An open heart operation is a cardiac surgical procedure in which the chest is opened (via a sternotomy: a vertical cut through the sternum or breastbone) to access the heart directly and perform surgery on its internal structures. The term ‘open’ refers to the surgical access to the heart, not necessarily to the heart always being entered, though many procedures (such as valve replacement) do require opening the heart chambers. Open heart surgery is performed under general anaesthesia and almost always requires cardiopulmonary bypass (heart-lung bypass).
During the procedure, the heart is connected to a heart-lung bypass machine, which takes over pumping and oxygenation while the surgeon operates. The heart is usually stopped using a cardioplegic solution so that the surgeon can work in a still, bloodless field. This allows repair or replacement of valves, correction of congenital defects, coronary artery bypass grafting (CABG), and other complex procedures that require direct access to the heart’s interior.
Common open heart operations include CABG, valve repair or replacement (aortic, mitral, tricuspid, or pulmonary), repair of congenital heart defects, heart transplantation, and operations on the aorta (including repair of aortic aneurysm or dissection).
Recovery involves several days in the intensive care unit or high-dependency unit, followed by a ward stay of typically 5 to 10 days, and weeks to months of recovery at home. Sternal wound healing takes approximately 6 to 8 weeks, during which lifting and driving restrictions apply. Cardiac rehabilitation is an important part of recovery from open heart surgery and is associated with better long-term outcomes.
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