• Talk with members of your surgical care team, including your surgeon, cardiologist and nurse. This is a good time to ask any questions that you may have forgotten during your pre-operative office appointments. You will also talk with your anesthesiologist about your medical history and the type of anesthesia you will have.
• A care team member will start an IV.
• The day of your surgery, you will receive medication to help you rest comfortably about an hour before your surgery begins.
• A surgical team member will insert a urinary catheter. This will occur after you have had anesthesia.
• The anesthesiologist will start your anesthesia.
• The care team will monitor your vital signs throughout the procedure and during your recovery until you are alert, breathing effectively, and all vital signs are stabilized.

What are the risks and potential complications of open heart surgery? 

Any surgical procedure involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during the procedure or throughout yourrecovery. 

General risks of surgery

The general risks of surgical procedures include:

• Adverse reaction or problems related to anesthesia, such as an allergic reaction and problems with breathing
• Bleeding or heavy bleeding (hemorrhage), which can lead to shock
• Blood clots, in particular a deep vein thrombosis that develops in the leg or pelvis and which can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke
• Infection and septicemia, which is the spread of a local infection to the blood