Heart Surgery: Before, During & After
By Dr Feras Hamati, Senior Fellow in Cardiac Intensive Care & Anaesthesia at University Hospital Southampton, England
Heart surgery has developed remarkably in the last 70 years, saving millions of people worldwide. The thought of undergoing heart surgery may cause anxiety, though. But knowing what the process is can help put your mind at ease.
Heart surgeries are as they require a highly skilled team: Cardiologist, cardiac surgeon, cardiac anaesthetist, perfusionist, operating room nurses and experienced ICU nurses.
The care of such patients starts in the cardiologist’s clinic, which runs and requests several images and investigations to obtain the correct diagnosis. Patients are transferred to cardiac surgeons for further management when surgical interventions are required.
Common indications of cardiac surgery
- Blocked heart arteries (which deliver oxygenated blood to the heart’s muscles)
- Infections or mechanical problems in one of the heart’s valves
- Congenital disabilities in the heart, putting the patient’s life at risk
What to expect before surgery
Patients are usually admitted to the hospital a few days in advance to run blood tests and heart and lung images, stop any blood thinning medications and optimise kidneys and lungs in case they have any issues.
Special drugs are administered to intentionally stop the heart while a patient is connected to a heart-lung machine to oxygenate and pump blood. The perfusionist runs and monitors this machine. A patient’s temperature is substantially lowered to protect vital organs in the body.
The anaesthetist’s role
Before surgery, the anaesthetist assesses the patient and puts together an appropriate anaesthetic, post-operative care and pain management plan. During the operation, the anaesthetist:
- Controls a patient’s level of consciousness and ventilation before and after being connected to the heart-lung machine
- Maintains a targeted blood pressure
- Monitors urine output and screens for abnormal blood clotting
- Deals with any cause of bleeding by preparing and transfusing blood products
- Assesses heart activity and valve function
- Guides the surgeon when deploying a new valve by using an echocardiography machine, which is an ultrasound machine used during surgery to get live images of the heart from different angles
The anaesthetist’s role continues after surgery, looking after the patient in the ICU, along with experienced ICU nurses. The goal is to wean the patient off the ventilator machine, control bleeding, deal with abnormal heart rhythms, manage pain and treat possible kidney injury.
The recovery period usually takes between 7 to 14 days of breathing exercises and physiotherapy sessions which helps the patient maintain a decent muscle reserve to move around as soon as possible.
You can contact Dr Feras Hamati at firstname.lastname@example.org