Open Heart Surgery

General Information

There are various types of heart disease and a variety of symptoms associated with each of them. Therapeutic methods currently used in various diseases of the heart, include medication to help fight the disease or delay its development, and surgical treatment, implying various operations. 

Open heart surgery - an operation on the heart, which is a unique surgical procedure that allows the heart surgeon to deal with a number of heart disease, especially when other treatments are not suitable or does not help. In many cases, it is a life-saving operation that is performed when the situation is urgent.

What is open-heart surgery?

Open-heart surgery begins with the opening of the chest and expose the heart. This is a very complex operation, so it is executed very heart surgeons who specialize in this area. During the operation, activity of the heart is stopped, and the patient is connected to a heart-lung machine (the machine "heart - lung"). That this operation is different from other heart surgery, during which the heart continues to beat normally. Open heart surgery can serve several purposes. This may be a heart transplant, bypass surgery , surgery to remove congenital defects in the heart and blood vessels, or surgery for valve replacement .

How is the operation?

As already mentioned, during open-heart surgery heart activity ceases, which allows the most successfully and without any interruption to perform various surgical procedures. Termination of cardiac function is made possible by connecting the patient to a heart-lung machine "heart - lung", imitating the work of the heart and lungs. Apparatus "heart - lung" includes two connections, one of which is responsible for the collection of blood from a vein, while the second compound is directly connected to the aorta, is responsible for pumping blood into the body. This unit, which works throughout the operation, allows you to remove waste from the blood and re-saturate it with oxygen, pumping back into the patient's body.

When connecting the patient to the machine "heart - lung" heart activity ceases gradually until it becomes obvious that the machine "heart - lung" is working properly. The first stage device helps cool the blood, to reduce the metabolic rate and heart rate without damage to the heart muscle. In the next step of the heart completely ceases operation with a special solution. After stopping of the heart to perform the required surgical procedure - coronary artery bypass grafting, valve replacement or correction of existing defects. When the operation is a normal activity of the heart is reduced, and the work unit "heart - lung" is stopped gradually, until it becomes obvious that the heart is working properly.

Other solutions in the treatment of heart problems

With the advanced technology, and also to avoid complex invasive procedures for treating various heart diseases, which in the past been impossible to avoid open heart surgery, currently used, and other solutions. Cardiac surgery, performed through a small incision, allows to cope with some heart disease minimally invasive methods, while achieving a high level of results. Such operations are, for example, help to overcome problems with the heart valves through small holes, caused by the ribs and chest wall. Through these holes the camera is introduced, helping to perform various manipulations. The advantage of this minimally invasive procedure generally is no need to perform the incision of the chest 30 cm, considered one of the most painful and difficult stages of open-heart surgery. This advantage significantly reduces recovery time and significantly reduces the period of hospitalization compared to open heart surgery. In addition, this type of surgical scars are practically invisible, and the prospects for the emergence of post-operative complications is very small.

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What is heart failure? A Brief Knowledge

Heart Failure - It happens when the heart is unable to pump enough blood to the body. Several diseases can cause it: valvular disease, arrhythmias ...

What is heart failure?

The heart failure usually happens when any imbalance happens between the heart's ability in order to pump blood and the needs of the body.

Causes of heart failure

The heart may fail due to a problem itself or because its responsiveness reaches not satisfy what the organism will demand.

Failure heart from heart disease

Heart failure is a syndrome characterized by the presence of symptoms (shortness of breath, tiredness, difficulty breathing, lying, etc.) and signs that the heart does not work well (expels bad blood) and accumulates in the legs, abdomen, etc. Many of heart disease just this. Possible causes that can cause heart failure are:

IHD

It occurs when the coronary arteries that distribute blood to the heart suffer narrowings reduce or prevent blood flow, and therefore oxygen supply. In some patients, it is a slow and progressive process. In others, it consists of a clot or thrombus which produces fast and complete blockage of the blood vessel. The latter is what is known as a heart attack, and can cause a death of heart muscle loses its blood.

Heart muscle disease ( cardiomyopathy )

They are diseases that affect the heart muscle:

• Hypertensive cardiomyopathy (produced by uncontrolled hypertension)
• Idiopathic dilated cardiomyopathy  (when the origin is unknown)
• Myocarditis (inflammation of heart muscle)
• Restrictive cardiomyopathy
• Diabetic cardiomyopathy (caused by diabetes)
• Hypertrophic cardiomyopathy
• Alcoholic cardiomyopathy (by abuse alcohol consumption)

Usually, these diseases cause dilation and significant loss of core strength. Some, such as alcohol cardiomyopathy or myocarditis, may be reversible with treatment.

Valvulopatías

They appear when the valves do not work properly and the heart muscle is not able to compensate for the malfunction of these increased force or number of beats.

Arrhythmias

Both fast and slow arrhythmias can cause heart failure.

Heart Failure by increasing demand

Anemia, generalized body infection, thyroid disease, arteriovenous fistulas or increased blood pressure lead to increased demand for blood body sometimes a healthy heart is not able to attend. Therefore, treatment of these patients should focus on the disease causing the failure rather than the heart itself.

Symptoms of heart failure

The heart failure can be a disease that has no symptoms for a long time throughout life (called asymptomatic phase). When they appear, the predominant symptoms are:

• Abnormal fatigue by efforts before caused not. Blood does not adequately reach the muscles and muscle fatigue situation is caused.
• Feeling of fullness in the abdomen, anorexia (lack of appetite).
• Labored breathing stagnant fluid in the alveoli of the lungs. If a choking sensation forcing sleep sitting up and lying down is presented.
• Reduced blood flow to the brain can cause feelings of dizziness, confusion, mind blank and brief loss of consciousness. If these figures related to low voltage episodes occur it is advisable to sit or lie down.
• Sometimes it can appear a dry and persistent cough motivated by fluid retention in the lungs or treatment with angiotensin converting enzyme. It is the latter case, the specialist can assess a change in treatment.
• Shortness of breath (dyspnea) with exertion and poor exercise tolerance fatigue.
• The failure can cause the blood flow to the kidneys is not enough, and fluid retention occurs due to decreased urination. This swelling usually located on the legs, ankles or abdomen. And sometimes urinating more at night than during the day (nocturia).

Diagnosis of heart failure

The specialist performs a detailed medical history:

• Cardiovascular risk factors in the patient
• Recent infections
• Symptoms related to exercise tolerance
• History of ischemic heart disease
• Heart rhythm disturbances
• Physical examination to check blood pressure and heart rate
• Cardiac auscultation and pulmonary
• Abdominal exploration
• Hypertension or diabetes
• Family history of cardiomyopathy or valvular disease
• Swelling

In some cases, additional tests necessary echocardiogram or stress test will be, as X-rays.

Prognosis of heart failure

Although the word failure suggests a benign process, heart failure, left untreated, it has a worse prognosis than many cancers. With treatment, the prognosis differs greatly from the cause that motivates it. For this reason, it is so important to prevent its occurrence and proper monitoring of indications and controls.

Treatment of heart failure

There are effective treatments to slow the progression of heart failure, improve the quality of life, exercise capacity and prolong survival. They are:

• Treat the cause that produces it (revascularization with angioplasty or bypass if for lack of watering, stop drinking if alcohol, etc.).
• Hygiene measures: weight control, low-salt diet, controlling your fluid intake, get the normal weight.
• Diuretics improve congestive symptoms and lower the swelling or lung congestion.
• Vasodilator drugs (such as nitrates or angiotensin converting enzyme inhibitors and receptor ACE inhibitors and ARBs ) reduce the load with which the heart must work, increase performance and lower the blood pressure. The latter are essential if heart function is impaired.
• Beta-blockers reduce the heart rate and improve the prognosis (they are essential if the function of the heart is decreased).
• Digoxin is indicated in patients with atrial fibrillation.
• Aldosterone inhibitors are also necessary, as they improve survival in patients with impaired function and symptoms despite treatment with beta-blockers and ACE inhibitors or ARBs heart.
• Ivabradine is a drug which reduces the heart rate only and may be beneficial in some types of heart failure.
• In other cases it is necessary to implant devices to patients despite appropriate treatment (weight loss, proper diet, etc.) continue to have symptoms, have some alterations in the ECG-determined and heart function decreased (<35% ). These devices in patients with a life expectancy appropriate can improve symptoms (TRC) or decrease the probability of dying suddenly (DAI).
• If the patient does not improve with all previous treatments, it could pose (depending on age and the presence of other diseases or complications) the heart transplant.