Saturday, December 3, 2022

Open Heart Surgery: Basic Things One Should Know

 During a heart transplant surgery, a deteriorating heart is replaced with a healthier donor heart to save the sick patient's life. Most frequently, patients who require a heart transplant are those whose cardiac diseases have not improved enough with medicine or other treatments. 


Everyone feels a little nervous whenever surgery is suggested, mainly when it concerns the heart. A renowned cardiac surgeon with a significant understanding of heart transplants, open heart surgery, and treatments for treating heart failure, Dr. Sujay Shad has offered vital information about Open Heart Surgery in Delhi in this blog.



When is Open Heart Surgery Required?


A CABG (coronary artery bypass graft) procedure may involve open-heart surgery. Individuals with coronary heart problems may require a bypass artery graft. Coronary heart disease develops when the arteries that provide oxygen and blood to the heart muscle narrow and harden. When fatty tissue forms plaques on the coronary artery walls, hardening occurs. Blood flow is hampered by the narrowing arteries caused by this plaque. A heart attack could happen if the heart's blood supply is impacted.


Other reasons may include the following:


  • The replacement or repair of heart valves, which allow blood to flow through the heart

  • The repair or replacement of damaged or abnormal heart tissue

  • The implantation of medical devices to assist the heartbeat normally

  • The replacement of a dysfunctional heart with a donor heart (heart transplantation)



What are the Risks Involved?


  • Refusal of the Implanted Heart: One of the most alarming risks after a heart transplant is the body rejecting the donor's heart. If the immune system considers the donor heart a foreign object, this could lead to rejection, which could harm the organ. Every patient receiving a heart transplant receives immunosuppressants.

  • Problems With the Arteries: The arterial valves in the heart could possibly thicken and harden after the transplant. Due to this, the heart may struggle to pump blood, which could cause a heart attack, cardiac arrest, myocardial infarctions, or early cardiac death.

  • Primary Graft Failure: The most frequent cause of death in the first few months after transplant is primary graft failure, in which the donated heart is not functioning. 


Note: Immunosuppressants must be taken by the person for the rest of their life; among other factors, they can significantly damage the kidneys. Immunosuppressive drugs make it more difficult for a person to fight infections—in the first year following the operation. Thus, it is advised to follow the doctor’s advice. 



What Happens Before the Surgery?


  • Inform the doctor about all medications one is taking, including over-the-counter pharmaceuticals, vitamins, and herbal remedies. Let them know if one has a herpes outbreak, the flu, a cold, or a fever. The doctor might advise quitting smoking and stopping blood-thinning drugs, such as two weeks before the procedure.

  • One can experience alcohol withdrawal if one regularly consumes three or even more drinks each day and stops soon before the procedure. Following open-heart surgery could result in potentially fatal consequences like seizures or tremors. To lower the chance of these issues, the doctor can assist patients with alcohol withdrawal. 



How is the Procedure Carried Out?


A CABG takes three to six hours:


  • Anaesthesia is administered to the patient. That guarantees that the patient will be sleeping off and will remain pain-free throughout the entire procedure.

  • An 8 to 10 inch cut is made in the chest by the surgeon.

  • The surgeon makes a full or partial cut through the breastbone to access the patient's heart. 

  • The patient might be attached to a heart-lung bypass device after the heart is visible. The machine pumps blood out from the heart for the surgeon to perform surgery. Some more recent techniques use something other than this device.

  • The surgeon creates a new passage around the obstructed artery using a functional vein or artery. The wire is left within the body after the surgeon uses it to seal the breastbone. The first cut has been repaired.

  • After surgery, the breastbone is repaired with small plates and screws known as sternal plating.  Sternal plates may normally be necessary for individuals who are at high risk, including those who have undergone several surgeries or are elderly. 



What Happens After the Procedure?


In order to determine whether the system is rejecting the new heart, periodic cardiac biopsies are performed in the first few months after transplantation, when rejection is particularly likely to happen. Over time, less frequent biopsies become necessary. Any signs of resistance, including gaining weight, feeling out of breath, a fever, weariness, and decreased urination, will be examined in terms of one's health.



Book an appointment with Dr. Sujay Shad, best bypass surgeon in Delhi, at Sir Ganga Ram Hospital straight away to learn more about heart problems and life-saving heart transplant surgery.

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