What are heart surgeries? Operations on the heart and blood vessels: types, features Show heart surgery

Heart surgery is performed only when other methods of therapy cannot help the patient's condition. Heart surgery can prevent death in a patient, but the risk of an adverse outcome remains quite high.

Despite the fact that cardiac surgery does not stand still and develops, heart surgery is very difficult to perform. The best specialists in cardiac surgery are engaged in it. But even this important fact cannot shield the operated person from complex consequences.

Complications in the postoperative period can even lead to death.

Indications for surgery

As mentioned earlier, cardiac surgery is used in cases where there are no other options to save the patient's life. Heart surgery requires a very serious approach.

Heart transplantation is considered the most complex and serious surgical intervention. The operation is carried out under the strict supervision of highly qualified specialists.

Indications for heart surgery of any complexity are as follows:

transient development of ailments of the cardiovascular system;
in the absence of results with drug treatment;
late referral to a medical facility.

Heart surgery helps to improve the general condition of the patient and eliminate the symptoms of a tormenting disease.

Cardiac cavity surgery is performed only after a complete diagnostic study and an accurate diagnosis by a cardio specialist.

Methods of surgical interventions

What are heart surgeries?

This is a pretty important question if you are going to have this major surgery. You will also need to know how the operation goes and how it is done.

This is necessary in order to make, perhaps, the main decision in your life, on which all future fate will depend.

Closed Interventions

This is a heart operation that does not affect the organ itself. It is done without touching the heart. For its implementation, there is no need for special equipment, except for such as the instruments of the surgeon.

The heart cavity does not "open". That is why it is called "closed".

Such an intervention is performed at the initial stage of the development of the disease, when the patient's condition can only be improved by operations.

Open Interventions

There is also open surgery. This type of operation requires the opening of the heart cavities in order to eradicate the existing pathology.

Open heart surgery is performed using a special device - heart-lung machine or heart-lung machine.

With an open intervention, the cavities are open, the heart and pulmonary organs are disconnected from blood circulation. This makes it possible to intervene on a "dry" organ.

All blood through the vein goes to specialized surgical equipment. There they pass through artificial lungs, enriched with oxygen and release carbon dioxide, transforming from the blood of a vein into an arterial one. Then it is driven by a special pump into the aorta of the operated person, in other words, into the systemic circulation.

Innovative techniques help to create all the "insides" of the equipment (also an artificial lung), with which the patient's blood comes into contact, "disposable", that is, once for one person. This will reduce the possible disastrous consequences.

Today, the heart-lung machine helps to stop the functioning of the heart organ and lungs for several hours. Thereby allowing to carry out the hardest operations of open character.

X-ray surgical interventions

This type of intervention began to be used quite recently. But thanks to innovative equipment, they occupy an important place in heart surgery.

With the help of a special catheter, surgical instruments are inserted into a strip section of the cardiac organ, or into the opening of the vessel. Further, with the help of the pressure that the device creates, the valves of the abdominal incisions are opened. They amplify or distort the partitions, or vice versa, using the device, the distortion is eliminated.

Special tubes are introduced into the lumen of the necessary vessel, thereby helping to slightly open it.

The process during such operations is carefully monitored by a special computer and control is made over each action. Thanks to this, operations are performed with less risk of injury and with a greater likelihood of a favorable outcome.

If you have had an X-ray surgery, the effectiveness of it is higher.

Action plan before surgery

Before surgery on the cardiac organ, preparation is necessary. If you have enough time, at least a few days or weeks, you need to take care of your body. Eat healthy, nutrient-rich foods.

Get plenty of rest, walk in the fresh air, do physical exercises that the treating specialist recommended to you.

Proper nutrition

Try to eat only natural foods every day and more than once, even if you have no appetite. Your body needs to consume plenty of proteins, vitamins and minerals.

Thanks to a healthy diet, the surgical intervention itself and the rehabilitation period are more favorable.

Rest

Do not force your body to overwork before surgery. The more you rest, the stronger and stronger your body will become.

If you want to visit relatives or invite you to visit, say that you need to gain strength before a difficult process. Relatives will always understand you and will not be offended.

Nicotine use

It's no secret for everyone that smoking affects negatively even the body of a completely healthy person. What can we say about patients with cardiac pathology.

Nicotine affects the heart in the following negative way: it develops arteriosclerosis, increases pressure in the blood vessels, and makes the heart vessels tighten. It also narrows blood-forming arteries and increases the concentration of mucous fluid in the pulmonary organs.

This leads to more difficult adaptation after surgery.

rehabilitation period

After a surgical intervention on the cardiac organ, if an insufficient amount of time has passed, it is even forbidden to get out of the ward bed. The entire rehabilitation period, the patient is in the intensive care unit.

