What is open heartsurgery?
Open heart surgery, referred to as cardiac surgery by thescientifically inclined, is a surgery that is performed on a humanheart that is directly exposed to the surroundings (and thus, thesurgeon). This is achieved by opening the chest cavity, and the termdoes not refer to the open heart, but to the open chest. This kind ofsurgery is used as part of the treatment aimed to resolvecomplications that emerged from the ischemic heart disease (lack ofoxygen and nutrient supply to the heart due to blockage of arteriesthat feed the heart), congenital (inborn) heart disease or valvularheart disease. Heart transplantation can also be regarded as one ofthe open heart surgery techniques.
Some background on openheart surgery
The earliest operations on theopen heart were performed already in the nineteenth century, andcutting edge surgeons from that period included such names asFrancisco Romero, Henry Dalton, and Dominique Jean Larrey. Firstsuccessful open heart surgery without complications (probably meaningthat the patient lived to tell the tale to the grandchildren) isattributed to a Dr. Ludwig Rehn, a German surgeon. This proceduretook place on September 7th, 1896.
By the first half of thenineteenth century, surgical procedures such as repair of aorticcoarctation (narrowing of the aorta, the primary artery, thatreceives the blood directly from the heart all other arteries withblood) and creation of a bypass known as Blalock-Taussig shunt werefairly commonplace. These procedures included procedures whose aimwas to palpate (examine by touching) the damaged mitral valve, removethe damaged or troublesome portions of the mitral valve, as well asresection of stenosis (narrowing) of the infundibular muscle anddivision of the stenosed pulmonary valve.
It took some time beforename of the surgical procedure had something to do with the hartitslef being opened. Two surgeons are credited with first suchsuccessful operation. These are Dr. C. Walton Lillehei and Dr. F.John Lewis. They performed the first successful intracardiaccorrection, by resolving the complications of an inborn heart defectwith the help. The trick they used to achieve this was hypothermia,cooling of the organism that slowed down contractions of the heart. ASoviet surgeon, Dr. Aleksandr Aleksandrovich Vishnevskiy, was thefirst to perform an open heart surgery with use of local anesthesia.
Tricks of the trade
The heart is a pump that worksby means of muscle contraction. It beats constantly. Proverbial"surgical precision" can be achieved only if the heart orthe portion of the heart that is to be operated is still. Varioussystems are used to achieve this. Hypothermia was used with success but its use is limited by the complexity of the repairs that need tobe done. Numerous techniques whose goal to 'shut down' the specificarea of the heart that were tested by a trial and error system.
Open heart surgery hasbeen perfected enough to achieve low mortality rates related to thesurgery itself. Risks such as neurological damage, stroke,neurocognitive deficits and postperfusion syndrome still remain.