All heart surgeries. Open heart surgery, stages and recovery period. 25 Cardiac arrest

But now, the diagnosis has been made and the doctors understand what needs to be done next. I would like you to understand well by this moment, what will be discussed when they will explain everything in detail to you, what was found during the examination, what diagnosis was made, what needs to be done and when to choose the best way of treatment.

Here and now the main questions are being decided, and you must exactly imagine what you want to know before you make a decision on which a lot depends.

There are several options for conversation.

You will be offered operation, as the only way out, and doctors believe that it needs to be done urgently.
You are offered an operation, but they say that it can be postponed for a while.
You are denied an operation for a variety of reasons.

You need to understand what is being said and prepare for the conversation. Try to be calm and confident in yourself and in the doctors who want to help you. You must be together, on the same side, in the fight for the future of the child. Discuss everything, but your questions should be literate. Believe me, a lot depends on this too.

What do you need to know about in order to ask the right question? What are the operations? What should the child do? How will it all be? Who will do it? Let's talk about it calmly.

Today, all interventions, or operations, for congenital heart defects can be divided into three categories: "closed" operations, "open" and "X-ray surgery".

✔ Closed Operations These are surgical interventions in which the heart itself is not affected. They are performed outside of it, and therefore do not require the use of any special equipment other than conventional surgical instruments. The cavities of the heart are not “opened” with them, which is why they are called “closed”, and they are widely performed as the first stage of surgical intervention.

✔ Open Operations- These are surgical interventions in which it is necessary to open the cavities of the heart in order to eliminate the existing defect. For this, a special apparatus is used - a heart-lung machine (AIC), or "heart-lungs". For the period of the operation, both the heart and the lungs are switched off from the circulation, and the surgeon gets the opportunity to perform any operation on the so-called "dry", stopped heart.

All the patient's venous blood is sent to the apparatus, where, passing through an oxygenator (artificial lung), it is saturated with oxygen and gives off carbon dioxide, turning into arterial. Then the arterial blood is pumped into the patient's aorta by a pump, i.e. into the systemic circulation. Modern technologies allow all the internal parts of the device (including the oxygenator), with which the patient's blood comes into contact, to be made "disposable", i.e. use them only once and only for one patient. This dramatically reduces the number of possible complications.

Today, thanks to AIC, it is possible without much risk to turn off the heart and lungs from work for several hours (and the surgeon has the opportunity to operate on the most complex defects).

✔ X-ray surgery appeared relatively recently, but, thanks to the incredible progress of modern technologies, they have already taken their rightful place in the arsenal of cardiac surgery. More and more doctors are now using thin catheters, the ends of which are fitted with balloons, patches, or expandable tubes (folded like a folding umbrella). With the help of a catheter, these devices are carried into the cavity of the heart, or into the lumen of the vessel, and then, expanding the balloon, break the narrowed valve with pressure, increase or create a defect in the septum, or, conversely, by opening the patch umbrella, this defect is closed. The tubes are inserted into the lumen of the desired vessel and create a wider lumen. In adults, they even try to pass an artificial aortic valve through the catheter in this way, but so far these are only attempts. Doctors monitor the course of an X-ray surgical operation on the monitor screen and clearly control all manipulations with the probe, and therefore the advantage of such operations is not only less trauma, but also high safety and efficiency. X-ray surgery has not yet supplanted traditional surgical methods, but it is gaining more and more space both as an independent method and as an “auxiliary”, i.e. which can be applied not instead of, but together with the usual operation, sometimes simplifying and supplementing it in many ways.

Depending on the type of defect and the condition of the child, surgical operations can be emergency, urgent and elective, i.e. planned.

emergency heart surgery are the ones that should be done immediately after the diagnosis is made, because any delay threatens the life of the child. With congenital malformations, such situations are not uncommon, especially when it comes to newborns. Here the question of life is often decided by hours and minutes.

Emergency operations- those for whom there is no such insane urgency. The operation does not need to be done right now, but you can calmly wait a few days, prepare both you and the child, but it must be done urgently, because then it may be too late.

Planned, or elective, operation- this is an intervention made at the time chosen by you and the surgeons, when the child's condition does not inspire fear, but the operation, nevertheless, should not be postponed.

