When you are told you need open heart surgery a sudden rush of fear is often the first reaction. Gruesome images of huge scars, bleeding, unbearable pain and overwhelming fear of terrible complications come to mind in a whirlwind blur. All these images in your mind are very far from reality and reflect the way heart surgery was performed OVER FIFTEEN YEARS AGO. I hope this article will help you appreciate the giant leap forward our specialty has made to devise a soft touch, low impact surgical technology to allow our patients a rapid and uneventful return to their life style after a coronary bypass or a heart valve operation. I will give you a brief outline of the hospital course for a minimally invasive heart operation to help you see the difference between your fears and what actually happens when you are in the hospital.
My example will be the all too common case of a 75 year old lady who needs a mitral valve repair to correct her severe mitral valve leakage. Here we go:
All the testing before surgery is done as an outpatient to give you time to discuss every detail about your state of health and your heart condition.
The day of surgery you arrive at the hospital early in the morning and meet again with your surgeon. A small intravenous line is inserted in your arm. It feels like a pinch.
Once you are in the operating room you'll be given some anesthesia right away and you'll fall asleep. The rest of the time you will not see, feel, hear or remember anything until you wake up in our recovery area after surgery.
The only person who's really suffering during surgery is your relative or friend sitting in the surgical waiting room.
The operation is carried out through a tiny incision in the skin crease under the right breast. There is no bone cutting involved because the opening is in the space between two ribs. This is important because bones don't heal well in many female patients because of osteoporosis (brittle bones) after menopause
Before closing the surgical incision a local anesthetic is injected in the space between the ribs to make that portion of the chest wall completely numb
You are then transported to our intensive care unit and you'll wake up feeling groggy but pain free
By the morning after you'll be out of bed and walking and maybe hungry enough for a small meal. You are ready to be transferred to the regular floor to continue walking and deep breathing exercises with our nurses and physical therapists
The second day after surgery most paytients are ready to go home with arrangements for a visiting nurse and physical therapy service and the surgeon's phone number
You are encouraged to resume your physical activity right away, including going out for a stroll, going up and down stairs and receiving friends and relatives at home.
Two weeks later you'll be back at the surgeon's office for your postoperative visit and by that time you'll have my blessing to resume your life style in full, including driving, traveling, going back to work
Again, this is what you should picture in your mind when you are told you need an operation. Ask your doctors about minimally invasive heart surgery techniques that do not involve bone cutting and are carried out through tiny incisions. If they are not familiar with them, consider consulting a Minimally Invasive Heart Surgery Center for a second opinion. More and more patients are gladly traveling out of town to get the best care available and they are glad they did. It's your body, it's your heart, it's the rest of your life!
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