Heart Procedures: A Guide to Heart Surgery and its Types

When it comes to cardiovascular surgeries, also known as heart or cardiac surgeries, some common questions come to mind. What is the success rate? What are the complications? How does it work? What are the post-surgery procedures? One important aspect that most people overlook is that there are different types of heart procedures for different ailments.

There are several heart procedures, each meant to treat a specific ailment. 

Role Of Our Heart

The heart, the fist-sized organ in our chest, is the central part of our circulatory system. It is situated between the left and right lungs at the front of the chest, protected by the rib cage. The heart has four chambers consisting of two atriums and two ventricles. The right atrium receives deoxygenated blood, which is then processed to the lungs to receive oxygen-rich blood, which is pumped throughout the body through the left ventricle.

The heart doesn’t just pump oxygen-rich blood, but nutrients as well, and removes the waste products. It works with the endocrine and nervous system to send hormones and regulate heart rate, respectively. The electrical conduction system of the heart also works to control the heartbeat by sending electrical signals. Any hindrance in the smooth functioning of the heart is caused by leading an unhealthy lifestyle or a family background of heart disease.

Which Heart Disease Leads To Cardiac Surgeries?

Not all heart diseases lead to cardiac surgeries. Most of them heal with changes in lifestyle and diet. However, some severe diseases must be treated properly before the complications grow. There are four main causes of heart failure, which must be avoided at any cost.

Some of the common diseases which lead to cardiac surgeries are coronary artery disease, valvular heart disease, aortic aneurysms, pericardiectomy, endocarditis, cardiac tumours, hypertrophic cardiomyopathy, congenital heart defects and heart failure. Usually, doctors recommend surgeries at the advanced stage when medication and lifestyle changes have run their course and failed.

Types Of Heart Surgery Procedures

1. Coronary Artery Bypass Surgery

Coronary artery bypass surgery is a procedure to deal with coronary artery disease where a build-up of plaque blocks efficient blood flow through the blood vessels. This is a type of heart attack surgery to reduce the risk of a heart attack and improve the quality of life.

The surgery is performed when the patient is unconscious under general anaesthesia. This surgery can be performed as an open heart, where an incision is made in the chest, and the heart is stopped to work on the blood vessels. A saphenous vein or internal mammary artery is used as a graft. These grafts create a bypass route to ensure smooth blood flow.

The other method is a minimally invasive surgery where a keyhole-sized hole is made to carry out the operation. Patients are advised to join cardiac rehabilitation programs for improved heart health post-surgery.

2. Valve Replacement Or Repair

When one or more heart valves don’t function properly, a valve replacement or repair surgery is performed. Valve repair and replacement is a type of cardiac surgery which can be either open heart or minimally invasive.

For valve repair, the valve leaflets are reshaped, excess tissue is removed, or the ruptured tiny chords called chordae tendineae are repaired. Valve replacement is where a prosthetic mechanical or biological valve is replaced by a damaged one. For a replacement made with a mechanical valve, lifelong blood thinning medications are monitored to prevent blood clots. Recovery time varies from weeks to months, depending on the severity of the patient. Cardiac rehabilitation is advised for a healthy heart.

3. Aneurysm Repair

Aneurysms are bulging areas in the blood vessels that are life-threatening if rupture. To treat them, an aneurysm repair is performed. This surgery is performed after monitoring anaesthesia. There are two types of aneurysm repair: an open surgical repair and an endovascular repair.

In the first type, an incision is made in the chest to access the aneurysm directly. Then, the weakened part of the artery is cut out and replaced with a graft sewn into place. In endovascular repair, a stent graft is inserted through a catheter. When the stent graft is expanded, it blocks blood flow to the aneurysm and allows smooth blood flow through the artery. The choice between both types depends upon the individual.

4. Pericardiectomy Surgery

The pericardium is a protective membrane surrounding the heart and also acts as a lubricant to reduce friction between the heart and surrounding organs. In some patients, this protective membrane becomes stiff due to infections and inflammation and can not stretch, leading to constrictive pericarditis.

