Open Heart Surgery

Open Heart Surgery- is any surgery where the chest is opened and surgery is done on the heart muscle, valves, arteries, or other parts of the heart

History:

1. The earliest known operation done on the b pericardium (the sac that surrounds the heart) took place in the 19th century and was performed by Francisco Romero,Dominique Jean Larrey, Henry Dalton, and Daniel Hale Williams.
2. The first surgery on the heart itself was performed in Norway by a Norwegian Surgeon by the name of Axel Cappelen
1.  Took place on September 4, 1895
2. Unfortunately  died from what the post mortum proved to be Mediastinitis on the third postoperative day.
1. Mediastinitis- is swelling and irritation (inflammation) of the area between the lungs. This area contains the heart, large blood vessels, windpipe (trachea), esophagus, thymus gland, lymph nodes, and connective tissues
3.  Then a heart surgery done by Dr. Ludwig Rehn of Frankfurt, Germany. Who repaired a stab wound to the right ventricle on September 7, 1896
1. This was the first successful heart surgery
4.  The first successful intracardiac correction of a congenital heart defect using hypothermia was performed by Dr. C. Walton Lillehei and Dr. F. John Lewis at the University of Minnesota on September 2, 1952. 
5. The following year, Soviet surgeon Aleksandr Aleksandrovich Vishnevskiy conducted the first cardiac surgery under local anesthesia.

How it's Done: 

A heart-lung machine is usually used during open heart surgery. While the surgeon works on the heart, the machine helps send oxygen-rich blood to the brain and other organs.(Procedure used from: http://www.nlm.nih.gov/medlineplus/ency/article/002950.htm)

1. Your heart surgeon will make a 2-inch to 5-inch-long surgical cut in the chest wall. Muscles in the area will be divided so your surgeon can reach the heart. The surgeon can fix or replace a valve or perform bypass surgery.
2. During endoscopic surgery, your surgeon makes one to four small holes in your chest. Then your surgeon uses special instruments and a camera to perform the surgery.
3. During robot-assisted valve surgery, the surgeon makes two to four tiny cuts (about 1/2 inch to 3/4 inch) in your chest. The surgeon uses a special computer to control robotic arms during the surgery. The surgeon sees a three-dimensional view of the surgery on the computer. This method is very precise.
4. You will not need to be on a heart-lung machine for these types of surgery. However, your heart rate will be slowed with medicine or a mechanical device. If there is a problem with these procedures, the surgeon may have to open the chest to do the surgery.

Risks and Complications: Like any surgery Open Heart Surgery has its risks and Complications. Down below is a list of the risks in heart surgery as well as possible complications that have been reported and that you have the possibly of getting.

1. Bleeding: May occur at the incision site or from the area of the heart where surgery is performed
2. Abnormal heart rhythm: In rare cases a temporary external, or permanent internal pacemaker may be necessary to correct this problem.
3. Ischemic heart damage: Damage to heart tissue caused by a lack of blood flow to the heart
4. Death: The risk of death is increased in surgeries where the heart is stopped for the procedure.
5. Blood clots: Clots may form in and around the heart or travel through the bloodstream.
6. Stroke: Often caused by clots that form in the blood after surgery
7. Blood Loss: In some cases, a transfusion may be necessary.
8. Emergency surgery: If a problem is discovered after surgery, an emergency surgery may be necessary to repair any problems.

Recovery

1. Keep your incision(s) clean and dry.
2. Use only soap and water to cleanse the area.
3. Do not apply ointments, oils, salves or dressings to your incision unless specifically told to do so.
4. Eat a healthy diet to help healing. 
5. Bathing
1.  If your incision is healing and dry, quick showers (no longer than 10 minutes) are usually allowed. If you have sutures in your chest, stand with your back to the shower spray.
6.  To cleanse the incision site:
1. Use regular soap, not perfumed soap or body wash. Don’t try a new brand of soap during your recovery.
2. Place soapy water on your hand or washcloth and gently wash the incision(s) up and down. Do not rub the incision(s) with a washcloth until the scabs are gone and the skin is completely healed.
7.  Call your doctor if signs of infection appear: 
1.  
2. Increased drainage or oozing from incision
3. Increased opening of the incision line
4. Redness or warmth around the incision
5. Increased opening of the incision line
6. Increased body temperature (greater than 101 degrees Fahrenheit or 38 degrees Celsius)
7. If you have diabetes and your blood sugar levels begin to vary more than usual