Open-heart surgery, which refers to the opening of the chest not the heart, is used for:
A surgeon makes a large incision (cut) in the chest to open the rib cage and operate on the heart. The surgeon also may open the heart, depending on the type of surgery. The patient is connected to a heart-lung bypass machine, which takes over the heart's pumping action and moves blood away from the heart. The surgeon is then able to operate on a heart that is neither beating nor has blood flowing through the chambers.
Coronary Artery Bypass Grafting (CABG)
A blood vessel is removed from another part of the body – usually the chest, leg or arm – and attached above and below the narrowed or blocked area of the coronary artery. The new blood vessel, known as a graft, ‘bypasses’ the narrowed or blocked parts of the artery to improve blood flow and oxygen supply to the heart.
A CABG is carried out under general anaesthetic and usually takes between three and six hours to complete.
Around 20,000 CABG procedures are performed in England every year, most of which are carried out on males, 80% of whom are aged 60 years and above.
Aortic Valve Repair or Replacement
The aortic valve is a flap that acts as a one-way gate, opening and closing to control the flow of blood out of the left hand side ventricle (chamber) of the heart to the main artery, known as the aorta.
The aortic valve may need to be replaced if:
- the valve becomes narrowed and obstructs the blood flowing through.
- the valve leaks and blood flows back into the left ventricle.
- the valve no longer works properly.
The heart is stopped and the aortic valve is removed and replaced with an artificial valve, known as a prosthesis.
Around one in 50 patients will not survive the procedure, due to complications that arise either during or shortly after surgery.
An aneurysm in the heart most often occurs in the heart's lower left ventricle (chamber).
An aneurysm is a balloon-like bulge in the wall of an artery or heart muscle, which can occur if the artery wall becomes weak. Pressure from blood passing through the artery or heart causes the weakened area to bulge. Over time, an aneurysm can grow and burst, causing dangerous, often fatal, internal bleeding.
Surgery to repair an aneurysm involves replacing the weak section of the artery or heart wall with a patch or graft.
A pacemaker is a small electrical device implanted in the chest, which is attached by a wire to the heart and sends electrical pulses to help keep the heart beating regularly.
An implantable cardioverter defibrillator (ICD) is similar to a pacemaker, but sends a larger electrical shock to get the heart pumping again.
The pacemaker is implanted under the skin near the collarbone on the left side of the chest and attached to a wire via a blood vessel to the heart.
The procedure is carried out under local anaesthetic and usually takes around one hour.