This department is intended for patients who have a risk of death.

A special dietary diet plays a huge role in rehabilitation. His attending specialist appoints individually for each patient. You can start eating only with lean gruels and vegetable broths, but after a few days the diet increases significantly.

After the patient is transferred to a regular ward, as a rule, the attending physician will allow the use of the following products:

cereals from coarse grinding (barley, barley groats, unpolished rice). You can also include oatmeal in the diet 2-3 times a week;
dairy production: fat-free curd mass, cheese with a fat content of not more than 20%;
vegetables and fruits: fresh, steamed and in various salads;
small pieces of boiled chicken, turkey and rabbit. As well as homemade steamed cutlets;
various varieties of fish: herring, salmon, capelin, etc.;
all soups without fried ingredients and without fat content.

Under no circumstances should the following foods be consumed.

Heart surgery helps to cure many diseases of the cardiovascular system that are not amenable to standard therapeutic methods. Surgical treatment can be carried out in different ways, depending on the individual pathology and the general condition of the patient.

Indications for surgical treatment

Cardiac surgery is a field of medicine in which physicians specialize in studying, inventing methods and performing operations on the heart. The most complex and dangerous cardiac surgery is heart transplantation. Regardless of what type of surgery will be performed, there are general indications:

the rapid progress of the disease of the cardiovascular system;
ineffectiveness of conservative therapy;
untimely visit to the doctor.

Heart surgery makes it possible to improve the general condition of the patient and eliminate the symptoms that disturb him. Surgical treatment is carried out after a complete medical examination and the establishment of an accurate diagnosis.

Do operations for congenital heart defects or acquired. A congenital defect is detected in a newborn immediately after birth or before birth on an ultrasound examination. Thanks to modern technologies and techniques, in many cases it is possible to detect and cure heart disease in newborns in time.

An indication for surgical intervention can also be coronary disease, which is sometimes accompanied by such a serious complication as myocardial infarction. Another reason for surgery may be a violation of the heart rhythm, since this disease tends to cause ventricular fibrillation (scattered contraction of fibers). The doctor should tell the patient how to properly prepare for heart surgery in order to avoid negative consequences and complications (such as a blood clot).

Advice: proper preparation for heart surgery is the key to a successful recovery of the patient and prevention of postoperative complications, such as a blood clot or occlusion of the vessel.

Operation types

Cardiac surgeries can be performed on an open heart as well as on a beating heart. Closed heart surgery is usually performed without affecting the organ itself and its cavity. Open heart surgery involves opening the chest and connecting the patient to a ventilator.

During open heart surgery, a temporary cardiac arrest is performed for several hours, which allows you to perform the necessary manipulations. This technique makes it possible to cure complex heart disease, but is considered more traumatic.

Surgery on a beating heart uses special equipment so that the heart continues to contract and pump blood during surgery. The advantages of this surgery include the absence of such complications as embolism, stroke, pulmonary edema, etc.

There are the following types of heart operations, which are considered the most common in cardiology practice:

radiofrequency ablation;
coronary artery bypass grafting;
valve prosthetics;
Operation Glenn and Operation Ross.

If surgery is performed with access through a vessel or vein, endovascular surgery (stenting, angioplasty) is used. Endovascular surgery is a branch of medicine that allows for surgical intervention under X-ray control and using miniature instruments.

Endovascular surgery makes it possible to cure the defect and avoid the complications that abdominal surgery gives, helps in the treatment of arrhythmias and rarely gives such a complication as a thrombus.

Advice: Surgical treatment of heart pathologies has its advantages and disadvantages, therefore, the most suitable type of operation is selected for each patient, which carries fewer complications for him.

Radiofrequency or catheter ablation (RFA) is a minimally invasive surgical intervention that has a high therapeutic effect and minimal side effects. Such treatment is shown for atrial fibrillation, tachycardia, heart failure and other cardiac pathologies.

By itself, arrhythmia is not a serious pathology requiring surgical intervention, but can lead to serious complications. Thanks to RFA, it is possible to restore a normal heart rhythm and eliminate the main cause of its violations.

RFA is performed using catheter technology and under x-ray control. Heart surgery takes place under local anesthesia and consists in bringing a catheter to the necessary part of the organ, which sets the wrong rhythm. Through an electrical impulse under the action of RFA, the normal rhythm of the heart is restored.

Attention! The information on the site is presented by specialists, but is for informational purposes only and cannot be used for self-treatment. Be sure to consult a doctor!

