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Beating Heart Surgery

Coronary Heart Disease can be caused when the arteries can not supply a sufficient amount of blood to the heart. In this case, the most recommended treatment is Coronary Artery Bypass Graft (CABG) surgery or Beating Heart Surgery. 

This surgery is performed while the heart is beating. During the surgery, the heart of the patient doesn't stop, nor does he require a heart-lung machine which means that the heart will continue to supply blood to the rest of the body. 

Surgeons immobilize the area of the heart by using a tissue stabilization system. Beating heart surgery is also called Off-Pump Coronary Artery Bypass Surgery (OPCAB). This method restores blood flow to the heart. Moreover, it has proven to decrease side effects in some patients. 

The coronary arteries transport nutrients and oxygen-rich blood to the heart. Atherosclerosis can cause the hardening of the arteries and narrow them gradually. When Atherosclerosis affects arteries that carry blood to the heart muscle, it is termed Coronary Heart Disease or Coronary Artery Disease. 

The hardening occurs due to the deposition of bad cholesterol and other materials around the artery walls. This results in the formation of plaque that decreases the blood flow to the heart and causes chest pain or angina. Plaque can also form blood clots which can completely block blood flow causing a heart attack. Beating Heart Surgery can effectively restore the functioning of arteries. 

What leads to beating heart surgery? 

If an individual has coronary artery disease (CAD), he can manage it by changing his lifestyle that includes proper food and exercise.
However, in severe CAD cases, the patient might require CABG surgery. These treatments can help decrease the risk of a heart attack and chest pain. Sometimes, blockages aren't removed by angioplasty. Here's when CABG surgeries come into the role. But, before going for the surgery, the patient needs to understand the risks and benefits associated with the processes. For this, he can discuss the complications with his surgeon. 

Once the patient and the surgeon have decided to go for CABG surgery, the next step is to choose the right one. Some people at high risks are generally benefited from off-pump or Beating Heart Surgery. These include patients suffering from severe CADs, chronic lung diseases, and kidney problems. 

Off-pump surgery can decrease the chances of postoperative inflammation, irregular heartbeats, and infections. An experienced surgeon should perform this complicated surgery. Also, the patient should ask the healthcare professional about the benefits and risks of the surgery in the presence and absence of a heart-lung machine. 

What are the risks associated with beating heart surgery? 

Beating Heart Surgery or off-pump CABG comes with fewer complications as compared to CABG with a heart-lung machine. Risks vary according to the medical conditions of the patient, age, and other factors. In the future, the patient might need other CABG surgery after going for an off-pump CABG. Hence, the patient must clear all his concerns beforehand. Although off-pump CABG has provided positive outcomes to numerous patients, it still has some associated risks that include bleeding, infection, irregular heartbeats, kidney failure, blood clots causing a heart attack or stroke, complications from anaesthesia, etc. Age and other medical conditions may also contribute to these risks. 

How to get ready for Beating Heart Surgery? 
Your healthcare team at CARE Hospitals will help you out. Meanwhile, the patient can follow the given suggestions. 

  • Do not drink or eat after midnight or before the surgery. 

  • Stop smoking before operation. 

  • Avoid taking some medications like warfarin tablets (anticoagulant tablets) before the surgery. 

  • Follow the surgeon's instructions for medicine before the operation.  

The patient may require some medical tests before the process to check the overall health before operation. These include:

  • Chest X-ray

  • Blood Tests

  • Cardiac Stress Testing- for evaluating blood perfusion to the heart. 

  • Electrocardiogram (EKG)- for evaluating the heart rhythm. 

  • Echocardiogram- for assessing pump function and structure of the heart. 

If required, someone will remove skin above the area of operation an hour before the surgery. Moreover, the patient will also get some medicines to relax. 

What happens in Beating heart surgery?
Firstly, our surgeon applies anaesthesia, so the patient goes into deep sleep without feeling pain. The operation can be several hours depending on the situation. 
The surgeon removes a part of a healthy artery or vein from an area of the body, maybe from the chest wall or leg. This part is called a graft. 

The surgeon then attaches an extremity of a graft to a section above the blockage in the artery. The other extremity is attached to a part of the coronary artery below the blockage. Blood flow is restored when the graft is attached. It is difficult to sew or suture a beating heart. Therefore, the surgeon uses a stabilisation system to keep it steady. 

The stabilisation system consists of a tissue stabiliser and a heart positioner. The positioner holds and guides the heart in such a position so that the blocked arteries can be accessed by the surgeons easily. Similarly, the tissue stabiliser keeps a small area of the heart steady during operation. 

In the case of minimally invasive off-pump CABG, the surgeon makes a small incision down in the middle of the patient's chest and separates a part of the breastbone. Sometimes, the healthcare providers can use special equipment and a camera during the surgery. In this method, the surgeon makes numerous tiny holes in the chest between the ribs. 

What happens after beating heart surgery? 

Right after the off-pump surgery- 

  • You might wake up after some hours of the surgery. He might be confused mental state after waking up, but after some time, he'll be conscious. 

  • The recovery team carefully monitors your vital signs, such as your heartbeat. They use several machines to assist in continuous monitoring. 

  • To facilitate breathing, the patient may have a tube inside his throat. This can be a little uncomfortable and won't let the patient talk. However, it is removed after 24 hours. 

  • You may also have a chest tube to drain excess fluid from the chest. 

  • You may not feel pain after surgery but can feel some soreness. He can ask for painkillers if needed. 

  • You will be able to perform daily activities like sitting and walking within 2 or 3 days after the operation. 

  • You can drink fluids the day after CABG. He can have normal foods when he can tolerate them. 

After leaving the hospital 

  • You must make sure to have someone to drive him home. He will need some assistance at home also. 

  • The stitches or staples are removed in a follow-up appointment after 8 to 10 days. Make sure to follow all the appointments timely. 

  • You will recover strength, but it may take certain weeks or so. 

  • Don't drive until the surgeon tells the patient to do so. 

  • Avoid picking heavyweights for a couple of weeks. 

  • Follow the instructions provided by the healthcare provider regarding medicines, diet, exercises, and wound care. 

  • The doctor can recommend you to a cardiac rehab program which can help him to restore his normal body functioning. 

Things to know before going for the surgery 
Before moving ahead with the process or surgery, you should know the following things to avoid confusion. 

  • The name of the procedure or test. 

  • Reasons for the test. 

  • What outcomes to expect and their meanings. 

  • The dangers and advantages associated with the surgery. 

  • Surgery's possible complications and side effects. 

  • Location and timing of the process. 

  • The performer of the surgery and his qualifications. 

  • Consequences for not going for the surgery. 

  • Any alternatives for treatment besides surgery. 

  • Timings and processes for getting operation results.

  • To whom he (patient) can contact after the test for solving health-related issues.   

  • Cost of the surgery. 

How Can CARE Hospitals Help?

Our multidisciplinary medical team at CARE Hospitals performs the surgeries with advanced technology. With the support of the medical unit, the patients can recover fast and can improve the quality of their lives. The infrastructure of the CARE Hospitals is highly advanced and all the needs of the patients are fulfilled. The staff also provides out-of-hospital support to solve the queries of the patients.

Frequently Asked Questions

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