Open heart surgery: the ins and outs

Each year, more than half a million people in the U.S. undergo open heart surgery—and many of those people are working professionals.

As an employer, the more you understand about this procedure and what it involves, the better equipped you will be to support employees through their recovery and return to work.

What is open heart surgery?

Open heart surgery isn’t the name of one specific surgery—there are a variety of procedures that fall under this category. Put simply, open heart surgery describes the method the surgeon uses to access the heart and perform the necessary procedure.

While more minimally invasive heart surgeries involve small incisions, during open heart surgery, a surgeon opens the chest by cutting through the breastbone and spreading the ribs. This allows the doctor to easily access and see the patient’s heart. It’s commonly used for more complex procedures, such as a heart transplant, heart valve replacement, or aneurysm repair.

It’s a fairly intense procedure, so patients are put under full anesthesia for the surgery. Many open heart surgeries also involve the use of a cardiopulmonary bypass machine, which is also called a “heart-lung machine” or known colloquially as being “on the pump.”

In some open heart procedures, the surgeon needs to stop the patient’s heart from beating so they can perform the procedure while the heart is completely still. In those cases, the cardiopulmonary bypass machine does the work of the patient’s heart and lungs—adding oxygen and removing carbon dioxide from the blood, and then pumping the blood back into the body.

Cardiopulmonary bypass machines are still common in many open heart surgeries. However, surgeons are continuing to refine new procedures that can be performed on a beating heart, eliminating the need for the heart-lung machine.

Regardless of the specific type of procedure that’s performed, open heart surgery is a major operation and comes with risks—particularly when these surgeries are performed in emergency situations or on patients who have other conditions and diseases (like diabetes or lung disease).

According to the National Heart, Lung, and Blood Institute, common risks include arrhythmias, bleeding, blood clots, damage to other tissues, infection, fever, swelling, memory loss, or pneumonia. Much like with any other surgery, death is also a risk patients should be aware of.

Why is open heart surgery performed?

Open heart surgery is just one method for performing heart surgery. There are less invasive approaches (like robotic-assisted surgery and thoracoscopic surgery) that use a camera on a long tube. Both of those require much smaller incisions, rather than opening the entire chest.

Those minimally invasive operations generally offer easier recoveries, but there are plenty of times when open heart surgery is the best (or only) option.

Why? Because open heart surgery gives doctors full visibility and easy access to the heart, as well as to any surrounding blood vessels. While that’s not necessary for every type of heart surgery, according to the Cleveland Clinic, there are many procedures where open heart surgery is required, including:

• • • Aneurysm repair: Repairing a weakened, bulging section of a blood vessel

    • Congenital heart disease repairs: Correcting structural heart defects present at birth

    • Coronary artery bypass grafting: Rerouting blood around blocked coronary arteries

    • Heart transplant: Replacing a failing heart with a donor heart

    • Heart valve replacement or repair: Fixing or replacing damaged heart valves

    • Left ventricular assist device (LVAD): Implanting a mechanical pump to support heart function

    • Total artificial heart replacement: Replacing both lower heart chambers with a mechanical device, often used as a bridge to a heart transplant

   


 

Beyond the specific type of procedure that’s performed, open heart surgery is often the recommended approach if:

• Previous procedures were unsuccessful, or the patient experienced complications

• Several issues need to be addressed at one time (such as multiple blocked arteries or valves)

• The condition is too complex or severe for minimally invasive techniques

As always, treatment plans and procedures are highly personal. So, patients should rely on the advice of their trusted medical providers to understand their options and make informed decisions.

Recovery time after an open heart surgery

Recovery time from open heart surgery varies based on the specific type of procedure that’s performed. In general, patients can expect to remain in the hospital for up to a week, often with the first few days spent in the intensive care unit (ICU).

Opening the chest is a major procedure, and that means a fairly long recovery. The American Heart Association says it can take patients four to six weeks to start feeling better following open heart surgery. Patients should also not expect to drive during that recovery time.

In terms of time away from work, six to eight weeks is a fairly safe estimate—but that time can be even longer for people who are in more physically demanding jobs, given the physical restrictions following surgery. Patients shouldn’t do any pushing, pulling, picking things up off the floor, or heavy lifting (more than five to 10 pounds) for six to eight weeks, as it takes that long for the sternum to grow back together.

Heart surgery with Carrum Health

Nobody wants open heart surgery, but there are plenty of times when it’s medically necessary. Unfortunately, cost can be a major barrier to care. Costs for open heart surgery vary based on the specific procedure, but can range between $30,000 and $200,000.

Your employees deserve cardiac care that’s high-quality and affordable—and that doesn’t have to mean major financial burdens for you as the employer.

Carrum Health partners with value-based centers of excellence to provide specialty care and procedures at a predictable cost, including heart surgery. That offers fewer financial surprises for your employees and fewer administrative headaches for you.

Open heart surgery is a big deal. But, with the right support, your employees can avoid navigating overwhelming costs and red tape and put their energy where it belongs: their recovery.

Learn more about how employers can partner with Carrum here.