No cardiac surgeon will ever suggest surgery if it can be avoided. So, anyway, it should be.

Depending on the approach to surgical treatment, radical and palliative operations are distinguished.

✔ Radical heart surgery is a correction that completely eliminates the defect. It can be done with an open ductus arteriosus, septal defects, complete transposition of the main vessels, abnormal pulmonary vein drainage, atrioventricular communication, Fallot's tetrad and some other defects, in which the heart is fully formed, and the surgeon has the opportunity to completely separate the circulatory circles, while maintaining normal anatomical relationships. Those. the atria will connect to their ventricles through correctly positioned valves, and the corresponding great vessels will depart from the ventricles.

✔ Palliative heart surgery- auxiliary, “facilitating”, aimed at normalizing or improving blood circulation and preparing the vascular bed for radical correction. Palliative operations do not eliminate the disease itself, but significantly improve the child's condition. With some very complex defects, which until recently were generally inoperable, the child will have one, and sometimes two palliative operations, before the final radical stage becomes possible.

During a palliative operation, another "defect" is surgically created, which the child does not initially have, but due to which the circulatory pathways disturbed by the defect in the large and small circles are changed. These include surgical expansion of the atrial septal defect, all variants of intervascular anastomoses - i.e. additional shunts, messages between circles. The Fontan operation is the most “radical” of all such methods, after which a person lives without a right ventricle at all. With some of the most complex heart defects, it is impossible to correct the anatomically, and surgical treatment aimed at correcting blood flow can be called the “final” palliative correction, but by no means a radical operation.

In other words, with heart defects, when the intracardiac anatomy - the structure of the ventricles, the condition of the atrioventricular valves, the location of the aorta and the pulmonary trunk - are so changed that they do not allow for a real radical correction, today's surgery follows the path of eliminating poorly compatible with life of circulatory disorders, and then - long-term palliation. The first stage of this path is saving lives and preparing for further treatment, and protection from future complications, the second is the final stage of treatment. All together - this is a long way to the final operation, and on it one, two, and sometimes three steps must be overcome, but, ultimately, to make the child healthy enough for him to develop, learn, lead a normal life, which this long-term palliation will provide him. Check it out, not so long ago - 20-25 years ago it was simply impossible, and children born with the defects of this group were doomed to death.

Such a “final palliation” is the only way out in many cases; although it does not correct the defect itself, it provides the child with an almost normal life by improving the mixing of arterial and venous blood flows, the complete separation of circles, and the elimination of obstructions to blood flow.

Obviously, the very concept of radical and palliative treatment for some complex congenital heart defects is largely arbitrary, and the boundaries are erased.

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.

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.

Tuesday is surgery day. The team is preparing for a long morning work. During the operation, the chest is opened and the heart is prepared for vessel transplantation.

Disease history

Mr. Thomas, a 59-year-old tanker driver, is married with two adult children. He had shingles on the right side of his neck, followed by an uncomfortable constriction in his throat, accompanied by sweating and nausea. He first felt these symptoms while walking up the steps of his truck. They continued, and Thomas decided to seek the advice of a therapist.

Thomas's high blood pressure, obesity, and long history of smoking were reason enough for an ECG. Her results showed the presence of coronary heart disease. Thomas was referred to a cardiac expert (a cardiac internist, not a surgeon). Despite the applied medical treatment, the pain continued.

Tests confirmed the presence of the disease, in particular an angiogram (a test using a dye injected into the artery to detect narrowing) revealed a narrowing in the left main coronary artery with damage to the left and right vessels. Since medical treatment was unsuccessful and angioplasty (stretching a narrowed vessel using a catheter) was not an option, Mr. Thomas was referred for surgery.

Monday

Mr. Thomas is hospitalized. His anamnesis, data of examinations and tests were analyzed. Two units of blood for transfusion are tested for compatibility. The patient is explained the essence of the operation and warned about the risk associated with it. Obtain written consent for CABG.

Tuesday

Early in the morning, Mr. Thomas is being prepared for the operation.

7:05 Premedication and anesthesia

8:15 a.m. Mr. Thomas was sedated 70 minutes ago and a ventilation tube has already been placed in his airway. After the application of anesthesia and paralyzing agents, his breathing is supported by a ventilator. Prior to transferring Mr. Thomas to the operating room, the anesthesiologist establishes monitoring of venous and arterial blood flow.

