Features of cardiac surgery. Types of heart surgeries - indications for performance What are open heart surgeries

Surgical interventions on the heart are necessary in the treatment of many pathologies of the cardiovascular system that are not amenable to standard drug therapy. With the implementation of surgical treatment, it becomes possible to improve the general condition of the patient and prolong his life. But depending on the pathology, there are different heart operations, which differ in their technique.

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Operations classification

Cardiac surgery is aimed at the treatment of cardiac pathologies through indirect or direct effects on this organ. There are such types of heart operations:

Closed, while the heart itself is not affected. Such operations are performed outside the heart, so they do not need to use special equipment, with the exception of classical surgical instruments. The cavities of the heart remain closed, hence the name of this category.
Open, they require opening the cavities of the heart, which requires the use of special equipment, such as a heart-lung machine. At the time when such a surgical intervention is performed, the heart and lungs are not functioning, which allows the specialist to work with a stopped heart.
X-ray surgery, in which special catheters and devices attached to them are used, they are inserted into the cavity of the heart or the lumen of the vessel to correct the defect. The progress of such an operation is controlled using the monitor screen.

In addition, the types of surgical interventions in cardiac surgery are classified according to the patient's condition and type of defect, as well as the approach to treatment.

According to the patient's condition and the type of defect, there are:

Emergency operations - when you need to act immediately after the diagnosis has become clear, otherwise the pathology threatens the patient's life.
Urgent - they do not require a lightning-fast reaction and a quick start of action. They are prepared for several days, but not longer, due to the high risks of complications or death.
Planned - interventions, the implementation of which is desirable, but not essential in the near future. They are prescribed by surgeons after consultation with patients.

Depending on what approach requires surgical treatment:

Radical - they are aimed at the complete elimination of vices.
Palliative - they are additional or auxiliary, their goal is to improve the patient's condition or prepare him for a radical intervention.

RF ablation

Such surgical intervention as radiofrequency ablation refers to X-ray surgical procedures. It is carried out to improve the condition of the patient suffering from heart failure and arrhythmia, and is characterized by low rates of side effects and complications.

Manipulations during the operation are carried out with special catheters, which are introduced to the patient under local anesthesia. The place of introduction of the catheter, remote from the heart itself, therefore, local anesthesia is carried out at the site of the future introduction of the catheter. In most cases, it is injected into the inguinal vein or femoral artery. After entering the organ, the catheters give electrical impulses to restore the heart rhythm.

Due to such a supply of impulses that eliminate a small area of cardiac tissue that causes pathological excitation of the myocardium, the technique received a second name - cauterization of the heart.

Valve prosthetics

Prosthetic heart valves are used when a valve is insufficiency or stenosis, which interferes with the normal passage of blood through it. Valve replacement can be performed during open surgery, endovascular or mini-access.

In the first case, the patient under general anesthesia is treated with the anterior surface of the chest, the sternum is dissected longitudinally, and the pericardial cavity is opened. To disconnect the heart from blood circulation, the patient is connected to a heart-lung machine, and the myocardium is systematically treated with cold saline during the entire operation in order to avoid its hypoxia.

To install the prosthesis, a longitudinal incision is made, opening the cavity of the heart, the modified structures of the valve are removed, it is replaced with an artificial one, and the myocardium is sutured. After that, the surgeon "starts" the heart with an electrical impulse or by performing a direct heart massage, and turns off the heart-lung machine.

After examining the postoperative view of the heart, pericardium and pleura, blood is removed from the cavities and the surgical wound is sutured in layers.

With endovascular surgery, there is no need to "disconnect" the heart from blood circulation. It is carried out through the leg, namely by introducing a catheter with implantable valves into the femoral artery or vein. After fragments of the damaged valve are destroyed and removed, a prosthesis is put in its place, which straightens itself, having a flexible stent frame.

If the option with a mini-access was chosen, then the surgeon makes an incision 2-5.5 cm long on the anterior wall of the sternum in the area of the projection of the apex of the heart. Then, through the apex of the heart, a catheter is inserted into the organ, advancing it to the affected valve, and replacing it.

