Traditional heart surgery is done under general anesthesia. The surgeon makes an incision about 8-10 inches long through the patient’s chest, through the breastbone. The rib cage is opened so the surgeon can access the heart.
During the surgery, you’ll be placed on a ventilator through a breathing tube down your throat. Your vital signs, such as your heart rate, breathing rate, and blood pressure, are constantly monitored. You’re also given medicine to thin your blood to decrease the chances of clotting.
Traditional heart surgery is commonly used for those patients who need complicated heart surgeries. Your doctor may recommend it if you are undergoing a multiple coronary artery bypass, or other complex aorta procedures.
With a traditional bypass, the surgeon uses a heart-lung bypass machine to take over the heart’s functions, to mechanically pump oxygen and nutrients to your body during surgery. This allows the surgeon to temporarily stop your heart so the bypass can be performed on a motionless heart. The heart-lung bypass machine, or “pump,” takes over your heart’s pumping while the surgeon is operating, until your heart can resume its pumping function.
A beating heart bypass surgery is performed while your heart is still beating, unlike a traditional bypass. A beating heart bypass is also called an “off-pump” bypass because the surgeon does not use a heart-lung machine, or “pump,” to stop the heart before operating.
With a beating-heart bypass, surgeons can perform multiple bypass grafts on all areas of the heart, including the backside (posterior), at the same time. In other words, the surgeon can perform a triple (three bypass grafts), quadruple (four bypass grafts) or more through a middle of the chest incision, all off-pump.
In some cases, the surgeon may still need to use the heart-lung machine during the operation. A perfusionist (a specialist trained to operate the heart-lung machine) may remain on standby during your operation.
The beating heart bypass allows individuals who have medical conditions such as diabetes, history of stroke, or poor physical health, to undergo cardiac surgery with lower risk for developing complications. This approach also can result in fewer complications and less time in the hospital after surgery. Talk with your doctor to see if beating heart bypass surgery is an option for you.
A thoracotomy is a surgical procedure performed to open the chest cavity. A surgeon makes an incision in the chest wall on your side, between your ribs, to access on your lungs. Through this incision, the surgeon can remove part or all of a lung. Thoracotomy is often done to treat lung cancer when the tumor can’t be removed safely through a minimally invasive procedure.
A thoracotomy might also be performed to treat problems with your heart or other structures in your chest, such as your diaphragm, or to diagnose disease through a biopsy of tissue.