Cardiothoracic Surgery
Heart surgery refers to a range of surgical procedures aimed at treating various conditions of the heart, including coronary artery disease, congenital heart defects, heart valve disease, and heart failure.
CORONARY ARTERY BYPASS GRAFT:
Description of Service:
Coronary Bypass Surgery, also known as CABG, aims to restore blood flow to the heart muscle by redirecting blood flow around a blocked artery.
Blockages in the heart arteries are typically caused by the accumulation of fatty deposits, a condition known as atherosclerosis. If left untreated, these deposits increase the risk of coronary artery disease, potentially leading to heart failure or a heart attack.
The primary objective of bypass surgery is to enhance the patient's quality of life and/or extend their life expectancy when previous treatments such as medications and other medical procedures have proven insufficient.
It's important to note that undergoing this surgery does not cure coronary artery disease. Continued attention to modifying risk factors is essential for recovery, including aspects such as weight management, smoking cessation, dietary adjustments, and regular physical activity.
What is this procedure?
Coronary bypass surgery generally takes between three to six hours to complete, depending on individual circumstances.
The number of bypasses required varies based on the location and severity of blockages in the heart arteries.
What happens during this procedure?
Patients receive general anaesthesia, ensuring they remain unconscious and pain-free throughout the surgery.
During the procedure, a breathing tube is inserted through the mouth, connecting to a ventilator that assists breathing during and immediately after surgery. In select cases, surgeons may perform off-pump or beating heart surgery, where the patient's heart continues beating without reliance on a machine. However, this approach is not suitable for everyone due to the challenges posed by the moving heart.
Bypass grafts, typically sourced from blood vessels in the leg, chest, or arm, are utilized to bypass the obstructed part of a coronary artery. The surgeon extracts a segment of healthy blood vessel from the chosen location and attaches it above and below the blocked artery, creating a detour for blood flow around the narrowed section of the diseased artery.
Once grafts are successfully completed, the heart-lung machine, if utilized during the surgery, is deactivated. The patient's heart resumes beating independently, and blood flow returns to normal.
What happens after this procedure?
Patients typically spend one to two days in the Intensive Care Unit following surgery.
Full recovery typically takes six to twelve weeks, with a gradual return to work and exercise possible after around six weeks, guided by the recommendations of the consulting physician.
Optimal results and long-term outcomes are achieved by adhering to prescribed medications and adopting healthy lifestyle habits as advised by the cardiac care team.
HEART VALVE SURGERY:
Description of Service:
Heart valve surgery aims to correct or replace a valve that is either narrowed or fails to close properly. Effective valve function is crucial for directing blood flow correctly through the heart. Surgical options for heart valve procedures include open-heart surgery, minimally invasive techniques, or accessing the heart through veins. Recovery typically spans one to two months, depending on the surgery.
Heart valve surgery repairs or replaces one or more of the four valves in your heart. These valves, positioned between the heart’s chambers, ensure that your blood flows in the correct direction. Normally, blood should flow through your heart smoothly with each heartbeat.
Heart valves open and close as your heart beats, allowing blood to enter and exit the chambers. When a valve malfunctions, some blood may leak back into the chamber it just left, or the valve may become narrow, hindering blood flow. This inefficiency can strain your heart’s function.
Your heart has 4 valves:
- Tricuspid: Allows oxygen-poor blood to flow from the right upper chamber (atrium) to the right lower chamber (ventricle)
- Pulmonary: Permits oxygen -poor blood to travel from the right lower chamber (ventricle) to the pulmonary artery, which carries blood to the lungs for oxygenation
- Mitral: Facilitates the passage of oxygen-rich blood from the left upper chamber (atrium) to the left lower chamber (ventricle)
- Aortic: Enables oxygen-rich blood to move from the left lower chamber (ventricle) to the aorta, which distributes blood throughout your body
There are 2 main types of heart surgery options:
- Valve repair surgery: The surgery aims to fix the damaged or faulty valve while preserving as much of the person’s own tissue as possible. The mitral valve is the most commonly repaired valve, but repair surgery can also address issues with the aortic and tricuspid valves
- Valve replacement surgery: In this surgery, the faulty valve is removed and replaced with either a biological (made from pig, cow, or human tissue) or a mechanical valve (made of metal or carbon). It’s important to note that all valve replacements are biocompatible, meaning your immune system will not reject a new valve.
What is this procedure?
For most patients, the procedure involves open-heart surgery to remove the damaged valve. However, some may be eligible for a less invasive approach. This involves making a small incision in the breastbone or under the right pectoral muscle to reach the heart valve. This method can potentially reduce pain, scarring, and recovery time.
What happens during the procedure?
Before the procedure begins, you will receive general anaesthesia. The time it takes to complete the surgery depends on how affected your valve is by disease.
Once a surgeon can access your valve, you’ll be connected to a heart-lung bypass machine. This machine temporarily takes over the work of your heart and lungs while the surgery is underway.
After the damaged valve is removed, it will be replaced with an artificial valve, which is securely stitched into place. Any incisions made during the procedure will be carefully closed with stitches or staples.
Once the procedure is finished, your heart will resume beating on its own, and you’ll be disconnected from the bypass machine.
What happens after the procedure?
Following the surgery, you will spend some time in the Critical Care Unit (CCU) for close monitoring, usually for 1 – 2 nights.
You will typically need to take medication for an extended period to prevent blood clots.
While you will be discharged home after 5 – 6 days, the recovery process usually takes between 8 – 12 weeks.
