Is heart surgery safe?
My doctor talks about risks versus benefits. What does this mean?
Will I feel anything during the operation?
How long will my recovery be?
How old is too old for heart surgery?
Will I have a lot of pain after the operation?
A friend of mine had heart surgery through a "mini" incision. Can I have my operation done the same way?




Is heart surgery safe?

As in other areas of medicine, cardiac surgery has undergone significant advancement over the past several years. It is safer now than at any time in the past. Nevertheless it is major and often complicated surgery with definite risks including heart rhythm disturbances, infection, stroke and even death. Also, the patients having surgery have been older and sicker than in the past which makes it riskier for them. On the positive side however, these complications tend not to be very frequent, and are generally much smaller compared to the risks involved by not having the surgery. Ask your cardiologist and surgical team to go over the risks involved in your specific case.

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My doctor talks about risks versus benefits. What does this mean?

The practice of medicine is as much an art as it is a science. Every medical procedure involves risks as well as benefits. For example, after a long, frustrating day at work you come home with a pounding headache. The headache medicine you take has the benefit of making your headache better but it also may have the risk of possibly giving you an upset stomach. You take the medicine because the benefits outweigh the risks. Your doctor also weighs the risks against the benefits to decide if you should have heart surgery. Ask your doctor to go over the risks and the benefits involved in your specific case.

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Will I feel anything during the operation?

Anesthesia for any operation is a balancing act between keeping people asleep and keeping people alive. Many of the drugs used in anesthesia lower your blood pressure as a side effect. Awareness under anesthesia (see our Topic of the Month) sometimes happens when a person is so sick that even small amounts of anesthetic drugs can cause the blood pressure to fall to an unsafe level. This is fortunately a rare occurrence for most operations. Unfortunately it tends to happen a bit more frequently in heart surgery because the patients are usually so much sicker. The most common effect is to hear the surgical team talking during the operation. Feeling pain can also happen but is very rare. Talk to your anesthesiologist about any concerns.

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How long will my recovery be?

Most people who undergo heart surgery are discharged from the hospital within a week. But a significant minority can stay much longer. There is no way to know ahead of time who will have complications that require them to stay in the hospital longer. Certain medical conditions such as diabetes may make that more likely. More complicated surgical procedures also tend to be associated with longer hospital stays. Advancing age may be another factor. Even after hospital discharge there will be a rehab period which may last several months. Ask your cardiologist, anesthesiologist and cardiac surgeon if you have any risk factors which may prolong your hospital stay.

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How old is too old for heart surgery?

As recently as five years ago in many institutions it was felt that people past their seventies were too old to have heart surgery. But now with improvements in technique and more relatively healthy older patients, many centers are doing patients of any age. It must be understood that with advancing age may come increasing risks and if those risks are not daunting in the face of the potential benefits, then surgery may still be an option even; for your 92 year old grandma. Speak to your cardiologist, anesthesiologist and cardiac surgeon to learn about your risk factors.

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Will I have a lot of pain after the operation?

It still isn't possible to eliminate all pain after surgery. And for most people that isn't necessary. You will likely have some pain; mostly when you try to take a deep breath or cough but it's almost always tolerable. There are several newer techniques of pain management including epidurals and PCA (Patient Controlled Analgesia) which can be used to help control your pain. In addition, many new medications are now available for pain relief. Ask your anesthesiologist and cardiac surgeon about pain management options that might be right for you.

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A friend of mine had heart surgery through a "mini" incision. Can I have my operation done the same way?

Minimally invasive cardiac surgery is one of the latest developments in new techniques for heart surgery. As with most new procedures patient selection is an important factor. Most cardiac sugeons tend to choose patients who are young, relatively healthy, and having a straightforward procedure. As experience increases, the selection criteria start to include patients who are older, sicker, or undergoing more complicated surgery. Even if you are chosen for a "mini" procedure there is always the possibility that it can turn into a "maxi" procedure if the surgeon feels that everything isn't going just right. Ask your cardiac surgeon if you might be a candidate for a minimally invasive procedure.

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