“Open-heart surgery” describes surgery in which the chest is cut open to operate on the heart or surrounding arteries. Cardiac surgeons may perform open-heart surgery to correct severe disease in the coronary arteries that supply blood to the heart, to repair or replace heart valves or to fix structural heart defects.
In patients with coronary artery disease, angioplasty and stenting—interventional procedures in which a thin tube called a catheter is inserted into an artery to reopen a blockage—may not always be the best option. Patients with widespread plaque (a fatty substance) in several arteries, or a severe narrowing in the main artery that transports blood from the aorta to the heart may be most effectively and safely treated with coronary artery bypass graft (CABG) surgery. During bypass surgery, arteries or veins are taken from other parts of the body, such as the chest and the legs, and sewn onto the diseased arteries in the heart, above and below the obstructive plaque. The new arteries and veins detour blood flow around the plaque, keeping blood flowing to the heart muscle.
Traditionally, heart valve replacement and repair and surgery to correct structural defects in the heart have also required open-heart surgery. The chest (including the breastbone, or sternum) is cut open to expose the heart. Increasingly, valve replacement and repair surgeries, bypasses and correction of heart defects are being accomplished through smaller chest incisions. These less invasive surgeries are often called “keyhole” surgeries.
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