Heart Surgery: Who Needs It, Preparation, and Treatment Options

Key Takeaway

Heart surgery is performed to directly access the heart and correct abnormalities such as blocked arteries, leaking valves, or congenital defects. It helps restore blood circulation, relieve chest pain, and improve quality of life. There are several surgical methods, including bypass surgery, valve repair or replacement, and open or minimally invasive procedures. Physicians select the most suitable approach based on the patient’s condition and disease severity. Patients must prepare carefully before surgery and follow strict postoperative care, including medication, lifestyle adjustments, exercise, and regular checkups, to minimize complications.

What Is Heart Surgery and Why Is It Performed?

Heart surgery is a medical procedure in which surgeons open or directly access the heart to treat structural problems or life-threatening diseases. It may involve repairing or replacing heart valves, creating new pathways for blood flow, or correcting congenital heart defects.

The procedure is recommended when medications or less invasive treatments cannot provide effective results. Conditions that often require surgery include coronary artery disease, valve disorders, abnormal heart rhythms, and congenital malformations.

The main goal is to restore healthy blood circulation, prevent heart failure, reduce chest pain, and lower the risk of future complications. Successful surgery greatly improves patient outcomes, overall well-being, and life expectancy.

Indications for Heart Surgery

Doctors may recommend heart surgery when alternative treatments are insufficient. Key indications include:

1. Coronary Artery Disease (CAD)
    
   • Severe chest pain (angina) unrelieved by medication or lifestyle changes.
   • Multiple blocked arteries or a critical blockage in the left main coronary artery.
   • Severe heart attack (acute myocardial infarction) not responsive to angioplasty.
      
2. Valvular Heart Disease
    
   • Leaking (regurgitation) or narrowed (stenosis) valves causing fatigue, dizziness, or irregular heartbeat.
   • Enlarged heart or heart failure due to valve malfunction.
   • Severely damaged or infected valves.
      
3. Congenital Heart Disease
    
   • Severe abnormal blood circulation, such as septal defects (VSD, ASD).
   • Symptoms include shortness of breath, pulmonary congestion, or enlarged heart.
      
4. Heart Failure
    
   • Persistent heart dysfunction despite optimal medical therapy.
   • May require valve repair/replacement, bypass surgery, or heart transplantation.
      
5. Aortic Diseases
    
   • Life-threatening aortic dissection or large aneurysm.
   • Surgery prevents rupture and sudden death.

Preparing for Heart Surgery

Proper preparation ensures safety and improves surgical outcomes:

• Comprehensive health checkup (blood tests, chest X-ray, ECG).
• Cardiac imaging such as echocardiography or CT scan.
• Disclose all medications, supplements, or herbal remedies to the physician.
• Follow fasting instructions to reduce anesthesia risks.
• Practice hygiene, including bathing and nail trimming.
• Prepare medical history documents and allergy information.
• Rest well and manage stress before surgery.

Types of Heart Surgery

1. Coronary Artery Bypass Grafting (CABG)

A new blood route is created using a vein or artery from another body part to bypass blocked coronary arteries.

Benefits: Relieves chest pain, improves blood supply to the heart, and reduces heart attack risk.
Drawbacks: Major surgery, longer recovery, but highly effective for severe multi-vessel disease.

2. Valve Repair or Replacement

Damaged valves are repaired or replaced with artificial or biological valves.

Benefits: Restores normal blood flow, reduces fatigue and swelling, prevents heart failure.
Considerations: Patients with artificial valves may require lifelong blood-thinning medication.

3. Open-Heart vs. Minimally Invasive Surgery

• Open-heart surgery involves opening the chest for complex repairs. Longer recovery but comprehensive results.
   
• Minimally invasive surgery uses small incisions and specialized instruments, resulting in less pain, faster healing, and lower infection risks.

4. Closed-Heart Surgery

Performed through small incisions without fully opening the chest or using a heart-lung machine. Suitable for minor valve problems or simple congenital defects.

Advantages: Faster recovery, less pain, smaller scars.
Limitations: Not ideal for complex conditions.

Postoperative Care and Recovery

Recovery is a critical phase requiring discipline and support:

• Lifestyle adjustments: Adopt a heart-healthy diet, quit smoking, and limit alcohol.
• Exercise: Follow a rehabilitation program for gradual physical activity.
• Medication: Take drugs for blood pressure, cholesterol, or anticoagulation as prescribed.
• Follow-ups: Regular checkups to monitor healing and detect complications early.
• Wound care: Keep surgical site clean and watch for signs of infection.
• Mental health: Manage stress and rest adequately to speed recovery.

Surgery Duration and Hospital Stay

• Open-heart surgery: 3–6 hours, followed by 1–2 days in ICU and 5–10 days in hospital.
• Minimally invasive surgery: 1–3 hours, with shorter hospitalization.
• Full recovery: 6–12 weeks, depending on health status and procedure type.

Risks and Considerations

Potential complications include:

• Infections at the wound site.
• Bleeding due to major surgical intervention.
• Blood clots, which may cause stroke or pulmonary embolism.
• Arrhythmia, temporary irregular heartbeat.
• Anesthesia reactions, depending on medical history.
• Delayed healing, especially in patients who fail to follow recovery guidelines.

Heart Surgery at Vibhavadi Hospital

At Vibhavadi Hospital, patients benefit from a comprehensive heart surgery center with expert cardiac surgeons, anesthesiologists, and advanced technology. Preoperative evaluation, surgical care, and postoperative rehabilitation are carefully integrated to ensure patient safety and long-term success.