Main types of cardiac surgery. Open heart surgery Lung heart surgery

Replacement heart valve
- Possible complications and care recommendations

Heart operations are performed only when necessary. The most common of these are heart valve replacement and coronary artery bypass grafting. The first is necessary if the patient is concerned about heart valve stenosis. It should be noted that heart operations pose a serious risk to the patient’s life; they are performed with maximum precision and care. Heart surgery sometimes leads to numerous problems and complications; to avoid this, you can use an alternative technique - valvuloplasty.

The procedure can replace replacement surgery and help normalize the activity of the heart muscles. During the process, a special balloon is inserted into the opening of the aortic valve, and at the end this balloon is inflated. It is worth considering: if a person is elderly, valvuloplasty does not have a long-term effect.

Heart Valve Replacement

To decide on such a procedure, it is necessary to establish a diagnosis.

The operation is carried out immediately or some time after the tests are completed.

In some situations, the results indicate that a person needs bypass surgery. Valve replacement is an open procedure that can be performed using minimally invasive surgery. It should be remembered that replacing a heart valve is a very complex procedure, despite this, it is performed very often.

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Stages of the procedure and further rehabilitation

First you need to open chest. Next, the doctor connects the patient to a special machine that provides artificial blood circulation. The device temporarily replaces the heart. The patient’s circulatory system is connected to the device, after which the natural valve is removed and replaced. When this manipulation is completed, the device is turned off. In most cases, heart surgery goes well, but a scar forms on the organ.

After recovery from the anesthesia state, the breathing tube is removed from the lungs. If you need to remove excess liquid, such a tube should be left for a while. After 24 hours, you are allowed to drink water and liquids; you can walk only after two days. After such an operation, pain in the chest area may be noticeable, and on the fifth day the patient is completely discharged. If there is a risk of complications, the hospital stay must be extended by 6 days.

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Can there be complications after valve replacement?

A person may encounter such problems different stages diseases. There is a risk during the operation heavy bleeding In addition, difficulties with anesthesia may arise. TO possible factors risk should be attributed internal bleeding, seizures, possible infections. A heart attack can also happen, but this is very rare. As for the greatest danger, it lies in the appearance of tamponade of the pericardial cavity. This phenomenon occurs when blood fills its cardiac sac. This causes serious disruptions in the functioning of the heart. Heart operations cannot but affect a person’s general condition. During the rehabilitation period, strict medical supervision is required. The need to visit a surgeon arises 3-4 weeks after the operation. It is important to support general health sick. The optimal dose of physical activity should be prescribed, and it is important to adhere to the diet.

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What is coronary artery bypass grafting?

Coronary artery bypass grafting is a type of surgery that restores blood flow in the arteries. The procedure is necessary to eliminate coronary disease hearts. The disease manifests itself when the lumen coronary vessels narrows, resulting in insufficient oxygen reaching the heart muscle. Coronary artery bypass surgery aims to prevent changes in the myocardium (heart muscle). After surgery, it should recover completely and contract better. It is necessary to restore the affected area of the muscle; for this, the following procedure is performed: everyday shunts are placed between the aorta and the coronary vessel that is affected. In this way, new ones are formed coronary arteries. They are designed to replace narrowed ones. After a shunt is placed, blood from the aorta flows through a healthy vessel, thanks to which the heart produces normal blood flow.

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Why is surgery necessary?

This procedure will be required if the left coronary artery of the vessel that provides flow to the heart is damaged. It is also needed if all coronary vessels are damaged. The procedure can be double, triple, single - it all depends on how many shunts the doctor needs. With coronary heart disease, a patient may need one shunt, in some cases two or three. Bypass surgery is a procedure that is often used for atherosclerosis of the heart vessels. This occurs when angioplasty cannot be performed. As a rule, the shunt can serve for a long time, its functional suitability is 12-14 years.

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Carrying out coronary artery bypass grafting

The duration of the operation is 3-4 hours. The procedure requires maximum concentration and attention. The doctor needs to gain access to the heart, this requires cutting soft fabrics, then open the sternum and perform a stenotomy. During the operation, a procedure is performed that is necessary for temporary, it is called cardioplegia. The heart needs to be cooled down very much cold water, then inject a special solution into the arteries. To attach the shunts, the aorta must be temporarily blocked. To do this, you need to clamp it and connect the heart-lung machine for 90 minutes. Plastic tubes should be placed in the right atrium. Next, the doctor carries out procedures that promote the flow of blood into the body.

What is conventional vascular bypass surgery? This method involves the implantation of special implants into the coronary vessels beyond the blockage, the end of the shunt is sutured to the aorta. To be able to use the internal mammary arteries, the procedure must take more time. This is due to the need to separate the arteries from the chest walls. At the end of the operation, the doctor carefully fastens the chest together using a special wire. With its help, the soft tissue incision is sutured, then drainage tubes are applied to remove residual blood.

Sometimes bleeding occurs after surgery and continues throughout the day. Installed drainage tubes should be removed 12-17 hours after the procedure. Upon completion of the operation, you must delete breathing tube. On the second day, the patient can get out of bed and move around. Heart rate recovery occurs in 25% of patients. As a rule, it lasts for five days. Regarding arrhythmia, this disease can be eliminated within 30 days after surgery, for this purpose they are used conservative methods therapy.

