Overview

Open-heart surgery is any type of surgery where the chest is cut open and surgery is performed on the muscles, valves, or arteries of theheart。

According to the 国家心脏，肺和血液研究所（NHLBI） ，，，，冠状动脉搭桥嫁接(CABG)是最常见的心脏urgery done on adults. During this surgery, a healthy artery or vein is grafted (attached) to a blocked coronary artery. This allows the grafted artery to “bypass” the blocked artery and bring fresh blood to the heart.

Open-heart surgery is sometimes called traditional heart surgery. Today, many new heart procedures can be performed with only small incisions, not wide openings. Therefore, the term “open-heart surgery” can be misleading.

Open-heart surgery may be done to perform a CABG. A coronary artery bypass graft may be necessary for people withcoronary heart disease。

Coronary heart disease occurs when the blood vessels that provide blood and oxygen to the heart muscle become narrow and hard. This is often called “hardening of the arteries.”

当脂肪材料在冠状动脉壁上形成斑块时，就会发生硬化。该牌匾狭窄，使血液难以通过。当血液无法正确流向心脏时，可能会发生心脏病发作。

Open-heart surgery is also done to:

  • 修理或更换心脏瓣膜，使血液通过心脏传播
  • 修复心脏受损或异常区域
  • implant medical devices that help the heart beat properly
  • replace a damaged heart with a donated heart (heart transplantation）

According to the National Institutes of Health ，CABG需要三到六个小时。通常按照以下基本步骤完成：

  • 给予患者全身麻醉。这样可以确保他们在整个手术中都会睡着和疼痛。
  • The surgeon makes an 8- to 10-inch cut in the chest.
  • The surgeon cuts through all or part of the patient’s breastbone to expose the heart.
  • 一旦可见心脏，患者就可以连接到心肺旁路机。机器将血液从心脏上移开，使外科医生可以手术。一些较新的过程不使用该机器。
  • The surgeon uses a healthy vein or artery to make a new path around the blocked artery.
  • 外科医生用电线关闭胸骨，将电线留在体内。
  • The original cut is stitched up.

有时是为有高风险的人（例如那些有多次手术或高龄的人）进行胸骨镀板。胸骨板是在手术后与小钛板重新加入胸骨时。

Risks for open-heart surgery include:

According to the Heart and Vascular Center at the University of Chicago Medicine, the heart-lung bypass machine is associated withincreased risks。这些风险包括中风和神经系统问题。

告诉您的医生您要服用的任何药物，甚至是非处方药，维生素和草药。通知他们您患有的任何疾病，包括疱疹outbreak, cold, flu, or fever.

In the two weeks before the surgery, your doctor may ask you toquit smokingand stop takingblood-thinning medications，例如阿司匹林，布洛芬或萘普生。

在准备手术之前，请与您的医生谈谈您的饮酒。如果您通常每天喝三杯或更多饮料，然后在进行手术之前停下来，您可能会进入戒酒。这可能会导致心脏直视手术后威胁生命的并发症，包括癫痫发作或震颤。您的医生可以帮助您抽出饮酒，以减少这些并发症的可能性。

手术前一天，可能会要求您用特殊的肥皂洗自己。这种肥皂用于杀死皮肤上的细菌，并减少手术后感染的机会。午夜后，您可能还会要求您不要吃或喝任何东西。

Your healthcare provider will give you more detailed instructions when you arrive at the hospital for surgery.

When you wake up after surgery, you will have two or three tubes in your chest. These are to help drain fluid from the area around your heart. You may have intravenous (IV) lines in your arm to supply you with fluids, as well as a catheter (thin tube) in your bladder to remove urine.

您还将与监控心脏的机器相连。如果应该出现什么话，护士将在附近为您提供帮助。

You will usually spend your first night in the intensive care unit (ICU). You will then be moved to a regular care room for the next three to seven days.

手术后立即照顾好自己是您康复的重要组成部分。

切口护理

切口护理是极其重要的。让你在cision site warm and dry, and wash your hands before and after touching it. If your incision is healing properly and there is no drainage, you can take a shower. The shower shouldn’t be more than 10 minutes with warm (not hot) water. You should ensure that the incision site isn’t hit directly by the water. It’s also important to regularly inspect your incision sites for signs of infection, which include:

  • increased drainage, oozing, or opening from the incision site
  • 切口周围发红
  • warmth along the incision line
  • fever

Pain management

Pain management is also incredibly important, as it can increase recovery speed and decrease the likelihood of complications like blood clots orpneumonia。You may feelmuscle pain，，，，喉咙痛，，，，pain at incision sites, or pain from chest tubes. Your doctor will likely prescribe pain medication that you can take at home. It’s important that you take it as prescribed. Some doctors recommend taking the pain medication both before physical activity and before you sleep.

足够的睡眠

一些患者在心脏直视手术后睡觉很难，但是要尽可能多地休息很重要。为了使睡眠更好，您可以：

  • 睡前半小时服用止痛药
  • arrange pillows to decrease muscle strain
  • avoid咖啡因，，，，especially in the evenings

In the past, some have argued that open-heart surgery leads to a decline in mental functioning. However, most recent research has found that not to be the case. Though some patients may have open-heart surgery and experience mental decline later on, it’s thought that this is most likelydue to the natural effects of aging。

有些人在心脏直视手术后确实会经历抑郁症或焦虑。治疗师或心理学家可以帮助您管理这些效果。

Rehabilitation

大多数拥有CABG的人都会从参加结构化的全面康复计划中受益。这通常是门诊病人，每周几次访问。该计划的组成部分包括锻炼，减少风险因素和处理stress，，，，焦虑，，，，anddepression。

期望逐步恢复。您可能需要六周的时间才开始感觉更好，并且最多六个月才能感受到手术的全部好处。但是，前景对许多人来说都是有益的，而移植物可以工作多年。

Nevertheless, surgery does not prevent artery blockage from happening again. You can help improve your heart health by: