Cardiothoracic Surgery

Cardiothoracic Surgery

Cardiothoracic Surgery is a specific type of surgical procedure, which involves surgical operations performed on the patient’s heart. Such operations are necessary in order to correct a number of heart disorders including, but not limited to heart valve disorders (pulmonary, aortic, mitral or tricuspid), coronary artery disease, aortic aneurysm, congenital heart disease, heart failure or arrhythmia (in cases where other non-invasive therapies have been tried and failed to result in an improvement of the patient’s condition). There are two types of heart valve disorders: one of them is caused by a leakage (regurgitation) of the blood, causing it to return back into the vessel / chamber from which it was just pumped; the other condition, called stenosis, refers to a narrowing of the valves which leads to a limitation of the blood volume that is able to pass into the next chamber of the heart. In both of these situations, the heart’s ability to pump the blood is diminished. There are several surgical procedures available to deal with this problem, involving either the replacement or the repair of the valves.

A congenital defect of the heart is an anomaly in the heart structure which is present at the individual’s birth. In many cases, these defects are holes in the walls separating the heart chambers, missing blood vessels, reversed or narrowed blood vessels or malformations of the heart valves. These can be treated through Cardiothoracic Surgery, with a high chance of success.Another cardiac disorder which may be treated through Cardiothoracic Surgery is aortic aneurysm, manifested through the presence of an abnormally large wall of the main artery of the body – the aorta. Untreated cases may result in a rupture of the aneurysm, which leads to severe complications and in many cases to the death of the patient.

Heart failure is caused by a progressive weakening of the cardiac muscle, causing the individual’s heart to become unable to pump the required quantity of blood. Arrhythmias are conditions which disrupt the heart rhythm, causing either chaotic, uncoordinated heartbeat or excessively fast or slow heartbeat. Both of these conditions can be surgically treated. However, in the case of arrhythmia, the treatment of choice is a non-invasive medication therapy. Only in situations when the heart rhythm cannot be controlled through medication will the doctors advise Cardiothoracic Surgery.

Cardiothoracic Surgery Description

Prior to a Cardiothoracic Surgery operation, the patient will have to refrain from ingesting any aliments or liquids in order to reduce nausea and the risks of complications affecting the lungs. If the patient needs to take any medication, it is advised that they do so, drinking only the necessary amount of water.

Before the Cardiothoracic Surgery operation starts, the patient will be administered medication to induce sleep (these medicines are called anesthetics and they are employed to induce unconsciousness or sleepiness in the patient, while also blocking pain). The anesthesiologist then will insert a catheter through the patient’s blood vessels and into the heart, in order to administer medication and fluids and to monitor the patient’s condition. Another catheter will be inserted in the patient’s wrist for monitoring blood pressure. Once the patient is completely anesthetized, he or she is intubated to ensure that the breathing functions are not hindered and another catheter will be inserted into the bladder to drain urine. The body temperature is lowered to reduce the metabolic rate.

The actual Cardiothoracic Surgery procedure will begin with the surgeon making an incision from the top part of the breastbone going down to the upper abdomen. The breastbone is then divided by use of a special instrument. The surgeon then opens the membrane surrounding the heart and connects the patient to a special apparatus (a heart-lung machine) with several tubes placed in the chambers of the heart and the main blood vessels, so that the heart can be stopped while the blood continues to be pumped to the other organs. This is necessary because of the very delicate nature of the operation and the sensitivity of the heart. Now the surgeon can perform the required operation (replacing the heart valves, grafting blood vessels etc) and the heart is allowed to start pumping blood once again. The body temperature is gradually raised, and the surgeon closes the site, after connecting several small wires to the heart so that, if needed, the heart can be assisted in its functioning.

Cardiothoracic Surgery Related Medication

After the Cardiothoracic Surgery has been successfully completed, the patient will require a period of recovery. In order to assist him or her during this phase the specialized health care professional may prescribe a number of medicines. These may serve various purposes, from preventing infections to allowing faster recovery or ensuring that the transplant is not rejected (in case of organ transplant surgical procedures).

Depending on each case, the patient may be prescribed one or several of the following medicines: Enteric Aspirin (a mild blood thinner used to prevent the formation of blood clots), HMG-CoA Reductase Inhibitors (commonly prescribed to patients suffering from coronary heart disease, this medicine lowers the blood lipid levels by limiting the production of certain compounds and stimulating the removal of cholesterol; examples of such medicines include Pravastatin, Simvastatin and Atorvastatin), Beta Blockers (used to reduce the patient’s risk of a heart attack or heart failure and to increase their chances of surviving an infarction), ACE Inhibitors (to reduce the risk of arteriosclerosis and to reverse dysfunctions of the blood vessel lining; these medicines also offer improved cardiac and vascular protection), Estrogen (especially in the case of postmenopausal women affected by coronary heart disease), Calcium Channel Blockers (most common in the case of patients who have undergone radial artery grafting operations; these medicines help prevent spasms). Other medicines may be prescribed as well, aiming at controlling other collateral symptoms or consequences of the Cardiothoracic Surgery operation. For example, the health care professional may direct administration of anti-inflammatory medication or painkillers, or of anti-ulcer drugs to control gastric acidity, as the Cardiothoracic Surgery may cause stress leading to the onset of gastric irritation. Stomach irritation may also occur as a result of the use of anti-inflammatory medication, of antibiotics and pain suppression medication. Also it is common for the supervising physician to direct the use of stool softeners as pain medication and inactivity may lead to the onset of constipation.