Operations on the heart and blood vessels are performed by such a field of medicine as cardiac surgery.

With the help of cardiac surgeons, many vascular and heart diseases can be effectively treated, thereby significantly prolonging the patient’s life.

Surgeries on the heart and blood vessels can significantly improve the general well-being of the patient.

They should be performed only after careful diagnosis and preparation of the patient.

It is very important to strictly follow all instructions from the specialist.

Regardless of what kind of disease was identified in a person, there are the following general indications for performing operations on the heart and blood vessels:

Rapid deterioration of the patient's condition and progression of the underlying heart or vascular disease.
Lack of positive dynamics from the use of traditional drug therapy, that is, when taking pills no longer helps a person maintain his condition normally.
The presence of acute signs of worsening of the underlying myocardial disease that cannot be eliminated with conventional analgesics or antispasmodics.
Neglect of the underlying disease, in which the patient delayed contacting a doctor, which led to very severe symptoms of the disease.

These procedures are indicated for patients with heart defects (regardless of whether they are congenital or acquired). Moreover, thanks to current techniques this disease can be treated even in newborns, thereby ensuring them a further healthy life.

Following frequent indication- this is myocardial ischemia. In this case, surgery may be required when the underlying disease is aggravated by a heart attack. In this condition, the sooner it is carried out surgical intervention, the greater the chance that a person will survive.

A significant indication for the need for surgical intervention may be acute heart failure, which provokes improper contraction of the myocardial ventricles. It is important that the patient prepares for surgery in advance (to avoid postoperative complications in the form of a blood clot).

Often surgical intervention is required for myocardial valve defect, which was caused by injury or inflammatory process. Less commonly, other reasons contribute to its appearance.

A serious reason for urgent surgical intervention is the diagnosis of narrowing of the coronary artery valve, as well as endocarditis of infectious origin.

Additional diseases for which a person may require myocardial surgery are:

Severe aortic aneurysm, which may occur due to trauma or be congenital.
Rupture of a ventricle of the heart, which disrupts blood flow.
Various types of arrhythmia that can be eliminated by introducing or replacing an already installed pacemaker. They are commonly used for atrial fibrillation and bradycardia.
Diagnosis of an obstruction in the myocardium in the form of tamponade, due to which the heart cannot normally pump the required volume of blood. arise this state maybe under influence viral infections, acute tuberculosis and heart attack.
Acute failure left ventricles of the myocardium.

Heart surgery is not always necessary for the indications described above. Each case is individual and only the attending physician can decide what will be best for a particular patient - traditional therapy medications or planned (urgent) surgery.

In addition, it should be noted that heart surgery may be required in case of exacerbation of the underlying disease, as well as if the first surgical intervention did not produce the expected results. In this case, the patient may require repeated manipulation. Its cost and preparation features (diet, medications) depend on the complexity of the operation.

Surgical interventions can be practiced both on open and closed myocardium, when the heart and its cavity are not completely affected. The first type of operation involves dissecting the chest and connecting the patient to artificial respiration equipment.

During operations open type surgeons artificially stop the heart for a while, so that they can perform the necessary surgical procedures on the organ within a few hours. These interventions are considered very dangerous and traumatic, but with their help even very complex myocardial diseases can be eliminated.

Closed operations are safer. They are usually used to correct minor heart and vascular defects.

The following are the most common types of myocardial operations, which are most often practiced in cardiac surgery:

Installation of artificial valves.
Operations using the Glenn and Ross method.
Coronary artery bypass grafting and arterial stenting.
Radiofrequency ablation.

An operation called radiofrequency ablation is a low-traumatic procedure that can achieve significant improvements in heart failure and various types of arrhythmia. She rarely calls side effects and is well tolerated by patients.

RA is done using special catheters, which are inserted under X-ray control. In this case, the patient is given local anesthesia. During this operation, a catheter is inserted into the organ and, thanks to electrical impulses, the person's normal heart rhythm is restored.

The next type of surgery is heart valve replacement. This intervention is very often practiced, since such pathology as myocardial valve insufficiency is extremely common.

It should be noted that in the event of a severe disturbance in the patient’s heart rhythm, he may require the installation of a special device - a pacemaker. It is needed to normalize the heart rhythm.

When replacing heart valves, the following types of implants can be used:

Mechanical prostheses, which are made of metal or plastic. They serve for a very long time (several decades), but require a person to constantly take medications to thin the blood, since due to the introduction of a foreign object in the body, a tendency to form blood clots actively develops.
Biological implants are made from animal tissue. They are very durable and do not require special medications. Despite this, patients often require repeat surgery after a couple of decades.

Glenn and Ross operations are usually used to treat children with congenital myocardial defects. The essence of these interventions is to create a special connection for the pulmonary artery. After this operation, the child can live a long time, with virtually no need for maintenance therapy.

During the Ross operation, the patient's diseased myocardial valve is replaced with a healthy one, which will be removed from his own pulmonary valve.

