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Open Heart Surgery

Author: Jenelle Castelli

There is no denying it. Unhealthy eating habits and lack of exercise account for an extremely high percentage of all heart disease. As a result, many people are facing a complicated and high risk surgery every year – open heart surgery. This is a procedure that can be avoided by simply taking care of our bodies. Why is that so difficult for so many (myself included)? We live in an easy world, a world where almost everything is drive-thru and almost everyone participates. The thought of cooking 3 healthy meals everyday used to be a given, and now it seems like an impossible task. "Good food" to the youth of America is pizza, cookies, ice cream and chocolate bars. In reality, such foods should not be considered "food" at all! One has to wonder, what would present day America be without the medical achievements of the past? How would people tend to their bodies if there was no such thing as open heart surgery?

I’ll explore this complex medical procedure in detail by first providing a brief history, then following up with some in depth analysis. You’ll learn about today’s advancements that support this procedure as well as an overview of how it is performed. Some general risks will be evaluated along with financial burdens of the surgery and signs that it may be necessary. I’ll finally conclude with some of my own words of wisdom.

Open heart surgery is a procedure or operation performed on the heart, in which it is mandatory for the patient to be placed on a heart-lung bypass machine. The heart-lung bypass machine actually takes over the operations of the heart and lungs in order to provide the body with oxygenated blood. It was first used in 1955 at Mayo clinic in Rochester, Minnesota. While the term "open heart surgery" may be easily defined, it is by no means easily done and should not be taken lightly by anyone facing the operation. The American Heart Association reports that roughly 646,000 people face open heart surgery every year. In addition, approximately 519,125 people annually receive either a valve replacement, cardiac revascularization, heart transplant, or heart bypass surgery – the re-routing of blood to avoid clogged arteries, improving blood flow and oxygen to the heart.

The first successful open heart surgery was performed on July 9, 1893 by Dr. Daniel Hale Williams (an African American doctor) at Provident Hospital in Chicago. Since then, many medical advancements have been made in the way the surgery is performed. Today’s advancements even allow a learning environment known as virtual open heart surgery, whereby a device is used for training that actually allows models of malformed hearts to be reconstructed from 3D MRI data. Because of virtual open heart surgery, there is now a more acute understanding of how congenital heart disease works. This is only one of the medical advances we have made throughout the years, and even now open heart surgery is becoming more ordinary and less extraordinary.

Still, performing open heart surgery is no easy task for even the most experienced surgeons. To begin the procedure, a high potassium solution called cardiopelegia stops and protects the heart muscle while surgery is being performed. Then, the surgeon must open the chest cavity by splitting the sternum (breast bone) in half directly down the middle. Part or all of the thymus gland (a gland related to the immune system) must also be removed to allow access to the heart. Interestingly enough, removal of this gland does not actually compromise the immune system's ability to work efficiently – one example of the many ways that the human body is able to overcome circumstance and keep performing the essential tasks that are key to our survival. The human heart is surrounded by a sac called the pericardium. The pericardium is also opened to allow access to the heart. Lastly, a vein (usually extracted from the leg through a hole about the size of a dime) is used to replace any damaged arteries in the heart. Amazingly enough, the total length of the operation is usually no more than around 4 - 5 hours.

Inherent risks are present in all open heart surgeries. A generally question surgeons are asked is, "What could happen to me as a result of this operation?” While the risks are related to a number of causes, they are mainly linked to the cardiopulmonary bypass and could include insufficient perfusion of the organs or tissues (meaning that the body is unable to heal correctly due to embolization of air particles), the inflammatory response (swelling) and (although extremely rare) neurological injuries that could result in stroke or seizures. Other risks include damage to the natural rhythm of the heart (requiring temporary or permanent pacing aid), trauma (due the need for the body to adapt quickly to the changes made during surgery) and compromise to myocardial function (resulting from a lack of blood flow during the actual operation). Despite all of this, the medical field has become so adapted to performing open heart surgery that it is only necessary to re-operate in 1-3% of surgeries performed.

The cost of open heart surgery can add up to as much as $60,000 in the United States, depending on the nature of the operation. In other countries the operation is not as expensive. However, one must also consider that America, when compared to places such as India and Europe, usually promises an operation higher in quality and performance. In any event, cost should not be the number one concern for a well insured open heart surgery candidate, because patients are typically responsible for only about 10% of the operation's total cost. F curse, this figure varies by state, hospital and insurance carrier.

Detecting heart problems early will significantly reduce chances of the need for open heart surgery. Some signs that your heart could be in trouble include fatigue, becoming tired quickly from walking or standing, high blood pressure, high cholesterol, discomfort in the chest or in other parts of the upper body, shortness of breath, and becoming lightheaded or dizzy suddenly and unexplainably. Congenital heart disease increases the risk of heart attack.

Eating healthy and exercising daily greatly reduces ones chances of developing heart disease. This may seem impossible for some, but try to look at the big picture and ask yourself, “What would be easiest in the long run?” Eating right and exercising has other positive affects as well, such as losing weight, and feeling healthy.

Heart attack is actually not a natural cause of death, yet it continues to compromise and claim the lives of so many each and every year. Everyone has the power to do something about heart disease It takes no more than choosing wheat over white and the stairs over the elevator. Before you say, "I have no time for exercise," think of how much time you spend waiting in line at the drive thru, watching television every evening, surfing the web and countless other activities that could be cut short in order to allow yourself about 30 minutes of exercise 4-6 times a week. Thanks to open heart surgery, many people have overcome heart disease and have recovered completely. But, should open heart surgery really be the answer to a problem that could be helped, if not solved, so easily? Imagine this scenario - A young boy gets a splinter while playing outside. Instead of asking his father to help him remove the splinter (which hurts a little but is over quickly and soon forgotten), he chooses to let the splinter stay. Over time the wound becomes severely infected and the boy now must go through so much more to solve such an initially simple problem. Is this scenario different from the typical journey of an open heart surgery candidate? Eating healthy and exercising may seem painful at first, but they seem insignificant in comparison to the pains resulting from heart disease. We may eventually see a shift in how people treat their bodies as more pro-health options are becoming available to the public. Baked chips, low fat and fat free milk, fat free ice cream, and sugar free Popsicles are just a sample of the foods we are becoming accustomed to. But until the world is free of heart disease, we will have a reliable option to turn to - open heart surgery.

Acknowledgements

"National Medical Group Practice Week." Medical Group Management Association. 2004-2006. 21 February 2007 www.medicalgrouppracticeweek.com/funfacts.cfm

"Life After Open Heart Surgery" Mid-Atlantic Surgical Associates. 2007. 21 February 2007. www.heartsurgeons.com/ed5.html

"American Heart Association" American Heart Association. 2007. 21 February 2007. www.americanheart.org

Emax Health. 2004-2005. 21 February 2007. www.emaxhealth.com

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