In the case of valve replacement, there are several types of implants:

Mechanical - they are made of metal or plastic. When choosing such an implant, the patient in the future will need to constantly take blood thinners.
Biological - they consist of animal tissues and do not require further use of drugs, but after a few decades they need to be replaced.

Installing a pacemaker

In the event that the patient suffers from heart failure, cardiomyopathy and cardiac arrhythmias, the specialist may prescribe a minor operation to install a pacemaker.

The technique for performing such an operation is simple. On the right or left under the left clavicle, local anesthesia is performed with novocaine or lidocaine, after which an incision is made in the skin and subclavian vein to insert a conductor into it, and through it into the superior vena cava and into the heart - an electrode. When the tip of the electrode enters the cavity of the right atrium, the doctor chooses a convenient place for optimal stimulation of the heart muscle, during the search he constantly records ECG changes. When a place is found, the electrode is fixed in the myocardial wall from the inside with the help of antennae or a corkscrew-like attachment. After fixation, it is required to hem a titanium case under the patient's arm, which is installed in the thickness of the pectoral muscle on the left. The wound is sutured and an aseptic bandage is applied.

Coronary artery bypass grafting

Coronary artery bypass grafting is a common heart surgery. It is prescribed when atherosclerotic plaques accumulate on the inner walls of the coronary vessels that feed the heart, disrupting blood flow. In addition, indications can be:

Stable angina 3-4 functional class.
Acute coronary syndrome.
Acute myocardial infarction within the first 4–6 hours of onset of pain.
Severe ischemia without pain.

Before the operation, the patient is intravenously administered sedatives and tranquilizers, and the intervention itself is carried out under general anesthesia. Operative access is done by dissection of the sternum or from a mini-access, making an incision in the intercostal space on the left in the area of the projection of the heart. Manipulation can be carried out both with the connection of the patient to the heart-lung machine, and without it.

The aorta is clamped and connected to the machine, then a vessel is isolated, which will become a bypass. This vessel is brought to the affected coronary artery and its other end is sutured to the aorta. As a result, from the aorta, bypassing the area affected by plaques, the blood will go to the coronary arteries without difficulty.

Depending on how many arteries supplying the heart are affected and at what intervals, the number of shunts can vary from 2 to 5.

When the shunts are fixed, metal staples are applied to the edges of the sternum, soft tissues are sutured and an aseptic dressing is applied. In addition, drainage is removed from the pericardial cavity so that there is an outflow of hemorrhagic fluid.

Operations Glenn and Ross

The Glenn operation is otherwise known as a bidirectional cavopulmonary connection. In this case, anastomosis of the upper part of the superior vena cava with the right pulmonary artery is performed according to the "end to side" principle.

Ross surgery is the replacement of a patient's damaged aortic valve with his pulmonary valve, and the removed pulmonary valve is replaced with a prosthesis.

The treatment of heart diseases using surgery is the field of surgery and cardiology, which is called cardiac surgery. To date, cardiac surgery is the most effective method of treating certain types of heart defects, coronary heart disease and helps prevent the development of myocardial infarction, as well as eliminate its consequences - aneurysms.
Surgical intervention is used only in cases where conservative methods of treatment cease to help and the patient's condition worsens. The untimely appeal of the patient to the doctor can also lead to heart surgery, when only surgical intervention remains the only way to help.

Today, cardiac surgery is one of the most actively developing and technically equipped branches of medicine. Every year, 700 patients undergo open heart surgery. The bulk of operations are in the United States. In Europe, the number of operations is 4 times less. In Asian countries, cardiac surgery is practically absent. In Russia, the number of heart surgeries is below the required minimum. This statistic is due to the fact that heart surgeries are expensive. In addition to open heart surgery, surgical intervention is also carried out without opening parts of the heart (for example, implantation of pacemakers, angioplasty).

Surgery is required for diseases such as:

1. Ischemic heart disease and its consequences (myocardial infarction);
2. Heart defects.
3. Violation of the heart rhythm.