Cardiac bypass surgery: indications and performance

Coronary artery bypass surgery is a surgical intervention on the heart, during which an additional vessel is sewn in to restore the impaired blood supply in blocked blood arteries.

Cardiac bypass surgery is practiced when the patient’s narrowed vessels are no longer amenable to drug treatment and blood cannot circulate normally in the heart, causing ischemic attacks.

A direct indication for cardiac bypass surgery is acute coronary aortic stenosis. Most often it develops launched form atherosclerosis, which contributes to the clogging of blood vessels cholesterol plaques.

Due to vasoconstriction, blood cannot circulate normally and deliver oxygen to myocardial cells. This leads to its defeat and the risk of a heart attack.

Today, cardiac bypass surgery can be performed both on a beating heart and on an artificially stopped one. It is worth noting that if bypass surgery is performed on a working myocardium, then the likelihood of developing postoperative complications is much higher than when performing the procedure on a stopped myocardium.

The procedure involves blocking the main aorta and implanting artificial vessels into the affected coronary arteries. Usually a vessel in the leg is used for bypass surgery. It is used as a biological implant.

Contraindications to this surgical intervention may be an existing pacemaker or artificial valve in the heart, the functions of which may be impaired during such an operation. In general, the need for bypass surgery is determined individually by the doctor for each individual patient, based on the diagnostic data and symptoms of the patient.

After bypass surgery, the recovery period is usually quick, especially if the patient has no complications after the procedure. The patient must remain in bed for a week after surgery. Until the stitches are removed, the person needs to dress the wound daily.

After ten days, a person can get out of bed and begin to perform simple physical therapy movements to restore the body.

After the wound has completely healed, the patient is recommended to swim and regularly walk in the fresh air.

It should be noted that the wound after bypass surgery is stitched not with threads, but with special metal staples. This is justified by the fact that the dissection occurs on a large bone, so it needs to heal as carefully as possible and ensure rest.

To make it easier for a person to move after surgery, he is allowed to use special medical support bandages. They have the appearance of a corset and provide excellent seam support.

After surgery, due to blood loss, a person may experience anemia, which will be accompanied by weakness and dizziness. To eliminate this condition, the patient is recommended to eat properly and enrich his diet with beets, nuts, apples and other fruits.

To reduce the likelihood of re-narrowing of blood vessels, you need to completely exclude alcohol, fatty and fried foods from the menu.

Cardiac stenting surgery: indications and features

Arterial stenting is a low-traumatic angioplasty procedure that involves placing a stent into the lumen of the affected vessels.

The stent itself is similar to a regular spring. It is introduced into the vessel after it has been artificially dilated.

Indications for cardiac stenting surgery are:

IHD (coronary heart disease), which leads to poor circulation and oxygen starvation myocardium.
Myocardial infarction.
Clogging of blood vessels with cholesterol plaques, which lead to narrowing of their lumen.

Additional contraindications to this procedure are the patient’s individual intolerance to iodine, which is invariably used during stenting, as well as the case when the total size of the diseased artery is less than 2.5 mm (in this case, the surgeon simply will not be able to install a stent).

The operation of stenting the heart vessels is performed by introducing a special balloon, which will expand the lumen of the diseased vessel. Next, a filter is installed in this place, which prevents subsequent blood clots and stroke.

After this, a stent is introduced into the vessel; it will support the vessel from narrowing, serving as a certain frame.

The surgeon monitors the entire progress of the operation through a monitor. In this case, he will be able to clearly see the stent and the vessel, since at the beginning of the procedure the patient is injected with an iodine solution, which will highlight all the surgeon’s actions.

The advantage of stenting is that this operation has a low risk of complications. Moreover, it is carried out under local anesthesia and does not require a long period of hospitalization.

After stenting, the patient must remain in bed for a certain period of time (usually for a week). After this, if there are no complications, the person is allowed to go home.

It is very important after this operation to regularly engage in physical therapy and exercises. At the same time, it is worth monitoring your condition and avoiding physical fatigue.

Every two weeks after the procedure, the patient must visit the doctor and undergo a follow-up examination. If pain occurs, a person should immediately report it to the doctor.

To recover faster, the patient should take all medications prescribed by the doctor. Sometimes drug therapy lasts a long time, more than one month in a row.

After stenting, the patient must follow a diet.

It provides the following:

Complete cessation of drinking alcohol and smoking.
Ban on all animal fats. You should also not eat caviar, chocolate, fatty meat and sweet confectionery.
The basis of the diet should be vegetable soups, fruit mousses, cereals and greens.
You need to eat at least six times a day, but the portions should not be large.
You should completely limit your intake of salt and salted fish.
It is important to drink plenty of fluids to maintain normal water balance in organism. It is recommended to drink fruit compotes, juices and green tea. You can also use rosehip decoction.

In addition, a person needs to control his arterial pressure and blood sugar levels. This is especially important in the presence of existing hypertension and diabetes mellitus, because these diseases can worsen the functioning of the heart.

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 unfavorable outcome remains quite large.

Despite the fact that cardiac surgery does not stand still and is developing, heart surgery is very difficult to perform. They are doing her the best specialists cardiac surgery. But even this important fact cannot protect the operated patient from complex consequences.

