Cardiothoracic Surgery

What are the various procedures performed under cardiothoracic surgery?

Some of the procedures performed under cardiothoracic surgery include:

• Angioplasty (percutaneous coronary intervention): This procedure is performed to open up blocked or obstructed blood vessels, responsible for supplying blood to the heart. It is performed to treat coronary artery disease, caused due to accumulation of fatty deposits in the coronary arteries.
• Heart valve surgery: This surgery is done to fix or replace the heart valves. Heart valves are responsible for regulating the course and flow of blood from the heart.
• Stent placement: Stent placement refers to a procedure where a small metal coil is positioned in the narrowed artery to keep it open. However, before this procedure, the healthcare provider typically performs an angioplasty procedure to remove any plaque buildup in the arteries.
• Ablation: This is a technique adopted by healthcare providers to treat irregular heart rates. In this procedure, a very small portion of the heart muscle is ablated ( destroyed).
• Coronary Artery Bypass Grafting (CABG): Patients who suffer from severe coronary artery conditions are generally treated using this surgical procedure. This procedure aims to improve the blood flow that reaches the heart of the patients. In this procedure, the surgeon takes a graft vessel ( a healthy blood vessel) from the leg or arm to create a new path around the narrowed or obstructed blood vessel. It helps in supplying blood flow around the obstructed area of the coronary artery and revives requisite blood flow to the heart muscle.

What tests or diagnostic procedures are conducted before cardiothoracic surgery?

Before cardiothoracic surgery, certain preoperative tests are conducted to ensure you are a suitable candidate for the surgery and to control the course of the surgery. These tests are also conducted to identify any risks that may occur, such as complications after surgery, individuals' response to anesthesia, etc. Some of the tests conducted include:

• Echocardiography: This test is typically conducted to assess coronary artery disorder. It also helps assess the structure of the heart and understand how it is functioning.
• Electrocardiogram (ECG): It helps estimate the irregularities in the heartbeat.
• Coronary Calcium Scan: This scan measures the calcium accumulation in the coronary arteries, which helps indicate the existence of coronary artery condition.
• Ankle-Brachial Index: At times, coronary artery bypass grafting is performed to treat coronary artery disease. In this procedure, a healthy blood vessel is taken from the leg or arm to create a new path around the narrowed or obstructed blood vessel. Hence, an ankle-brachial test may be performed to evaluate artery blockages in your arms or legs.
• Lymph node biopsy: Cardiothoracic surgery involves the treatment of conditions impacting the heart, and the other parts of the chest such as the lungs. A lymph node biopsy is conducted by surgeons to know whether lung cancer is curable.

What happens during a cardiothoracic surgery?

Cardiothoracic surgery involves procedures on the heart, lungs, and other parts of the chest cavity. The specific procedure followed depends on the procedure the patient is undergoing, however, let's understand an overview of the surgery.

Before the surgery begins, the patient is administered anesthesia to ensure he/she doesn't experience any pain during the procedure. Once this is done, the surgeon creates an incision (cut) near the chest or abdomen. The location of the cut depends on the type of surgery being performed which directly depends on the condition suffered by the patient.

After creating the incision, the surgeon opens the chest to access the affected organs such as the heart and lungs. The surgeon and the healthcare team then perform the procedure according to the condition. This can involve procedures like angioplasty, cardiomyoplasty, transplantation, minimally invasive surgeries, etc. The procedures revolve around fixing the impaired heart valves, repairing the flaws in the coronary arteries, or excising tumors from the lungs. Throughout the surgical procedure, the anesthesia team monitors the patient to keep him/her pain-free. Once the procedure is executed, the surgeon closes the incision using staples or sutures.

How to prepare for cardiothoracic surgery?

Here's a general guide:

• It is generally advised by doctors to stop eating anything after midnight a night before the procedure. It is because eating or drinking anything can lead to aspiration of food during the surgery which can lead to infection.
• You might need to stop taking certain medications such as diabetes medications, anticoagulants, and aspirin (acetylsalicylic acid). These medications can encourage bleeding during the procedure or can impact blood sugar levels.
• If you smoke, it is instructed by doctors to quit smoking several days before the procedure. This can enhance the recovery period and minimize the risk of complications.
• Make sure you carry your photo ID and insurance card on the day of surgery. Also, since cardiothoracic surgery is an inpatient procedure, it is crucial to carry certain items to the hospital. These include loose tops to avoid strain on the stitches. It is also essential to carry toiletries, robes, socks, and reading materials like magazines to ensure you are prepared for the procedure by all means.
• Arrange for transportation to and from the hospital on the day of surgery.

What are the recovery tips to follow after cardiothoracic surgery?

Recovery after cardiothoracic surgery is a slow and steady process that needs patience. Here are some essential tips to follow post-surgery:

• Give your body adequate time to rest and recover after operation.
• Always keep your wound dry and clean. Follow the instructions provided by your healthcare provider regarding wound cleaning.
• If infection occurs in the wound area, contact your healthcare provider instantly. Symptoms of wound infection include a rapid high rate, fever, and extreme pain around the chest area.
• Avoid heavy lifting for 5 to 6 weeks after surgery. Also, avoid activities like swimming, tennis, and golf that can apply unnecessary pressure on the surgical site.
• Avoid driving for a minimum of 5 weeks after your cardiothoracic operation.
• Incorporate deep breathing exercises into your schedule. These activities can play a major role in preventing complications like atelectasis (collapse of a lung or part of a lung).