What is heart surgery?

Heart surgery is done to correct problems with the heart. More than half a million heart surgeries are done each year in the United States for a variety of heart problems.

Heart surgery is used to correct heart problems in children and adults. This answer specifically discusses heart surgeries for adults.

Overview

The most common type of heart surgery for adults is coronary artery bypass grafting (CABG). During CABG, surgeons use healthy arteries or veins taken from another part of the body to bypass (that is, go around) blocked arteries. CABG relieves chest pain and reduces the risk of heart attack.

Heart surgery also is done to:

• Repair or replace valves that control blood flow through the heart
• Repair abnormal or damaged structures in the heart
• Implant medical devices that regulate heart rhythms or blood flow
• Replace a damaged heart with a healthy heart from a donor (heart transplant)

Traditional heart surgery, often called "open heart surgery," is done by opening the chest wall to operate on the heart. Almost always, the chest is opened by cutting through a patient's breastbone. Once the heart is exposed, the patient is connected to a heart-lung bypass machine. The machine takes over the pumping action of the heart. This allows surgeons to operate on a still heart.

In recent years, new ways of doing heart surgery have been developed. One new way is called off-pump, or beating heart, surgery. It's like traditional open-heart surgery, but it doesn't use a heart-lung bypass machine.

This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

There are many different types of surgery performed on the heart for many different reasons. The most common heart surgery in adults is called coronary artery bypass surgery, or as many call it "coronary bypass". This type of surgery is performed to relieve symptoms caused by blockage in the coronary arteries that supply the blood flow to the heart muscle. In this type of operation, arteries or veins from elsewhere in the body are used grafted to the patient's native coronary arteries creating bypassess around the blockages.  There are several approaches to this type of sugery.

The traditional method is via an incision in the middle of the chest and connection  the patient to a circulatory bypass pump machine that takes over the function of pumping the blood through the body so the heart can be still while surgeon places the grafts. Sometimes the bypass grafts can be placed while the heart is beating, avoiding the need and associated additional risks of using the circulary bypass pump machines. New methods also aloow the surgeon to perform the operation through small incision with use of robotics or other less invasive techniques. Cornoary artery bypass surgery does not require cutting into the heart tissue itself to access the inside chambers of the heart. Therefore, this is considered a "closed heart" procedure.

Another common type of heart surgery is valve repair or replacement. This is performed when one or several of the heart valves is damaged, either congenitally or acquired during one's lifetime. Many different typed of heart valve surgery are performed, depending on the etiology of the problem. this type of surgery is typically also performed using the circulatory bypass pump machine so that the heart can be still while the surgeon opens up the heart chamber to gain access to the valve(s).  This is therefore considered an "open heart" procedure. We are currently on the threshold of exciting new techniques that allow cardiologsits and cardiac surgeons to repair or replace heart valves without opening up the chest wall or the heart. Some of these techniques are currently being investigated at the Piedmont Heart Institute.

Heart surgery in children is usually performed because of congenital abnormalities. There is a vast spectrum of such problems with an equally vast array of operations. These types of operation tend to "open heart" in nature, but there are also less invasive, newer techniques available and under investigation.