Cardiac ischemia

Ischemic heart disease occurs as a result of insufficient blood supply to the working myocardium. The main cause of coronary heart disease is atherosclerosis (plaque formation on the walls of blood vessels). A slight narrowing of the lumen of the vessel leads to angina pectoris (a person feels pain only when the heart's need for oxygen is increased, for example, during exercise). A strong narrowing of the lumen of the vessel causes pain even at rest, and the duration of pain attacks can also become more frequent and increase - unstable angina. With a strong violation of the coronary blood flow, the death of the muscle fibers of the heart occurs - this is a myocardial infarction.

One of the severe complications of myocardial infarction is the formation of a post-infarction aneurysm of the left ventricle. An aneurysm is a bubble-like bulge. It is formed due to the fact that dead tissue is replaced by scar tissue, which in turn is not able to contract. Under the pressure of healthy contracting fibers, the scar tissue swells, part of the blood is retained in the ventricle in the area of aneurysmal expansion. With each contraction, organs and tissues receive less blood in an amount equal to the volume of the aneurysm. This is its main negative meaning. Very often, blood clots form in the aneurysm area, which can break off and be transferred with the blood flow to any organs, causing their heart attack (death of part or all of the organ). When a blood clot enters the brain, a stroke occurs.

Surgical intervention (heart surgery) for coronary heart disease is aimed at restoring the normal nutrition of all parts of the heart. The degree of damage to the coronary arteries will depend on what kind of operation should be done. An analysis of the state of the vessels is carried out using coronary angiography - this is an X-ray contrast research method that allows you to determine the location, nature and degree of narrowing of the coronary artery. Most often, stenting of the coronary artery, which causes pain, is done. In the case of severe atherosclerotic lesions of the coronary vessels, the patient needs coronary artery bypass grafting.

Types of surgery for coronary heart disease

Angioplasty and stenting of the coronary arteries

Angioplasty and stenosis is aimed at removing obstructions to blood flow by expanding the artery from the inside.
The operation is carried out as follows: with the help of special equipment, a catheter is inserted through a puncture in the thigh area under the control of a fluorographic preparation into the artery that feeds the heart. It must reach the site of narrowing of the artery, where a special balloon is inflated with a stent - a device that does not allow the artery to subside. The stent remains in the artery, and the catheter is brought out through the same hole in the thigh.

Coronary artery bypass grafting (ACS)

Coronary artery bypass grafting - restoring the blood supply to the heart muscle by creating a new blood flow path around the affected area of the coronary vessel using shunts - pieces of arteries or veins taken from the patient himself (for example, in the limb area). This operation is aimed at preventing myocardial infarction. To date, CABG operations are performed both with the use of a heart-lung machine and on a beating heart (cardiac immobility is only in the operated area).
One of the types of coronary artery bypass surgery is mammary coronary artery bypass grafting (MCB). The internal mammary artery is used as a shunt. The use of this vessel is beneficial, since in this case no additional incisions are needed due to the close location of the thoracic artery and the heart, and also because atherosclerotic plaques do not form in the artery, and therefore, the service life of such a shunt is quite long.

Plastic surgery of postinfarction aneurysm of the left ventricle

The essence of the intervention is to reduce the volume of the left ventricle by delimiting the area of aneurysmal expansion and the healthy part of the left ventricle. The surgeon removes the blood clots that have arisen in the area of the aneurysm, then sews a septum made of dense elastic human tissue across the cavity of the left ventricle. Two cavities are formed: one with normal, actively contracting walls, the other - from scar tissue that is not able to contract, but does not interfere with the normal functioning of the heart. Thus, blood circulation is restored and the risk of a blood clot breaking off is eliminated.

Heart defects

Heart disease is called defects in the structure of the heart, which lead to disruption of normal blood circulation, there is stagnation of blood in the pulmonary or systemic circulation.
The following violations are distinguished:

- stenosis (narrowing) of the valvular apparatus;
With valve stenosis, it stops passing the required volume of blood through the reduced opening.
- insufficiency of the valvular apparatus;
The valve leaflets cannot close tightly and allow blood to pass in the direction opposite to normal blood flow.

