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OPEN-HEART SURGERY
Human Heart ~ Heart Surgery ~ Pre& Post Care ~ Risks of Heart Surgery ~FAQ ~ Glossary & Other Sources
July, 2010
I. HUMAN HEART
The heart is the organ that pumps blood to the rest of the body. It is located on the left side, in the chest cavity behind the breast bone. It is about the size of human fist and is made of cardiac muscles.
A. Hearts function
All organs require blood in order to function accurately. The right atrium receives the blood from the organs after they have extracted the needed oxygen. This blood is pumped into the right ventricle, which then pumps the blood to the lungs. In the lung, the carbon dioxide present in this blood is removed and new oxygen is added. This oxygenated blood then reaches the left ventricle via the left atrium. The left ventricle then pumps this newly oxygenated blood back to the bodys organs. Fig.1:Parts of a human heart
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The heart is controlled by the autonomic nervous system of the brain that tells the heart to speed up or slow down depending on the bodys needs. The heart functions non-stop throughout ones life time. Fig.2: Blood vessels
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blocked arteries in the heart, repair or replace heart valves, treat atrial fibrillation, and do heart transplants.3 Open-Heart Surgery is performed under general anesthesia. A breathing tube is placed in the lungs through the throat and then is connected to a ventilator (breathing machine). During the surgery, the surgeon makes a 6- to 8-inch incision (cut) down the center of the patients chest wall to open the rib cage so that the surgeon can get to the heart. The chest is opened by cutting through the patients breastbone. Once the heart is exposed, the patient is connected to a heart-lung bypass machine. The machine takes over the pumping action of the heart. The bypass machine allows the cardiothoracic surgeon to operate on a heart that is static and not full of blood.
Diseases and Conditions Index. National Heart Lung and Blood Institute, U.S. Department of Health & Human Services http://www.nhlbi.nih.gov/health/dci/Diseases/hs/hs_all.html
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Diseases and Conditions Index. National Heart Lung and Blood Institute, U.S. Department of Health & Human Services http://www.nhlbi.nih.gov/health/dci/Diseases/hs/hs_all.html
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The doctor will discuss: The kind of heart problem patient has, the symptoms and how long the patient has had symptoms. Patients history and past treatment of heart problems, including surgeries, procedures, and medicines as well as other health problems and conditions, such as diabetes or high blood pressure and Patients family history of heart problems Note: Blood tests, such as a complete blood count, a lipoprotein panel (cholesterol test, may also be needed).
EKG (Electrocardiogram) Stress Test & Echocardiography Coronary Angiography Aortogram & Chest X Ray Cardiac Computed Tomography Scan Cardiac Magnetic Resonance Imaging
Depending on the type of heart surgery, the patient may spend a number of days in the hospital's intensive care unit (ICU). He or she may have an intravenous (IV) needle inserted in a blood vessel in his/her arm or chest to give fluids until the patient is ready to drink on their own. Extra oxygen through a face mask or an endotracheal tube (breathing tube)4 can also be given. When the patient leaves the ICU, he or she will be moved to another part of the hospital for several days before going home. The entire time the patient is at the hospital, doctors and nurses will closely watch his or her heart rate, blood pressure, breathing, vital signs, and incision site(s).
D. Recovery at Home
Each person responds differently to heart surgery. After-effects of heart surgery are normal. They may include muscle pain, chest pain, or swelling. Other after-effects may include loss of appetite, problems sleeping, constipation, and mood swings and depression. After-effects usually
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go away over time. Recovery time varies for different types of heart surgery. Full recovery from traditional open-heart coronary artery bypass graft (CABG) may take 6 to 12 weeks or more.
Bleeding
Are older than 70 Have diseases or conditions such as high blood pressure, diabetes, kidney disease, lung disease, or peripheral arterial disease Mortality (Heart surgery is more likely to be life threatening in people with pre-existing conditions.)
Infection, fever, swelling, and other signs of Have had previous heart surgeries inflammation
Reaction to the medicine used to temporarily put you to sleep during surgery
Arrhythmias (irregular heartbeats) Memory loss and problems concentrating or thinking clearly
5 A SUMMARY REPORT ON NEW JERSEY HOSPITAL READMISSIONS 30 DAYS AFTER CABG SURGERY 1999-2001. Health Care Quality Assessment Division of Health Care Quality & Oversight http://www.state.nj.us/health/healthcarequality/documents/cabg_readmissions99-01.pdf
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V. FAQ
1. When can I go home following open-heart surgery?
Not before five to seven days following the surgery.
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8. Is bypass surgery considered open-heart surgery? Anybody requiring cardiopulmonary bypass is considered to have had open-heart surgery. 9. How far can I travel after I have had surgery? It is recommended that any trip that is more than two to three hours long should not be taken for at least four to six weeks after your procedure. 10.Does Medicare pay for heart surgery? Yes, at least 80 percent.
VI. Glossary
Autonomic Nervous System: a part of the peripheral Atrial: of or referring to the atrium or atria nervous system that affects heart rate, digestion, respiration rate, salivation, perspiration, diameter of Breast bone: also known as sternum is a long flat bone shaped like a capital 'T' located in the the pupils, urination, and sexual arousal. center of the thorax (chest). Aorta: the large single artery arising from the left CABG: coronary artery bypass graft; vein or ventricle carrying blood to the systemic circulation artery grafted surgically to permit blood to travel Atrium: a chamber affording entrance to another from the aorta to a branch of the coronary artery structure or organ; at a point past an obstruction Right. atrium the upper right cardiac chamber that Cardiac: of or referring to the heart receives blood from the venae cavae and delivers Ventricle : a small cavity or chamber, as in the blood to the right ventricle brain or heart Left. atrium the upper left cardiac chamber that Right v. the lower chamber of the right side of receives blood from the pulmonary veins and delivers the heart, which pumps venous blood through blood to the left ventricle (pleural form is atria) the pulmonary trunk and arteries to the capillaries Artery: a blood vessel that carries blood away from of the lung the heart; arteries usually carry oxygenated blood Left v. the lower chamber of the left side of the Arrhythmia: irregularity or loss of rhythm of the heart, which pumps oxygenated blood out heartbeat through the aorta to all the tissues of the body
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