Complications in 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 procedure. The operation is carried out under the strict supervision of highly qualified specialists.

Indications for cardiac surgery of any complexity are as follows:

rapid development of illnesses of cardio-vascular system;
in case of lack of results with drug treatment;
late contact with a medical facility.

Heart surgery helps improve general state patient and eliminate the symptoms of the painful disease.

Abdominal heart surgery is performed only after complete diagnostic study and making an accurate diagnosis by a cardio specialist.

Methods of surgical interventions

What types of heart surgeries are there?

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

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

Closed interventions

This is a heart operation that does not affect the organ itself. It is performed without touching the heart. To carry it out, there is no need for special equipment other than surgeon's instruments.

The heart cavity does not “open”. This is why it is called “closed”.

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

Open interventions

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

Open heart surgeries are performed using a special device - heart-lung or heart-lung equipment.

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

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

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

Today, a heart-lung machine helps stop the functioning of the heart organ and lungs for several hours. Thus allowing the most difficult open operations to be carried out.

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.

Using a special catheter, surgical instruments are inserted into a strip section of the heart organ or into the opening of a vessel. Next, using the pressure created by the device, the valves of the cavity incisions are opened. They enhance or distort the partitions, or vice versa, using a device to eliminate the distortion.

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

The process of such operations is carefully monitored by a special computer and every action is monitored. Thanks to this, operations are performed with a lower risk of injury and a greater likelihood of a favorable outcome.

If you have undergone X-ray surgery, it is more effective.

Action plan before surgery

Before surgery cardiac organ preparation is required. If you have enough time, at least a few days or weeks, you need to take care of your body. Eat healthy, rich useful elements food.

Get plenty of rest, walk in the fresh air, do physical exercise, which was recommended to you by your treating specialist.

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 a large number of proteins, vitamins and minerals.

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

Rest

Don't overwork your body before surgery. The more you rest, the stronger and stronger your body will become.

If your loved ones want to visit you or invite you to visit, say that you need to gain strength before complex process. Your family will always understand you and will not be offended.

Nicotine use

It has long been no secret to everyone that smoking has a negative effect even on 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 causes the heart vessels to strain. It also narrows the 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 surgery on a cardiac organ, if not enough time has passed, it is forbidden to even get out of the ward bed. During the entire rehabilitation period, the patient is in the intensive care unit.

This department is intended for patients who are at risk of death.

Specialists play a huge role in rehabilitation dietary ration. The treating specialist prescribes it individually for each patient. You can start eating only with lean porridges 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:

coarse porridge (barley, barley, unpolished rice). You can also include in your diet oatmeal 2-3 times a week;
dairy production: low-fat curd mass, cheese with a fat content of no more than 20%;
vegetable and fruit crops: 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 are free of fried ingredients and contain no fat.

Under no circumstances should you use following products nutrition.

This kind of surgical manipulation falls within the competence of cardiac surgeons, and is one of the most complex in nature. Heart operations are last resort treatment of serious cardiovascular diseases, which are used to improve the patient’s quality of life, 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 evolving, which allows 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 blood supply to the myocardium. This condition is called coronary heart disease in medical circles. IHD can lead to the formation of an aneurysm and extensive thrombus formation. For all the described ailments, certain surgical procedures on the heart may be required.
Heart defects, which have both congenital and acquired nature. Many defects in the structure of the heart valve are incompatible with life. Therefore, such pathologies are diagnosed in the prenatal period, and the operation itself is performed in the first days of the baby’s life.
Disturbances in the frequency, sequence and rhythm of heart contraction, - arrhythmias.

The following pathological conditions are general indications for heart surgery:

Active deterioration 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 fails to seek qualified help in a timely manner.

It is also necessary to take into account that any surgical manipulation of the heart carries a risk and is fraught with the development of a number of exacerbations in 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 in question is:

Emergency. In such a situation, examination and preparation are carried out to a minimum extent, and the operation itself is carried out in as soon as possible. This type of manipulation is prescribed for life-threatening conditions, when every minute counts: when an aneurysm ruptures, extensive heart attack myocardium. Emergency cardiac interventions are often performed in newborns with complex heart defects.
Urgent. Time for diagnostic and preparatory activities there is, but there is not much of it. After receiving the examination results, surgical treatment of the heart disease is performed.
Planned. In some medical sources similar look operations are called elective. After a detailed examination of the patient’s condition, the cardiac surgeon finally makes a decision 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 negotiated.

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, they use various methods surgical intervention:

Note!

Not so long ago, cardiac surgery began to apply a new direction in the treatment of heart defects - X-ray surgeries. At their core, they are minimally invasive - the doctor makes small incisions or punctures and brings special instruments to the heart area through a catheter. The 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 dilating tubes, vascular stenosis is eliminated.

The progress of the entire procedure is monitored through a monitor screen - this ensures the effectiveness of the operation, as well as its safety for the patient. In addition, when carrying out the manipulation in question, general anesthesia is not used: the doctor confines himself to anesthetizing mini-approaches.

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

The most popular types of heart surgery

Today, the following operations are used in cardiac surgery practice:

1. For coronary heart disease:

2. If a heart defect is diagnosed:

3. In the presence of arrhythmia:

In cases where 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, perform heart transplant .