-defects of the interventricular and interatrial septum;
With defects in these partitions, blood enters from a cavity with high pressure into a cavity with less pressure, and venous blood, poor in oxygen, mixes with oxygenated arterial blood, which leads to oxygen starvation of tissues.
Heart defects can be congenital or acquired. Most of them do not require surgery. Sometimes the disease proceeds unnoticed by the patient. Congenital heart disease can disappear with age, but if this does not happen and signs of heart failure increase, then surgery is required.

Treatment of heart defects is aimed at correcting the existing mechanical defect in the functioning of the heart.

There are the following types of surgical intervention:

Prosthetics and plastic heart valves

Operations to install prostheses are performed on the open heart, using a heart-lung machine.
Valve prostheses are mechanical and biological.

Mechanical valves

Mechanical valves are made of metal and plastic. The validity period of such prostheses is about 80 years. However, when using them, a person has to take anticoagulants daily, since blood clots are easily formed on the prostheses, which contribute to the formation of blood clots. In rare cases, a breakdown of a mechanical prosthesis is possible, which most often leads to the death of the patient. Mechanical valve prostheses can be in the form
- rotating disc
The disc completely covers the hole, but is fixed at one end only. Blood moving in the right direction presses on the disc, turns it on the hinge and opens the hole; when the blood moves back, the disc completely covers the hole.
- built on the principle of a ball in a grid
The blood flow in the right direction pushes the ball out of the hole, pressing it to the bottom of the mesh and thereby creating the possibility of further passage of blood; the reverse flow pushes the ball into the hole, which is thus closed and does not allow blood to pass through.

biological valves

Biological prostheses, usually made from animal heart tissue, are considered more efficient. After their installation, treatment with anticoagulants, which have many contraindications, is not necessary. Such a prosthesis works from 10 to 20 years, its aging occurs gradually and you can prepare in advance for its replacement in a planned manner. Of course, in this case, a second operation is needed.
Biological valves do not require mandatory anticoagulation (although it is often recommended), but wear out faster than mechanical valves.

Plastic defects of the interatrial and interventricular septum

If the structure of the septum is violated, with a small defect (the size of the hole is not more than 3 cm), it is sutured, and with a significant size, a plastic patch is performed (using synthetic tissues or autopericardium)

Heart rhythm disorder

Cardiac arrhythmias are violations of the sequence, rhythm and frequency of contractions of the heart. Arrhythmias can occur as a result of metabolic disorders, for example, endocrine and autonomic, or the effects of certain drugs. They are also often caused by heart disease, and sometimes - intoxication.
The danger of arrhythmia is that it can lead to ventricular fibrillation (scattered contraction of fibers).
For the treatment of arrhythmias, drugs, catheter ablation, or a pacemaker (pacemaker) are implanted.

Surgical methods for the treatment of arrhythmias:

RF ablation

This is a minimally invasive surgical method that is used for:
- high heart rate with a pronounced pulse deficit;
- atrial fibrillation;
- progressive heart failure;
- supraventricular tachycardia.

The method of radiofrequency ablation consists in passing a special catheter to the area of the heart that causes an abnormal pathological rhythm. An electrical impulse is applied to this department, which destroys the tissue site that sets the wrong rhythm.
Ablation restores normal heart rhythm.

Pacemaker implantation

The operation is done in patients with heart rhythm disturbances that threaten life. The pacemaker aims to control and restore the normal contraction of the heart.
Doctors implant a special device under the skin or under the pectoral muscle. Two or three electrodes depart from the pacemaker, which are connected to the chambers of the heart to transmit an electrical impulse to them.

Defibrillator implantation

The principle of operation of a defibrillator is similar to a pacemaker. Its distinctive feature is the elimination of too fast and too slow heart rate. The heart rate is assessed using electrodes. Installing a defibrillator is similar to installing a pacemaker.

Installing a defibrillator is indicated for ventricular tachycardia.

Heart transplant

In critical cases, when the heart cannot perform its function and does not respond to any treatment, they resort to a heart transplant. Thanks to this operation, doctors prolong the life of the patient for a period of about 5 years. Research is currently underway to extend the life of people who have undergone heart transplants.

