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All You Need to Know About Open Heart Surgery

Open heart surgery is performed when the coronary arteries supplying blood to the heart are blocked and is the gold standard treatment for the same. The condition arising due to blockage of coronary artery is known as coronary artery disease. Open heart surgery is done to regulate the flow of blood through the arteries and prevent damage to the heart. In the procedure, blood vessels from other parts of the body are used to create a bypass. Generally, two to four coronary arteries are grafted for regulating blood flow to the heart.

There are three types of bypass surgeries depending on the number of bypasses done, namely double bypass, triple bypass, and the quadruple bypass.

Open Heart Surgery – Open heart surgery is considered only if the blockage is such that placing the stent is not feasible. Also, if there is severe coronary disease in the left main artery or in multiple arteries and there is high risk of heart damage. To check the exact blockage scenario cardiac surgeons advice on having a complete testing done. An angiogram is used for checking the severity of coronary disease. The other tests done before and after the surgery include electrocardiogram (EKG), blood tests and specific dietary instructions.

Open Heart Surgery

Types of Open Heart Surgeries

  • On Pump Open heart surgery

During the on pump open heart surgery the surgery is performed under general anesthesia while keeping the patient on ventilator support. The primary step in the surgery is harvesting the blood vessels. Generally, the saphenous vein in the leg is used as it is long enough to create multiple grafts. Alternatively, if it cannot be used then vessels from the arm can be used. After the saphenous vein work is done, the chest is opened by making an incision along the breastbone. The surgeon cuts the sternum to gain access to the heart.

In traditional or off-pump CABG procedure, the heart needs to be stopped using potassium so that the surgeon does not have to perform the surgery on a beating heart. The blood circulation is kept on with the help of a heart-lung machine and the ventilator is switched off. The machine then does the work of the heart as well as the lungs. The surgeon either removes the existing blood vessel and replaces the same to remove the blockage or reroutes the blood around the blockage. There could be one or more grafts to be performed. Once the grafting is completed the heart is restarted. The sternum is placed in its original position and closed with the help of a surgical wire. The surgical wire helps in providing strength to the bone for healing. Lastly, the surgeon closes the incision.

On pump, surgery is recommended for unstable patients. The surgeon performs the surgery on a still heart so the process is quicker and even the bleeding is minimal. Alternatively, the cons include inflammation/ clotting after surgery, transfusion and fluid retention. Though after on-pump surgery the risk of stroke does increase.

  • Off Pump Open heart surgery

The off-pump surgery is very much similar to on-pump except that the blood flow through the body is maintained by the heart only and not the heart-lung machine as in on-pump surgery. The area to be grafted is held with the help of surgical instruments while the heart keeps pumping. This surgery is done on tentatively 20% of the CABG patients undergoing the surgery for the first time.

This surgery is less expensive surgery compared to on pump and it also reduces the risk of stroke. Also, blood loss and transfusions are less compared to on pump. The hospital stay required is also less. 70% of the patients are not recommended to do the surgery due to the condition. The surgery is not recommended for unstable patients.

Recovery
The recovery period includes staying in Intensive care unit for 24 hours. The chest tubes are removed post 48 hours and then the patient is shifted out of ICU. Once the patient is awake the breathing tubes are removed so that the patient can breathe on his/ her own. Though supplemental oxygen may be given through the nose to help with breathing. The patient will be monitored closely and if he/she is unable to breathe, the breathing tube might be inserted again. Once the patient starts breathing on his/her own, swift rehabilitation steps are put into place. This includes sitting up on the edge of the bed, walking while taking care of the wound and preventing pain, etc.

Life Expectancy
The life expectancy has greatly increased over the years up to 98% people undergoing the surgery can easily lead a normal life as that of the others who haven’t undergone any surgery.

” Vydehi Institute of Cardiac Sciences is a well equipped super speciality centre located in Vydehi Hospital designed to serve your hearts needs. It is equipped to treat all cardiac, cardiothoracic and vascular cases.  It uses all the latest equipment and technology coupled with the years of experience in its faculty.”

*Sourced from the Internet

Heart Disease and its Few Types – Overview

Heart disease is one condition that has spread its vicious roots not only in the Indian subcontinent but also across the world. Statistics say that one in four in the USA die of heart issues. It is also a leading cause of deaths in UK, Australia and Canada other than India, where it is known to be the top killer as well.

