Facts about Open Heart Surgery

Records: Records reveal that the earliest pericardium operations were performed as early as the 19th century. Surgeons on record include Francisco Romero, Henry Dalton, and Dominique Jean Larrey. Dr. Ludwig Rehn of Germany is credited with the first successful open heart surgery without complications, on September 7, 1896. Surgery for repair of aortic coarctation and creation of Blalock-Taussig shunt soon became common by the first half of the nineteenth century. The operations included measures to palpate damaged mitral valve, remove portions of the mitral valve, resection of the infundibular muscle stenosis and division of the stenosed pulmonary valve. In 1952, Dr. C. Walton Lillehei and Dr. F. John Lewis performed the first successful intracardiac correction. They addressed the complications of congenital heart defect with the help of hypothermia. The first surgery under local anesthesia was performed by Dr. Aleksandr Aleksandrovich Vishnevskiy of the Soviet Union.

Implications: Open Heart Surgery involves the opening of the chest cavity for surgery on the heart. Thus, the term 'open heart' does not refer to the heart, but the chest. The use of hypothermia is limited according to the complexity of intracardiac repair involved. The 'controlled cross-circulation technique', extracorporeal circulation via oxygenators and pump-oxygenators were part of the trial and error applications used by a number of surgeons across the globe. The latest trend is the off-pump bypass surgery. This method involves bypass surgery of the coronary artery, without cardiopulmonary bypass. In all these applications the primary aim is to stabilize the beating of the heart to achieve a near-still work area. This helps to ward off the postperfusion syndrome. The latest form of open heart surgery is also referred to as 'robot-assisted' heart surgery. The machine used to perform the surgery is controlled by the surgeon. The main advantage is that the dimension of the incision made is greatly reduced. Patients have successfully recovered in a matter of weeks, with improved heart health.

Risks: Open Heart Surgery has greatly reduced mortality rates. However, the major concerns remain neurological damage, stroke, neurocognitive deficits and postperfusion syndrome. Open heart surgery involves the use of a heart-lung machine to support blood circulation, while the surgery is performed on the arteries or the heart itself. There are a number of complications that are known to set in due to a decrease in heart pulse rate and low blood pressure. Patients are known to succumb to transient ischemic attacks and complications such as internal bleeding and infection.

Types: In the coronary artery bypass graft, the arteries that get clogged with a plaque build-up are replaced by healthy blood vessels from another part of the body. In dedicated heart valve procedures, the catheter-based procedure involves the correction of the defective valve via replacement with a mechanical or biological substitute. Transplants are open-heart surgeries wherein the organ is replaced with a healthy substitute from an organ donor. Open heart surgery is also performed to address and remove the causes of heart attack or heart failure, atrial fibrillation, tumor, congenital heart disease and cardiac trauma.

Results: Open heart surgery successfully corrects congenital defect of the organ, replaces defective valves and repairs blocked arteries. However, in a coronary artery bypass graft surgery, sometimes a second surgery is required if restenosis sets in. The surgery has become fairly common, with an increased survival rate. Nevertheless, the risk factor is definitely higher in the case of older people and those with related medical conditions of a serious nature.