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heart disease overview > Tests & Treatments >

Open-Heart Surgery 101

By Doug Donaldson

Your guide to open-heart surgery-what to expect in and out of the hospital.

When surgeons dive deep within us to fix ailing atrial muscles or to patch leaky heart valves, it’s just a few shades short of miraculous. Cardiologists can swap valves, rewire electrical circuits, and create new blood flow patterns during open-heart surgery. The doctor literally holds the patient’s heart—and life—in his hands.
Such surgery may be more common than you think. In 2004, about 646,000 open-heart procedures occurred in the United States, according to the American Heart Association. The vast majority of those were bypass operations, in which a surgeon reroutes blood around blocked arteries.
Is such a surgery in your future? If so, what will happen before, during, and after the procedure? Tomislav Mihaljevic, M.D., a heart surgeon for the Cleveland Clinic, guides us through open-heart surgery and recovery.

Who is a candidate for open-heart surgery?
Open-heart surgery is usually seen as the last, sometimes drastic, step to addressing heart disease if a patient’s heart condition can’t be controlled with medication or more minor surgery. Open-heart surgery is most commonly performed on patients with blocked heart vessels or patients who have malfunctioning or inappropriately functioning heart valves. The critical questions that determine whether someone needs open-heart surgery are: Are the blood vessels to the heart blocked? Is there damage to the heart valves?
“If there are severe blockages, such as more than 70 percent on every blood vessel, then the patient is best served by having open-heart surgery,” Mihaljevic says.

Along with addressing blockages, open-heart surgery can be used to replace and repair heart valves. Some diseases cause leakage of the heart’s mitral valve, often in patients who are 40 to 60 years old. Such leakages are discovered by physicians who hear heart murmurs. Another procedure that often requires open-heart surgery is aortic valve replacement, common in older patients.


Continued on Page2: Surgery Specifics
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