Heart surgery can correct heart problems when other treatments haven't worked or can't be used. Sometimes it is an emergency — surgery for a severe heart attack, for example, may have to happen at once. Other times it can be planned ahead. Some operations are major, such as bypass surgery for blocked heart arteries; others are minor procedures, such as putting in a pacemaker.
What it treats
| Condition | What surgery does |
|---|---|
| Coronary artery disease — plaque narrows or blocks the arteries feeding the heart muscle | Coronary artery bypass graft (CABG), or heart bypass: a new path for blood around the blockage. The most common heart surgery in adults |
| Heart valve disease — problems with the valves that control blood flow through the heart | Repairs valves, or replaces them with a mechanical valve or a biologic one made from pig, cow or human heart tissue |
| Arrhythmia — an abnormal heart rate or rhythm, from changes in the heart's electrical signals | Places a pacemaker or an implantable cardioverter defibrillator (ICD) in the chest; treats atrial fibrillation with small cuts in the heart muscle whose scars guide the electrical signals (Maze surgery) |
| Heart failure — the heart is too weak or stiff to pump enough oxygen-rich blood | Places a device: an ICD to help prevent sudden cardiac arrest, a biventricular pacemaker to coordinate and strengthen pumping, a ventricular assist device, or a total artificial heart; or replaces the heart (heart transplant) |
| Aneurysm — a balloon-like bulge in an artery wall, life-threatening if it tears or bursts | Repairs or replaces the weak section with a fabric patch or tube |
| Angina — chest pain from coronary artery disease | Uses a laser to make small channels through part of the heart muscle (transmyocardial laser revascularization) |
| Damaged or abnormal heart structures, including congenital defects present from birth | Repairs the damage or malformation, depending on the defect |
How surgeons operate
The approach depends on the heart problem, the patient's overall health and other factors.
- Open-heart surgery (traditional heart surgery): the chest is opened to reach the heart. Because operating on a beating heart is difficult, medicines stop it, and a heart-lung bypass machine keeps oxygen-rich blood circulating.
- Off-pump surgery: open-heart surgery on a beating heart, without the bypass machine; a device holds the heart steady. It is used for some coronary bypass operations, in certain cases only.
- Minimally invasive surgery: tools go in through small cuts between the ribs, as small as 2 to 3 inches, with or without the bypass machine.
- Robotic-assisted surgery: a minimally invasive method in which the surgeon uses a computer to control tools on robotic arms, allowing great precision in difficult operations.
Risks
Results are often excellent, but like any surgery, heart surgery carries risks:
- bleeding;
- infection, fever and swelling;
- problems from anesthesia;
- arrhythmia;
- damage to the heart, kidneys, liver or lungs;
- stroke.
Risks tend to be higher when the surgery is an emergency, or when the patient has other conditions such as diabetes, kidney disease, lung disease or peripheral artery disease.
Sources
Based on the MedlinePlus health topic "Heart Surgery," National Library of Medicine, with a summary from NIH's National Heart, Lung, and Blood Institute; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from medlineplus.gov
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