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

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

Heart surgery helps cure many diseases of the cardiovascular system that cannot be treated with standard treatments. therapeutic techniques. Surgical treatment can be performed in different ways, depending on the individual pathology and general condition of the patient.

Indications for surgical treatment

Cardiac surgery is a field of medicine in which doctors specialize who study, invent methods and perform operations on the heart. Heart transplantation is considered the most complex and dangerous cardiac surgery. Regardless of what type of surgery will be performed, there are general indications:

rapid progression of cardiovascular disease; inefficiency conservative therapy; failure to consult a doctor in a timely manner.

Heart surgery makes it possible to improve the patient’s general condition and eliminate the symptoms that bother him. Surgical treatment is performed after complete medical examination and establishing an accurate diagnosis.

Heart disease

Surgeries are performed for congenital or acquired heart defects. A congenital defect is detected in a newborn immediately after birth or before birth. ultrasound examination. Thanks to modern technologies and techniques, in many cases it is possible to detect and treat heart defects in newborns in a timely manner.

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 surgical intervention may be cardiac arrhythmia, since this disease tends to cause ventricular fibrillation (disjointed 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 blood clots).

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

Types of operations

Cardiac surgeries can be performed on an open heart as well as 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.

Endovascular intervention

During open heart surgery, the heart is temporarily stopped for several hours to allow the necessary manipulations to be performed. This technique makes it possible to cure complex heart defects, but is considered more traumatic.

During beating heart surgery, special equipment is used so that the heart continues to contract and pump blood during surgery. The advantages of this surgical intervention include the absence of complications such as embolism, stroke, pulmonary edema, etc.

Exist the following types heart surgeries, which are considered the most common in cardiological practice:

radiofrequency ablation; coronary artery bypass grafting; stenting of coronary arteries; valve replacement; Glenn operation and Ross operation.

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 surgery to be performed under X-ray guidance 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 arrhythmia and rarely causes such a complication as a blood clot.

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 just for him.

Radiofrequency ablation

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

Arrhythmia itself is not a serious pathology requiring surgical intervention, but can lead to serious complications. Thanks to RFA, it is possible to restore normal heart rhythm and eliminate main reason his violations.

RFA is performed using catheter technology and under X-ray control. Heart surgery is performed under local anesthesia and involves inserting a catheter to the required area of the organ that sets the abnormal rhythm. Through electrical impulse under the influence of RFA it is restored normal rhythm hearts.

Coronary artery bypass grafting

Coronary artery bypass grafting (CABG) helps restore blood supply to the heart muscle. Unlike the RFA technique, this treatment gives a high result due to the formation of a new passage for blood flow. This is necessary in order to bypass the affected vessels using special shunts. To do this, take a vein or artery from the patient lower limb or hands.

This type of heart surgery helps prevent the development of myocardial infarction and atherosclerotic plaques. Its essence lies in the fact that sclerotic vessels are replaced with healthy ones. Often after bypass surgery, angioplasty is used, when through the vessels ( femoral artery) the tube is inserted with a balloon into the damaged vessel. Pressurized air puts pressure on the plaques (thrombus) in the aorta or artery and helps remove or promote them.

Stenting of coronary arteries

Stenting

Together with angioplasty, stenting can be performed, during which a special stent is installed. It expands the narrowed lumen in the aorta or other vessel and helps prevent blood clots and remove atherosclerotic plaque, as well as normalize blood flow. All these manipulations can be carried out simultaneously, so that repeated surgery is not prescribed.

The most common heart defect is a narrowing of the valve or its insufficiency. Treatment of such a pathology should always be radical and consist of correction of valvular lesions. Its essence lies in prosthetics mitral valve. The indication for heart valve replacement surgery may be severe valvular insufficiency or fibrosis of the leaflets.

In case of serious heart rhythm disturbances and the presence of atrial fibrillation, there is a serious need for installation special device called a pacemaker. A pacemaker is necessary to normalize the rhythm and heart rate, which can be disturbed by arrhythmia. To normalize the heart rhythm, a defibrillator may be installed, which has the same type of effect as a pacemaker.

Heart valve replacement

A patient who has a pacemaker should undergo frequent medical examinations.

During surgery, a mechanical or biological implant is installed. Patients who have a pacemaker must adhere to certain restrictions in their lives. Some time after installation, a blood clot or other complication may appear, so lifelong use of special medications is often prescribed.

Glenn operation and Ross operation

Glenn's operation is part of the complex correction of children who have a congenital heart defect. Its essence is to create an anastomosis connecting the superior vena cava and the right pulmonary artery. After the treatment has been carried out, the patient can live a full life.

Ross's procedure involves replacing a patient's damaged aortic valve with his own pulmonary valve.

Laser cauterization can also be used to treat arrhythmia. Cauterization can be performed using ultrasound or high frequency current. Cauterization helps to completely eliminate the signs of arrhythmia, tachycardia and heart failure.

Thanks to modern technologies and the development of medicine, it has become possible to carry out effective treatment arrhythmias, eliminate heart defects in newborns, or cure other pathologies with heart surgery. Some time after such an operation, many people can live their normal lives, with only some restrictions.

