Open-Heart Surgery — Frequently Asked Questions

The term commonly describes surgery in which the surgeon gains direct access to the heart. Many such operations use a heart-lung machine to support circulation and oxygenation, often while the heart is temporarily stopped. Definitions vary: the size of the incision, whether a heart chamber is opened and whether the machine is used are separate aspects of the procedure.

No. Coronary artery bypass grafting is one type of heart operation. Conventional bypass often uses a breastbone incision and a heart-lung machine. Off-pump bypass is performed on the beating heart without the machine, although the chest may still be opened. For bypass-specific information, see Coronary Bypass Surgery — Frequently Asked Questions for further details.

Operations may repair or replace heart valves, bypass narrowed coronary arteries, correct congenital defects, treat some aortic aneurysms or address selected rhythm disorders. Catheter procedures or smaller-incision operations are alternatives in some cases. The appropriate option depends on the disease, anatomy and overall health.

These terms are used inconsistently. In everyday language, “closed” surgery may refer to a smaller incision, but this does not mean that a heart-lung machine is unnecessary or that the procedure is minor. Beating-heart bypass can use a large chest incision without the machine. Ask which access, equipment and operation are planned. Read more: What Is Minimally Invasive Bypass? Is It Really “Closed”?

Yes, depending on how the term is used. Smaller-incision surgery may still involve opening a heart chamber, using a heart-lung machine and temporarily stopping the heart. Other minimally invasive procedures do not require all these steps. Suitability depends on the patient and operation. Read more: Minimally Invasive Heart Surgery — Frequently Asked Questions

It temporarily supports circulation and oxygenation during an operation. Blood is diverted through the machine, oxygenated and pumped back to the body. A specialist perfusionist manages it with the surgical and anaesthetic teams. When the operation is complete and the heart and lungs can take over, the patient is gradually separated from the machine.

In many operations, medication temporarily stops and protects the heart while the heart-lung machine supports the body. The heart is restarted after the repair, sometimes with electrical assistance or temporary pacing. Some operations are performed on a beating heart. In off-pump coronary bypass, a stabilising device steadies the area being treated. This approach is not suitable for everyone. Read more: Off-Pump Coronary Bypass — Frequently Asked Questions

A sternotomy divides the breastbone to give access to the heart. At the end of the operation, the bone is brought together with wires or another fixation system. Healing takes time, and the team provides instructions about movement, lifting and wound care.

The decision uses the diagnosis, imaging, symptoms, heart function and overall health. Cardiologists and cardiac surgeons, often working as a Heart Team, compare surgery with medicines or catheter treatments where appropriate. The expected benefits, risks, alternatives and your preferences are discussed before a decision is made.

Tests assess the heart condition and fitness for surgery. They may include blood tests, an ECG, echocardiography, other imaging and, when indicated, coronary angiography. The exact investigations depend on the planned procedure and your medical history.

Ask the team which medicines and supplements to continue or pause, when to take them, how to wash before surgery, when to stop eating and drinking, and where and when to attend. Tell them about allergies and all medicines you take. Do not stop or change medication without their instructions.

General anaesthesia keeps you unconscious during surgery, and a ventilator supports breathing. Afterward, pain relief is adjusted to help you breathe, cough and move. Tell the team if pain is not controlled or changes unexpectedly.

It depends on the procedure, complexity and whether several operations are combined. Coronary bypass commonly takes several hours, sometimes around three to six, but individual cases can be shorter or longer. Your surgeon can give a more relevant estimate.

The team closely monitors heart rhythm, blood pressure, breathing and other functions. You may initially have a breathing tube, chest drains, intravenous lines and temporary pacing wires. These are removed as you recover. Intensive care may last a day or two after uncomplicated surgery, but longer monitoring is sometimes needed.

Potential complications include bleeding, rhythm disturbances, infection, heart attack, stroke, kidney injury, breathing problems and death. Some complications require further procedures. Risk depends on the operation, urgency, heart function and other health conditions. The team explains your individual risk and how complications are monitored and treated.

Around a week is common after uncomplicated coronary bypass, but the stay varies with the operation and recovery. Combined procedures or complications can prolong it. Before discharge, the team explains medicines, wound care, activity and follow-up.

Healing takes several weeks or longer. Follow your centre's instructions for getting up, arm movements, lifting, pushing and pulling. Supporting the chest when coughing may help comfort. Gentle walking is usually encouraged. Contact the team if the wound opens, becomes increasingly red or drains fluid, if you develop a fever, or if the breastbone feels unstable or clicks painfully.

Recovery depends on the operation, incision, health and job demands. Activities are increased gradually; full recovery after major heart surgery may take around two to three months or longer. Driving requires medical clearance and compliance with local licensing and insurance rules. Heavy work may need a longer pause. Discuss return to work, driving and sex with your team. Read more: Before and After Heart Surgery: Practical Advice and Coronary Bypass Surgery — Frequently Asked Questions

The plan depends on the operation and other conditions. A mechanical valve requires lifelong vitamin K antagonist anticoagulation, usually warfarin, with monitoring. A tissue valve or repair may require an initial course of antithrombotic treatment, and other conditions can require longer treatment. Antiplatelet medicines such as aspirin are commonly used after bypass. Do not change treatment without the surgical or cardiology team's advice.

Yes. Rhythm disturbances, including atrial fibrillation, can occur after surgery. Some resolve, but others need medication, cardioversion, anticoagulation or pacing. Monitoring helps detect them. Report palpitations; fainting, chest pain or severe breathlessness with an abnormal heartbeat needs urgent assessment.

Some people experience confusion, difficulty concentrating, memory problems, anxiety or low mood. Acute confusion may be delirium and needs prompt assessment; it is not the same as ordinary tiredness. Recovery varies, and some problems persist beyond the first weeks. Report new, worsening or persistent symptoms. Sudden speech difficulty or one-sided weakness requires emergency help. Read more: Mood, Behaviour and Memory Changes After Heart Surgery

Contact the team promptly for fever, worsening wound redness, warmth, drainage or opening, breastbone instability, new swelling, vomiting or palpitations. New or worsening breathlessness or chest pain also needs assessment. Severe chest pain, severe breathlessness, collapse or stroke symptoms require emergency help: call 112 in Turkey or the local emergency number. Do not drive yourself.

Cardiac rehabilitation is a supervised programme that can include exercise, education about heart health, medication support and help with stress. It supports a safe return to activity and longer-term prevention. Your team can advise on suitability, timing and the most appropriate programme.

Some patients need a transfusion, but not everyone does. The decision depends on blood loss, blood count, symptoms and overall condition. The team may assess and treat anaemia before surgery and use measures to reduce blood loss. Discuss individual needs and preferences during preparation.

They are alternatives for selected conditions and patients, but they are not interchangeable with every operation. TAVI/TAVR can treat selected aortic valve disease, and angioplasty with stenting can treat some coronary disease. A Heart Team considers anatomy, age, risk, expected durability and patient preferences when comparing options. Read more: Endovascular and Transcatheter Treatments — Frequently Asked Questions