Postoperative recovery period

An important stage of recovery after surgery is the period of postoperative recovery. Strict monitoring of human health is necessary. This period is different and individual for each patient. Patients are prescribed special cardio training, diets. Emotional calm is needed.

Heart surgeries are dangerous due to their complications. The main signs of complications are fever, pain in the operated area, tachycardia, drop in blood pressure, shortness of breath. The ECG shows characteristic changes. The recovery period lasts six months - a year.

An example of monitoring the health of postoperative patients is the work of the doctor of medical sciences, professor, arrhythmologist Andrey Vyacheslavovich Ardashev. He does over 200 surgeries a year. Postoperative monitoring of patients began in 2011 with the help of the project. The doctor controls both the conclusion of the cardiovisor and the ECG itself in postoperative patients. Using the site service helps to monitor the recovery of the health of operated people via the Internet. This is a huge plus, since a large number of patients come to Moscow from all over Russia in order to have heart surgery. They pass the postoperative period already at home. Using the Cardiovisor allows you to take ECG readings at home and send them to the doctor using the site.

Rostislav Zhadeiko, especially for the project .

The operation on the heart, which at one time was compared with the first manned flight into space, is exactly 50 years old. It is very pleasant that our surgeon Vasily Kolesov conceived and executed it. Now it is one of the most common procedures in the world to prevent a heart attack and bears the name of its developer.

"The Soviet surgeon dared to raise his hand on his heart" - in 1964 this news outraged the entire world medical community. No one believed that coronary heart disease could be treated with surgery. Numerous experiments on animals ended unsuccessfully. But Vasily Ivanovich Kolesov, a professor at the Leningrad Medical University, proves that operating on a healthy heart in dogs and a diseased heart in humans is not the same thing, and he decides on a bold experiment.

Stanislav Pudyakov then assisted the surgeon. He recalls: a 44-year-old patient was tormented by severe pain in the region of the heart.

“His idea, if compared historically, is similar to the thoughts of Tsiolkovsky, who said that tomorrow we will be on the moon. They didn’t believe him until they really flew. And until Vasily Ivanovich did this first operation, no one believed in it” - says Stanislav Pudyakov.

The surgeon operated on a beating heart, which was also hard to believe. No one had done this before Kolesov, neither in our country nor in the world. Moreover, the doctor literally felt the sore spot with his hands. The equipment for diagnosing heart diseases simply did not exist then.

To restore the normal blood supply to the heart, Kolesov singled out the internal thoracic artery and sewed it to the coronary artery below the narrowing caused by the so-called atherosclerotic plaque. The blood flow went around, the patient was saved from a heart attack.

After the operation, people quickly returned to normal life and forgot about the pills forever. About operations that saved people from heart attacks and pains in the heart, they started talking abroad as a sensation. American magazines wrote about Kolesov: "Pioneer of coronary surgery."

“There were confessions among colleagues, among foreigners. A lot of Americans, Germans, French came, they looked at these operations with great curiosity and really wanted to continue what was started here,” says surgeon Alexander Nemkov.

Vasily Kolesov immediately warned: it would not be easy for young surgeons to repeat this. From now on, operations must be performed on a stopped heart. The advice was regarded as a guide to action. In 1967, American surgeons put them on stream.

The method of treatment of coronary heart disease, proposed by Vasily Ivanovich Kolesov, is considered the most effective after 50 years. Operations are performed by the best cardiac surgeons in clinics around the world. This is aerobatics, because, in fact, doctors must restart the main human organ.

“Speaking specifically about the operation of Vasily Ivanovich Kolesov, it is now being performed widely on a beating heart. What he did is incredible. The range of suture material that we use has changed, the needle holders that we use have changed incredibly. We use special magnifying lenses and we see this artery magnificently, which can be a millimeter, a millimeter and a half,” says surgeon Leo Bokeria.

Like half a century ago, coronary heart disease is the most common disease in the world. Now we can say with confidence that doctors have learned to deal with it. Thanks to the revolutionary method of Vasily Kolesov, even the most difficult patients can be saved.

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 given. 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 operations

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

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.

Relaxation

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.