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 your doctor!

DlyaSerdca → Symptoms and treatment → Surgeries and invasive studies of the heart

Heart operations are performed very often today. Modern cardiac surgery and vascular surgery very developed. Surgical intervention is prescribed when conservative drug treatment does not help, and accordingly, normalization of the patient’s condition is impossible without surgery.

For example, a heart defect can only be cured surgically, this is necessary in the case when blood circulation is severely impaired due to pathology.

And as a result of this, the person feels unwell and begins to develop severe complications. These complications can lead not only to disability, but also to death.

Surgical treatment of coronary heart disease is often prescribed. Since it can lead to myocardial infarction. As a result of a heart attack, the walls of the cavities of the heart or aorta become thinner and protrusion appears. This pathology can also be cured only by surgery. Surgeries are often performed due to abnormal heart rhythm (RFA).

They also perform heart transplantation, that is, transplantation. This is necessary in the case when there is a complex of pathologies due to which the myocardium is not able to function. Today, such an operation prolongs the patient’s life by an average of 5 years. After such an operation, the patient is entitled to disability.

Operations can be performed urgently, urgently, or scheduled intervention. This depends on the severity of the patient's condition. Emergency surgery is performed immediately, immediately after diagnosis. If such intervention is not carried out, the patient may die.

Such operations are often performed on newborns immediately after birth with congenital heart disease. In this case, even minutes matter.

No emergency surgery required quick implementation. In this case, the patient is prepared for some time. As a rule, this is several days.

A planned operation is prescribed if given time There is no danger to life, but it must be carried out to prevent complications. Doctors prescribe myocardial surgery only if it is necessary.

Invasive research

Invasive methods for examining the heart involve catheterization. That is, the study is carried out through a catheter, which can be installed both in the heart cavity and in a vessel. Using these studies, you can determine some indicators of heart function.

For example, blood pressure in any part of the myocardium, and also determine how much oxygen is in the blood, evaluate cardiac output, vascular resistance.

Invasive methods make it possible to study the pathology of the valves, their size and the degree of damage. This study takes place without opening the chest. Cardiac catheterization allows you to take an intracardiac electrocardiogram and phonocardiogram. This method is also used to monitor the effectiveness of drug therapy.

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Such studies include:

Angiography. This is the method used contrast agent. It is injected into the heart cavity or vessel for accurate visualization and determination of pathologies. Coronary angiography. This study allows you to assess the degree of damage to the coronary vessels, it helps doctors understand whether it is necessary surgery, and if not, what therapy is suitable for of this patient. Ventriculography. This is a study using an x-ray contrast method, which will determine the condition of the ventricles and the presence of pathology. All ventricular parameters can be studied, such as cavity volume measurements, cardiac output, measurements of cardiac relaxation and excitability.

In selective coronary angiography, contrast is injected into one of the coronary arteries (right or left).

Coronary angiography is often performed in patients with angina pectoris of functional class 3-4. In this case, it is resistant to drug therapy. Doctors need to decide which method surgical treatment needed. It is also important to carry out this procedure in case of unstable angina.

Invasive procedures also include punctures and probing of the heart cavities. Using sounding, you can diagnose heart defects and pathologies in the left ventricle, for example, these could be tumors or thrombosis. To do this, use the femoral vein (right), a needle is inserted into it through which a conductor passes. The needle diameter becomes about 2 mm.

When performing invasive examinations, local anesthesia is used. The incision is small, about 1-2 cm. This is necessary to expose the desired vein for installing the catheter.

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These studies are carried out in different clinics and their cost is quite high.

Surgery for heart disease

Heart defects include

heart valve stenosis; heart valve insufficiency; septal defects (interventricular, interatrial).

Valve stenosis

These pathologies lead to many disturbances in the functioning of the heart, that is, the goals of operations for defects are to relieve the load on the heart muscle and restore normal functioning ventricle, as well as restoration contractile function and a decrease in pressure in the cavities of the heart.

To eliminate these defects, the following surgical interventions are performed:

Valve replacement (prosthetics)

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This type of operation is performed on an open heart, that is, after opening the chest. In this case, the patient is connected to a special machine for artificial blood circulation. The operation consists of replacing the damaged valve with an implant. They can be mechanical (in the form of a disk or ball in a mesh, they are made of synthetic materials) and biological (made from animal biological material).

Valve implant placement

Plastic surgery of septal defects

It can be carried out in 2 options, for example, suturing the defect or plastic surgery. Suturing is carried out if the hole size is less than 3 cm. Plastic surgery is performed using synthetic fabric or autopericardium.

Valvuloplasty

In this type of operation, implants are not used, but simply expand the lumen of the affected valve. In this case, a balloon is inserted into the lumen of the valve and inflated. It should be noted that such an operation is performed only on young people; as for older people, they are only entitled to open-heart surgery.

Balloon valvuloplasty

Often, after surgery for a heart defect, a person is given disability.

Surgeries on the aorta

Open surgical interventions include:

Prosthetics of the ascending aorta. In this case, a valve-containing conduit is installed; this prosthesis has a mechanical aortic valve. Prosthetic replacement of the ascending aorta, without the aortic valve being implanted. Prosthetics of the ascending artery and its arch. Surgery to implant a stent graft in the ascending aorta. This is an endovascular intervention.