Open heart surgery is one of the methods of treating cardiovascular diseases, in which special surgical procedures are performed. The general principle is that there is an intervention in the human body in order to carry out the necessary activities on the open heart. In other words, this is such an operation, during which an opening or dissection of the region of the human sternum is performed, affecting the tissues of the organ itself and its vessels.

Open heart surgery

Statistics show that the most common intervention of this type among adults is an operation in which artificial blood flow is created from the aorta to healthy areas of the coronary arteries - coronary artery bypass grafting.

This operation is performed for the treatment of severe coronary heart disease, which occurs due to the development of atherosclerosis, in which there is a narrowing of the vessels supplying blood to the myocardium, their elasticity decreases.

The general principle of the operation: the patient's own biomaterial (a fragment of an artery or vein) is taken and sutured in the area between the aorta and the coronary vessel in order to bypass the place affected by atherosclerosis, in which blood circulation is impaired. After the operation is performed, the blood supply to a certain area of the heart muscle is restored. This artery / vein supplies the heart with the necessary blood flow, while the artery in which the pathological process occurs is bypassed.

Coronary artery bypass grafting

Today, taking into account the progress in medicine, for surgical treatment on the heart, it is enough to make only small incisions in the corresponding area. Another intervention, more complex, will not be needed. Therefore, the concept of "open heart surgery" sometimes misleads people.

Reasons for open heart surgery

The need to replace or restore the patency of blood vessels for the correct flow of blood into the heart.
The need to repair defective areas in the heart (for example, valves).
The need to place special medical devices to maintain the working capacity of the heart.
The need for transplantation operations.

What you need to know about coronary artery bypass surgery?

Time spending

According to medical data, this type of operation takes no less than four and no more than six hours. In rare, especially severe cases, when the operation requires more work (creation of several shunts), an increase in this period may be observed.

The first night after heart surgery and all medical procedures, patients spend in the intensive care unit. After three to seven days have passed (the exact number of days is determined by the patient's well-being), the person is transferred to a regular ward.

Operation Hazards

Despite the qualifications of doctors, no one is immune from unplanned situations. What is the danger of surgery, and what risk can it carry:

infection of the chest due to an incision (this risk is especially high for people who are obese, diabetic, or undergo a second operation);
myocardial infarction, ischemic stroke;
heart rhythm disturbances;
thromboembolism;
increased body temperature for a long time;
cardiac discomfort of any nature;
pain of a different nature in the chest area;
pulmonary edema;
short-term amnesia and other transient memory problems;
loss of a significant amount of blood.

These negative consequences, as statistics show, occur much more often when using an artificial blood supply device.

The risk of unpleasant consequences is always present

Preparation period

In order for the planned operation and general treatment to be successful, it is important not to miss anything significant before they begin. To do this, the patient must tell the doctor:

About medications that are currently being used. These may include medications prescribed by another doctor, or those that the patient purchases himself, including dietary supplements, vitamins, etc. This is important information and should be announced before surgery.
About all chronic and past diseases, health deviations that are currently available (runny nose, herpes on the lips, indigestion, fever, sore throat, fluctuations in blood pressure, etc.).

The patient should be prepared for the fact that two weeks before the operation, the doctor will ask him to refrain from smoking, excessive alcohol consumption, taking vasoconstrictor drugs (for example, nasal drops, ibuprofen, etc.).

On the day of the operation, the patient will be asked to use a special antibacterial soap, which significantly reduces the risk of infection during the operation. In addition, a few hours before the intervention, you can not eat food and drink water.

Operation

When open heart surgery is performed, the following actions are sequentially performed:

The patient is placed on the operating table.
He is given general anesthesia.
When the anesthesia begins to take effect and the patient falls asleep, the doctor opens the chest. To do this, he makes an incision in the appropriate area (usually it is no more than 25 sentiments in length).
The doctor dissects the sternum, partially or completely. This allows access to the heart and aorta.
Once access is secured, the patient's heart is stopped and connected to a heart-lung machine. This allows the surgeon to calmly perform all manipulations. Today, technologies are used that allow in some cases to perform this operation without stopping the heartbeat, while the number of complications is lower. than traditional intervention.
The doctor creates a shunt around the damaged part of the artery.
The cut part of the chest is fixed with a special material, most often with a special wire, but in some cases plates are used. These plates are often used for the elderly or for people who have had frequent surgeries.
After the operation is completed, the incision is sutured.

Postoperative period

After the operation is completed and the patient wakes up, he will find two or three tubes in his chest. The role of these tubes is to drain excess fluid from the area around the heart (drainage) into a special vessel. In addition, an intravenous tube is installed for the flow of therapeutic and nutrient solutions into the body and a catheter into the bladder to remove urine. In addition to the tubes, devices are connected to the patient to monitor the work of the heart.