8:16 OR Mr. Thomas is set up. On the left - a table with instruments, on the right - a ready-to-use heart-lung apparatus.

8:25 Patient in the operating room. The skin of his chest and legs are treated with an antiseptic solution to reduce the risk of infection.

8:40 Opening of the chest

The skin has already been processed, the patient is dressed in sterile clothes. One of the surgeons makes an incision in the leg to extract the vein, and the second cuts the skin on the chest. After a preliminary incision with an ordinary scalpel, he uses an electric one, which cuts the vessels, stopping the bleeding.

8:48 The surgeon cuts the sternum bone with an electric saw with a pneumatic drive.

8:55 Artery and vein removal

View of the internal thoracic (mammary) artery in the mirror in the center of the surgical lamp. This artery is very elastic. The top end of it will remain in place, it will be cut off at the bottom and then connected to the coronary artery.

An angled retractor is placed along the left edge of the sternum to lift it and expose the mammary artery that runs along the inside of the chest.

At the same time, one of the main veins on the leg - the great saphenous vein - is prepared for transplantation. It is almost completely removed from the left thigh.

9:05 Connecting to the heart-lung machine

The heart-lung machine is not yet connected to the patient. One of the five rotating pumps circulates the blood, while the rest are used as side pumps to transport separated blood to prevent blood loss during surgery. The patient needs to enter heparin - a means to thin the blood and prevent the formation of clots during its passage through plastic tubes.

Tubes to the heart-lung apparatus. On the left, with bright red blood, is the arterial return line, which carries blood back into the patient's aorta. On the right - two tubes that drain blood from the inferior and superior vena cava under the influence of gravity. The incision in the sternum is fixed with a spacer.

Part of the heart-lung apparatus is a membrane oxygenating device that maintains blood circulation in the patient's body. At the moment, the device is filled with blood, carbon dioxide is removed from it. The blood is re-oxygenated and returned to the patient's body.

An arterial return tube is inserted into the aorta (the main artery of the body) and two venous drains are inserted into the vena cava (the main vein of the body).

9:25 Cardiac arrest

On the main artery - the aorta - a clamp is placed to isolate the heart from artificial blood circulation. Chilled fluid is injected into the isolated aorta to stop the heart. The surgeon puts on special glasses for microsurgery with loupes that give a magnification of 2.5 times. The blood vessels he will transplant are 2-3 mm in diameter, and the sutures are the diameter of a human hair.

A thorough examination of the heart is carried out to confirm the data obtained using the angiogram. It is specified which coronary arteries need to be bypassed. It was decided to make two shunts.

After stopping the blood flow in the left anterior descending artery, a 1 cm long incision is made at the bypass site using a surgical loop.

10:00 First bypass

Close-up of the heart. The left internal mammary (mammary) artery - in the upper left corner - is sutured to the left anterior descending artery so that blood flow to the heart is restored. Arteries are hidden by epicardial fat.

The end of the left internal mammary artery is sutured laterally to the left anterior descending artery. This forms the first bypass shunt.

The position of the first performed shunt. The end of the lower part of the left internal mammary artery - a blood vessel with a diameter of 3 mm - is completely sutured to the left anterior descending artery.

10:22 Second bypass

The second bypass shunt is sutured with the upper end to the aorta, and with the lower end to the right posterior descending artery. The transverse clamp is removed, blood flow through the heart is restored.

The upper end of the venous shunt is connected to the aorta. Part of the aorta is isolated with an arcuate clamp and a hole is made into which a vein is sutured.

End of both bypass processes. The second shunt, shown on the left side of the diagram, is formed from the saphenous vein of the leg.

11:18 Chest closure

Circulation is restored, the heart contracts after an electric shock with the transition from ventricular fibrillation to sinus mode. Two drains are installed in the anterior and posterior parts of the heart. The blood thinning effect of heparin was eliminated by the drug protamine. The surgeon sews the separated halves of the sternum together. The skin will be closed with an internal absorbable suture.

The nurse applies tape to the suture and to the drainage tubes leading from the patient's chest. Soon the patient will be placed in the intensive care unit, where he will be observed.

The human body. Outside and inside. №1 2008

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.