There are different kinds of heart problems that tend to affect different body parts. Here is a run down some of the common types of problems that cause heart disease.

Heart Disease and Types

Myocardial Infarction – Also known as Heart attack, coronary thrombosis or cardiac infarction, this is caused due to a blood clot occurring in the coronary thrombosis. Due to the clot, the heart muscles get damaged. It can also occur if an artery spasms or narrows.

Coronary Artery Disease – The role of the coronary arteries is to provide nutrients and oxygen to the heart. The condition arises when due to plaque deposit damage the arteries as they narrow them thus cutting the supply of nutrients and oxygen to the heart.

Congenital Heart Disease – This condition is a result of deformities at the time of birth. This includes conditions like Obstruction defects, generally caused due to blockage of blood flow through different chambers of the heart and Cyanotic heart disease which is a shortage of oxygen in the body due to defect in the heart.

Pulmonary Stenosis – This condition is caused when the pulmonary valve is too tight making it difficult for the heart to pump blood into the pulmonary artery. If an infant suffers from this condition severe in nature then he or she can turn them blue.

Arrhythmia – It is a result of irregularity in heartbeat. The heart can lose its rhythm due to reasons like heart beating too fast (tachycardia), heart beating too slow(bradycardia), fibrillation or premature ventricular contractions.

Mitral Valve Prolapse – This is a condition which rarely needs treatment as it is not life threatening. In this condition the valves between the left ventricle and left atrium does not fully close but simply bulges in upward direction or back into the atrium.

Dilated Cardiomyopathy – This condition arises when the heart muscle becomes dilated due to weakness and is not able to pump blood properly. The is caused when the heart is deprived of oxygen due to coronary heart disease which usually affects the left ventricle.

Mitral Regurgitation – When the mitral valve does not close as tightly as it should, it causes mitral incompetence or regurgitation or insufficiency. This causes the blood to flow backwards into the heart when it should move out of it. As a result, a person suffering from this condition often feels tired or out of breadth.

Heart Failure – when the heart is not able to pump blood efficiently, it leads to heart failure. Either side of the heart is affected usually. The heart becomes weak over a period of time due to high blood pressure or coronary artery disease.

Well, maintaining a healthy lifestyle can go a long way in reducing the risk factors of the aforementioned heart conditions. So, Stay Fit. Stay safe.

Vydehi Institute of Cardiac Sciences is a well equipped super specialty centre located in Vydehi Hospital designed to serve your hearts needs. It is equipped to treat all cardiac, cardiothoracic and vascular cases.

*source from internet

Achievements of Institute of Cardiac Sciences

Vydehi Institute of cardiac sciences designed to serve your hearts needs. It is distinguished by the services of highly qualified senior full time surgeons and physicians. The services of specialists are available round the clock to attend the emergencies.

Director of VIMS & RC

Mrs. D.A. Kalpaja, the director of the VIMS & RC, has proved by her action that life is not its duration, but lies in its dedication, commitment, and achievement. According to her Vydehi Institute of Cardiac Science is one of the Centers of excellence in Vydehi Hospital. All surgeries of Cardiac Science met with 100% success with track record of 1000 Cardiac Surgeries. The Institute of Cardiac Science is committed to providing affordable healthcare to the lesser privileged sections of society providing healthcare absolutely free to the truly poor. Cardiac surgeries have been performed for the nominal cost in India which is inclusive of Medicines & Food. The crew behind the mission lead by director has been phenomenal in getting funds for the operations conducted for the under privileged. It has also associated with the scheme of Prime Minster National Relief Fund (PMNRF).

The extensive services of the department include adult cardiac surgery, adult and pediatric valve repairs and replacements and a coronary care unit. The team comprises of highly skilled cardio thoracic surgeons, anesthetists, intensive care specialists and dedicated critical care nurses. Treating cardiac disorders from pediatric to the elderly and 60% of them are from West Bengal.

Exploring the frontiers of cutting edge research in angiogenesis, endothelium-coated grafts, pericardial patches and more, are Homograft and Xenograft facilities. The institute is really ‘matching to the beat of a different drum’. At Vydehi Institute of Cardiac Sciences matters of the heart, so to speak is a consuming interest.