The patient should not worry, in case of questions or discomfort, he can always contact the medical workers who will be assigned to monitor him and promptly respond if necessary.

The duration of the recovery period depends not only on physiology, but also on the person himself.

Each patient should understand that rehabilitation after surgery is not a quick process. After six weeks of treatment, some improvements can be observed, and only after six months will all the benefits of the operation become visible.

But each patient is able to speed up this rehabilitation process, while avoiding new heart ailments, which reduces the risk of a second operation. To do this, it is recommended to take the following measures:

follow the diet and special diet prescribed by the attending physician;
limit salty, fatty, sweet foods);
devote time to physiotherapy exercises, walks in the fresh air;
stop drinking alcohol frequently;
monitor the level of cholesterol in the blood;
track blood pressure.

If these measures are followed, the postoperative period will pass quickly and without complications. But you should not rely on general recommendations, the advice of your attending physician, who has studied the medical history in detail and is able to draw up an action plan and a diet during the recovery period, is much more valuable.

Such surgical manipulations are within the competence of cardiac surgeons, and are one of the most complex in nature. Heart surgery is a last resort in the treatment of serious cardiovascular diseases, which are resorted to in order to improve the quality of life of the patient, and sometimes even save his life.

In Russia, this type of surgical intervention is not practiced as often as, for example, in America or in European countries. First of all, this is due to the cost of such treatment: not every citizen of the Russian Federation is able to pay the costs of the operation out of his own pocket.

At the same time, this branch of medicine in domestic medical institutions is constantly developing, which makes it possible for patients to receive qualified advice and assistance when applying.

When is heart surgery performed - indications and timing

The main pathologies that may require surgical intervention are:

Poor myocardial blood supply. A similar condition in medical circles is called coronary heart disease. IHD can lead to the formation of an aneurysm, extensive thrombosis. With all the described ailments, certain surgical procedures on the heart may be required.
Heart defects that have both innate and acquired nature. Many defects in the structure of the heart valve are incompatible with life. Therefore, such pathologies are diagnosed even in the prenatal period, and the operation itself is carried out in the first days of the baby's life.
Failures in the frequency, sequence and rhythm of heart contraction, - arrhythmias.

Common indications for heart surgery are the following pathological conditions:

Active deterioration of vital signs against the background of the development of underlying heart disease.
The inability of drug therapy to cope with the manifestations of the disease.
Noticeable deterioration in the functioning of the heart muscle that cannot be eliminated with medications.
advanced stage of the disease. This happens when the patient does not seek qualified help in time.

It should also be taken into account that any surgical manipulations on the heart carry a risk and are fraught with the development of a number of exacerbations in the rehabilitation period. Doctors turn to such treatment when other measures do not bring the desired effect.

In addition, heart surgery requires a comprehensive examination of the patient and careful preparation for the operation. This will ensure a successful recovery and minimize the likelihood of postoperative complications.

Based on the patient's condition, the type of surgical intervention under consideration is:

emergency. In such a situation, examination and preparation are carried out in a minimal amount, and the operation itself is carried out as soon as possible. This type of manipulation is prescribed for life-threatening conditions, when every minute counts: with aneurysm rupture, extensive myocardial infarction. Often, emergency interventions on the heart are performed on newborns with complex heart disease.
Urgent. There is time for diagnostic and preparatory measures, but not much. After receiving the results of the examination, surgical treatment of the heart disease is carried out.
planned. In some medical sources, this type of operation is called elective. After a detailed study of the patient's condition by a cardiac surgeon, a final decision is made on the need for surgical intervention. Together with the patient or his parents (when operating on a child), the exact date of the operation is agreed.

Closed and open heart surgeries - how they are performed and to whom they are prescribed

Based on the type of defect that needs to be eliminated, various methods of surgical intervention are used:

Note!

Not so long ago, a new direction in the treatment of heart defects began to be applied in cardiac surgery - X-ray surgery. In essence, they are minimally invasive - the doctor makes small incisions or punctures, and brings special instruments to the heart zone through the catheter. An access point can be, incl. and femoral vessels. Using cans, you can increase the diameter of the narrowed valve - or reduce it by opening the patch (its design is similar to an umbrella). With the help of expanding tubules, vascular stenosis is eliminated.

The progress of the entire procedure is monitored through the monitor screen - this ensures the effectiveness of the operation, as well as its safety for the patient. In addition, during the manipulation under consideration, general anesthesia is not used: the doctor is limited to anesthesia with mini-accesses.

X-ray surgery can be both the main and auxiliary methods of treating errors in the work of the heart.