Ascending aorta replacement is the replacement of this section of the artery. This is necessary in order to prevent serious consequences, such as rupture. To do this, prosthetics are used by opening the chest, and endovascular or intravascular interventions are also performed. In this case, a special stent is installed in the affected area.

Of course, open heart surgery is more effective, since in addition to the main pathology - aortic aneurysm, it is possible to correct the accompanying one, for example, stenosis or valve insufficiency, etc. But the endovascular procedure gives a temporary effect.

Aortic dissection

When replacing the aortic arch, the following is used:

Open distal anastomosis. This is when the prosthesis is installed so that its branches are not affected; Half-replacement of the arc. This operation consists of replacing the artery where the ascending aorta meets the arch and, if required, replacing the concave surface of the arch; Subtotal prosthetics. This is when, when replacing an artery arch, replacement of branches (1 or 2) is required; Complete prosthetics. In this case, the arch is prosthetic along with all supra-aortic vessels. This is a complex intervention that can cause neurological complications. After such an intervention, the person is entitled to disability.

Coronary artery bypass grafting (CABG)

CABG is an open-heart surgery that uses the patient's blood vessel as a shunt. This heart surgery is needed to create a bypass for blood that will not affect the occlusive portion of the coronary artery.

That is, this shunt is installed on the aorta and brought to a section of the coronary artery unaffected by atherosclerosis.

This method is quite effective in the treatment of coronary heart disease. Due to the installed shunt, blood flow to the heart increases, which means ischemia and angina pectoris do not occur.

CABG is prescribed if there is angina pectoris in which even the smallest loads cause attacks. Also, indications for CABG are lesions of all coronary arteries, and if a cardiac aneurysm has formed.

Coronary artery bypass grafting

When performing CABG, the patient is put under general anesthesia, and then after opening the chest, all manipulations are carried out. This operation can be performed with or without cardiac arrest. And also, depending on the severity of the pathology, the doctor decides whether the patient needs to be connected to a heart-lung machine. The duration of CABG can be 3-6 hours, it all depends on the number of shunts, that is, on the number of anastomoses.

As a rule, the role of a shunt is performed by a vein from the lower limb; sometimes a part of the internal one is also used thoracic vein, radial artery.

Today, CABG is performed, which is performed with minimal access to the heart and at the same time the heart continues to beat. This intervention is considered not as traumatic as others. In this case, the chest is not opened; an incision is made between the ribs and a special expander is used so as not to affect the bones. This type of CABG lasts from 1 to 2 hours.

The operation is performed by 2 surgeons, while one makes an incision and opens the sternum, the other operates on the limb to take a vein.

After all necessary manipulations The doctor installs drains and closes the chest.

CABG significantly reduces the likelihood of a heart attack. Angina pectoris does not appear after surgery, which means the patient’s quality and life expectancy increases.

Radiofrequency ablation (RFA)

RFA is a procedure performed under local anesthesia, as the basis is catheterization. This procedure is carried out in order to exfoliate the cells that cause arrhythmia, that is, the focus. This occurs through a guide catheter that conducts electricity. As a result, tissue formations are removed using RFA.

Radiofrequency catheter ablation

After conducting an electrophysical study, the doctor determines where the source that causes the rapid heartbeat is located. These sources can be formed along pathways, resulting in a rhythm anomaly. It is RFA that neutralizes this anomaly.

RFA is performed in the following cases:

when drug therapy does not affect the arrhythmia, and also if such therapy causes side effects. If the patient has Wolff-Parkinson-White syndrome. This pathology is perfectly neutralized by RFA. If a complication such as cardiac arrest may occur.

It should be noted that RFA is well tolerated by patients, since there are no large incisions or opening of the sternum.

A catheter is inserted through a puncture in the thigh. Only the area through which the catheter is inserted is numbed.

The guide catheter reaches the myocardium, and then a contrast agent is injected. With the help of contrast, the affected areas become visible, and the doctor points an electrode at them. After the electrode has acted on the source, the tissues become scarred, which means they will not be able to conduct the impulse. After RFA, a bandage is not needed.

Carotid artery surgery

There are the following types of operations on the carotid artery:

Prosthetics (used for large lesions); Stenting is performed if stenosis is diagnosed. In this case, the lumen is increased by installing a stent; Eversion endarterectomy - in this case, atherosclerotic plaques are removed along with the inner lining of the carotid artery; Carotid endarectomy.

Such operations are performed under both general and local anesthesia. More often under general anesthesia, since the procedure is performed in the neck area and there are discomfort.

The carotid artery is pinched, and in order for the blood supply to continue, shunts are installed, which are bypass routes.

Classic endarterectomy is done if long plaque lesions are diagnosed. During this operation, the plaque is detached and removed. Next, the vessel is washed. Sometimes it is still necessary to fix the inner shell; this is done with special stitches. Finally, the artery is sutured using a special synthetic medical material.