During the pericardiectomy procedure, the surgeon removes the pericardium from your heart. This allows your heart to stretch freely. There is no negative effect of removing the pericardium, and patients who undergo this procedure continue living a normal life. This is an open-heart procedure, as minimally invasive surgery can restrict the pericardium removal path.

5. Endocarditis Surgery

The endocardium is the innermost lining of the heart’s chambers and valves. When germs enter the bloodstream, in an attempt to neutralise these contaminants, the heart’s chambers inflame. This inflammation can restrict the blood flow and cause other complications, resulting in endocarditis.

Infective endocarditis cardiac surgeries are the best option for people suffering from severe heart infections. Usually, the procedure is done within days of diagnosis to minimise the risk of infection spreading. The infected tissue is removed and either replaced or reconstructed.

6. Cardiac Tumour Removal Surgery

Cardiac tumour removal surgery is the solution for patients with a tumorous growth in their heart. Non-cancerous tumours can be completely removed with the help of surgery. On the other hand, surgery can only relieve the pain and discomfort of cancerous tumours. Cardiac surgeons can completely remove the tumour with the help of surgery.

Cardiac tumour removal surgery should be done as soon as possible after diagnosis. This is true for both malignant (cancerous) and benign (non-cancerous) tumours. This surgery can be either done via open-heart or minimally invasive methods. Because cardiac tumours are rare, this surgery should only be performed by a trained and experienced cardiac surgeon.

7. Septal Myectomy

Septal Myectomy is an open-heart surgery for hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is a genetic disease which causes the heart tissue to become stiff and enlarged, making blood circulation tough. Hypertrophic cardiomyopathy, where the ventricle walls thicken to block blood flow into the aorta, is called obstructive hypertrophic cardiomyopathy.

Septal Myectomy improves the blood circulation in the heart by removing a portion of thickened heart tissue. This is a major surgery and requires three to four hours for the procedure. Patients need extensive care post-surgery and might even be required to spend time in the ICU for recovery. It might take the collective effort of physiotherapy and weeks of rest to completely recover. However, this is an important procedure that drastically improves the quality of life.

8. Heart Transplant

A heart transplant is the last resort for people at risk of fatality from heart failure. Generally, surgeons do not suggest heart transplant as it is a complex procedure. A cardiac surgeon will only recommend a heart transplant if medical management has failed for end-stage heart disease.

The patient’s damaged heart is replaced with a healthy heart from an organ donor. Organ donors are difficult to find, and even then, there are many criteria that the patient must fulfil. The donor’s heart must be of the right size and match the blood type, among other things. The medical team monitors the patient closely in the ICU after the surgery. Even after discharge, they have to follow strict lifelong medication and lifestyle changes to keep the heart healthy.

Debunking Common Myths

Most people fear heart surgeries as they’re scared of the success rate and complications. However, technology and medical science have advanced enough to have minimally invasive techniques and safe procedures for most heart conditions.

There are a number of myths surrounding cardiac surgery; such as, it is extremely risky or the recovery procedure is extremely long and painful. You can refer to our blog about the 10 common myths about cardiac surgery to be better informed. A good surgeon will take you through the procedure by explaining everything in advance to make you feel as safe as you can be.

Conclusion

From valve replacement and repair to cardiovascular surgeries, several lifesaving procedures are now revolutionized for patients with unique circumstances. Cardiac surgeries are capable of reviving an unhealthy heart and giving patients the chance to live a healthy life with a few lifestyle changes. After all, a healthy heart is what contributes to an efficiently functioning body.

It is crucial for your health that you maintain your heart health so you do not need cardiac surgery. However, if you face any issues with your heart, it is advisable to not waste any time seeking a cardiac surgeon. If you are looking for an experienced and trusted cardiac surgeon in Mumbai, contact us today!