Most popular types of heart surgery

To date, the following operations are used in cardiac surgery practice:

1. With coronary heart disease:

2. In case of diagnosing heart disease:

3. In the presence of arrhythmia:

In cases where the treatment of individual anatomical structures of the heart is impossible or ineffective, and the main organ for pumping blood cannot cope with its main function, they perform heart transplant .

This operation is fraught with a number of complications, among which is graft rejection.

Today, scientists are conducting research to maximize the life extension of those who have survived heart transplants.

How are operations performed?

An operation is an intervention in the human body with a violation of its integrity. Each disease requires an individual approach, which naturally affects the way the operation is performed.

How heart surgery is done: preparation for surgery

Heart surgery (cardiac surgery) is one of the most difficult to perform, dangerous and responsible type of surgical intervention.

Planned operations are usually carried out in the morning. Therefore, the patient is not allowed to eat or drink in the evening (for 8-10 hours), and immediately before the operation, a cleansing enema is made. This is necessary in order for the anesthesia to work as it should.

The place where operations are performed must be sterile. In medical institutions, special rooms are used for these purposes - operating rooms, which are regularly sterilized by quartz treatment and special antiseptics. In addition, all medical personnel who take part in the operation wash themselves before the procedure (you even have to rinse your mouth with an antiseptic solution), and also change into special sterile clothes, put on sterile gloves on your hands.

The patient is also put on shoe covers, a cap on his head, and the operation field is treated with an antiseptic. If necessary, before the operation, the patient's hair is shaved if the surgical field is covered with it. All these manipulations are necessary to avoid infection of the surgical wound with bacteria or other dangerous active microorganisms.

Narcosis or anesthesia

Anesthesia is a general anesthesia of the body with its immersion in drug-induced sleep. During surgical interventions on the heart, general anesthesia is used, and in some cases, during endovideosurgical operations, spinal anesthesia, in which a puncture is made into the spinal cord at the level of the lower back. Substances that cause pain relief can be administered in various ways - intravenously, through the respiratory tract (inhalation anesthesia), intramuscularly or in combination.

Course of open heart surgery

After the person goes into medical sleep and ceases to feel pain, the operation itself begins. The surgeon uses a scalpel to open the skin and soft tissues on the chest. Cardiac surgery may also require an “opening” of the chest. To do this, with the help of special surgical instruments, the ribs are sawn. Thus, doctors “get” to the operated organ and put special dilators on the wound, which provide better access to the heart. Junior medical staff, using suction, removes blood from the surgical field, and also cauterizes cut capillaries and blood vessels so that they do not bleed.

If necessary, the patient is connected to an artificial heart machine, which will temporarily pump blood through the body, while the operated organ is artificially suspended. Depending on what kind of heart surgery is performed (what kind of damage is eliminated), appropriate manipulations are carried out: it can be the replacement of blocked coronary arteries, the replacement of heart valves in case of defects, vein bypass surgery or the replacement of an entire organ.

Extreme care is required from the surgeon and all staff, as the life of the patient depends on it. It should also be added that during the operation, blood pressure and some other indicators are constantly monitored, which indicate the patient's condition.

Endovideosurgery: stenosis and angioplasty

Today, more and more often, heart surgery is performed not by an open method - with a chest incision, but with access through the femoral artery on the leg, under the control of an X-ray machine and a microscopic video camera. After preparing for operation, which is similar for all types of surgical interventions, and putting the patient into a medical sleep, access to the femoral artery is opened through an incision in the leg. A catheter and a probe with a video camera at the end are inserted into it, thanks to which access to the heart is provided.

In this way, angioplasty with stenosis of blood vessels is carried out in cardiac surgery, which is necessary for blockage of the coronary vessels that feed the heart itself with blood. Special stands are installed in the narrowed vessels - cylindrical implants that do not allow the arteries to clog anymore, which prevents the possibility of developing coronary disease.

After the main part of the operation is over and the heart is on its own again functions, stitching of damaged nerves, vessels and tissues is performed. The wound is again treated with an antiseptic, the surgical field is closed, soft tissues and skin are sutured with special threads. A medical bandage is applied to the external wound. After the end of all these procedures, the patient is taken out of anesthesia.

Other types of transactions

In addition to the abdominal operations described above, there are also operations performed in a less traumatic way:

Laparoscopy - is performed using a laparoscope, which is inserted through 1-2 cm incisions in the skin. Most often used in gynecology, gastrectomy and other operations in the abdominal cavity. You can read more about this
Laser surgery - is carried out using a special laser beam. Usually, operations are performed in this way on the eyes, when removing skin formations, etc. You can read more about the method