Carotid endarterectomy

Eversion endartectomy is performed in such a way that inner layer The carotid artery at the site of the plaque is removed. And after that they fix it, that is, sew it on. To perform this operation, the plaque should be no more than 2.5 cm.

Stenting is performed using a balloon catheter. This is a minimally invasive procedure. When the catheter is located at the site of stenosis, it inflates and thereby expands the lumen.

Rehabilitation

The period after heart surgery is no less important than the operation itself. At this time, the patient’s condition is monitored by doctors, and in some cases cardio training is prescribed, therapeutic diets etc.

Other recovery measures are also needed, for example, you need to wear a bandage. The bandage secures the suture after the operation, and of course the entire chest, which is very important. This type of bandage should only be worn if open heart surgery is performed. The cost of these products may vary.

The bandage worn after heart surgery looks like a T-shirt with tightness fixers. You can purchase male and female versions of this headband. The bandage is important because it is necessary to prevent congestion of the lungs, for this you need to cough regularly.

Such prevention of stagnation is quite dangerous because the seams can come apart; in this case, the bandage will protect the seams and promote durable scarring.

The bandage will also help prevent swelling and hematomas, and promote the correct location of organs after heart surgery. And the bandage helps relieve stress on the organs.

After heart surgery, the patient needs rehabilitation. How long it will last depends on the severity of the lesion and the severity of the operation. For example, after CABG, immediately after heart surgery, you need to begin rehabilitation, this is simple exercise therapy and massage.

After all types of heart operations you need drug rehabilitation, that is, maintenance therapy. In almost all situations, the use of antiplatelet agents is mandatory.

If there is high blood pressure, then prescribe ACE inhibitors and beta-blockers, as well as drugs to lower blood cholesterol (statins). Sometimes the patient is prescribed physical therapy.

Disability

It should be noted that disability is given to people with diseases of the cardiovascular system even before surgery. There must be evidence for this. From medical practice It can be noted that disability is necessarily given after coronary artery bypass grafting. Moreover, there may be a disability of both groups 1 and 3. It all depends on the severity of the pathology.

People who have circulatory problems coronary insufficiency 3 degrees or suffered a myocardial infarction, disability is also required.

Regardless of whether the operation has been performed or not yet. Patients with heart defects of the 3rd degree and combined defects can apply for disability if there are persistent circulatory disorders.

Clinics

Research Institute of SP named after. N.V. Sklifosovsky	Moscow, Bolshaya Sukharevskaya square, 3	CABG without IR CABG with valve replacement Angioplasty and stenting of coronary arteries RFA Aortic stenting Valve replacement Valve plastic surgery	64300 rub. 76625 rub. 27155 rub. 76625 rub. 57726 rub. 64300 rub. 76625 rub.
KB MSMU im. Sechenov	Moscow, st. B. Pirogovskaya, 6	CABG with valve replacement Angioplasty and stenting of coronary arteries RFA Aortic stenting Valve replacement Valvoplasty Aneurysm resection	132,000 rub. 185500 rub. 160,000-200,000 rub. 14300 rub. 132200 rub. 132200 rub. 132000-198000 rub.
FSCC FMBA	Moscow, Orekhovy Boulevard, 28	CABG Angioplasty and stenting of coronary arteries RFA Aortic stenting Valve replacement Valve plastic surgery	110000-140000 rub. 50,000 rub. 137,000 rub. 50,000 rub. 140,000 rub. 110000-130000 rub.
Research Institute of SP named after. I.I. Dzhanelidze	St. Petersburg, st. Budapestskaya, 3	CABG Angioplasty and stenting of coronary arteries Aortic stenting Valve replacement Valve plastics Multivalve replacement Probing of cardiac cavities	60,000 rub. 134400 rub. 25,000 rub. 60,000 rub. 50,000 rub. 75,000 rub. 17,000 rub.
St. Petersburg State Medical University named after. I.P. Pavlova	St. Petersburg, st. L. Tolstoy, 6/8	CABG Angioplasty and stenting of coronary arteries Valve replacement Multivalve replacement RFA	187000-220000 rub. 33,000 rub. 198000-220000 rub. 330,000 rub. 33,000 rub.
Sheba MC	Derech Shiba 2, Tel Hashomer, Ramat Gan	CABG Valve replacement	$30,000 $29,600
MedMira	Huttropstr. 60, 45138 Essen, Germany 49 1521 761 00 12	Angioplasty CABG Valve replacement Cardiac examination Coronary angiography with stenting	8000 euros 29000 euros 31600 euros 800-2500 euros 3500 euros
Greekomed	Central Russian office: Moscow, 109240, st. Verkhnyaya Radishchevskaya, house 9 A	CABG valve replacement	20910 euros 18000 euros

Do you still think that it is impossible to get rid of HEART DISEASES!?

Do you often experience discomfort in the heart area (pain, tingling, squeezing)? You may suddenly feel weak and tired... Constantly felt high blood pressure... There’s nothing to say about shortness of breath after the slightest physical exertion... And you’ve been taking a bunch of medications for a long time, going on a diet and watching your weight...

But judging by the fact that you are reading these lines, victory is not on your side. That is why we recommend reading the story of Olga Markovich, who found an effective remedy for cardiovascular diseases. >>>

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