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.

Heart Transplant Surgery: Cause, Procedure and Risks

A Heart Transplant Surgery is performed when a malfunctioning heart is replaced with a healthier donor heart. People who need a heart transplant are typically those whose condition hasn't progressed adequately with medication or other procedures. Although a heart transplant is a major surgery, patient survival is excellent if ongoing medication and follow-up can be assured.  

Everyone is a little apprehensive about surgery whenever it is mentioned, especially when it involves the heart. The top heart surgeon in Delhi, Dr. Sujay Shad, has extensive knowledge about heart surgery, equipment, and procedures concerned with heart transplant. 

Why is it done?

When other methods of treating cardiac issues have failed and heart failure has a high risk, heart transplants are done. Congenital heart defects or cardiomyopathy are the two main causes of heart failure in children. In adults it is done because:

• Cardiomorphy or deterioration of the heart's muscle

• Cardiovascular disease

• Congenital heart defect or heart valve dysfunction, an inherited heart condition

• Ventricular arrhythmias that are dangerously recurrent and are not under control with conventional therapies

• Heart transplant surgery that was done earlier but has failed now.

Ideal Candidate for Heart Transplant:

 

• Is too old to heal from transplant surgery because of their senior age.

• Have a major kidney, liver, or lung illness or other medical issue that could reduce the life even if you receive a donor heart.

• Have an existing infection

• Have recently been diagnosed with cancer personally

• Is unable or unwilling to make the lifestyle modifications required to maintain the health of the donor heart, such as quitting smoking, abstaining from drugs of abuse, and consuming less alcohol.

Risks Involved:

• Donor Heart Rejection: The body refusing the donor heart is one of the most concerning dangers following a heart transplant. The immune system can attempt to refuse the donor heart if it perceives it as a foreign object, which could harm the organ. Immunosuppressants are administered to every heart transplant patient to minimize organ rejection. Rejection frequently happens without warning. 

• Primary graft failure: The donor heart is not functional in this condition, which is the most common reason for death in the initial months following transplant.

• Atrial problems: It's possible that following the transplant, the artery walls in one's heart could thicken and stiffen, developing cardiac allograft vasculopathy. As a result, the heart may have trouble pumping blood through it, which may result in a heart attack, arrhythmias,  heart failure or sudden death.

• Side effects of medicines: One needs to take immunosuppressants for the rest of their life, and they can significantly damage kidneys, among other things.

• Cancer: Risk can also be increased by immunosuppressants. These drugs can increase the risk of developing several cancers, including non-lymphoma.

• Infection: In the initial year following a heart transplant, a lot of recipients experience infections that necessitate hospital admission.

Availability of Donor Heart:

One will be added to a waiting list by the transplant facility if the medical staff determines that one is an ideal candidate for a heart transplant. The chances of locating a donor depends on one's size, blood type, and degree of illness. The doctors may advise having a ventricular assist device (VAD) placed to maintain one's heart while they wait for a donor organ if medical treatment is unable to support the sensitive organs. 

Procedure:

• Open-heart surgery for heart transplants lasts for several hours. If one had past cardiac operations, the procedure will be more difficult and take longer. General anesthetic is given before the surgery. To maintain oxygen-rich blood moving throughout the body, the surgeons will attach patients to a heart-lung bypass machine.

• The chest will be cut open by the surgeon. To perform a cardiac operation, the surgeon will split your chest bone and crack apart your rib cage.

• The damaged heart is subsequently removed by your surgeon, who then stitches the donor heart into position. The important blood vessels are then reconnected to the donated heart by the surgeon. 

After the Surgery:

• After the procedure, patients will be given medicine to assist in managing the pain. Additionally, one will have tubes in the chest to drain fluid from the area around the heart and lungs as well as a ventilator to assist with breathing. 

• During the first three months, a lot of people remain near the transplant center because of the frequency and severity of the monitoring. Once treatment is complete, follow-up appointments become less regular, and travel is simpler. Throughout the first year following the transplant, patients will undergo many cardiac biopsies to assess whether the body is refusing the new heart. 

• Additionally, one's health will be checked for any indications of refusal, such as shortness of breath, weight gain, exhaustion, fever and decreased urination.

Result:

The majority of heart transplant recipients have a decent quality of life. One  might be able to resume a lot of their regular activities, including employment, interests and sports, and exercise, depending on overall health. 

If one is feeling any discomfort that can lead to heart problems or heart failure, one must book an appointment at Sir Ganga Ram Hospital to know more about heart transplant surgery in Delhi, and to get examined and treated by Dr. Sujay Shad. Over the years, countless local patients have placed great trust in the doctor. Consult now for more information!