There are numerous risks when it comes to any surgery, and when it comes to open heart surgery, specifically, the risks are no less numerous. There are many types of heart surgery. One of these is MIDCAB surgery (minimally invasive direct coronary artery bypass surgery), which is often called a "keyhole" operation. It is less invasive than CABG (coronary artery bypass graft) when surgically treating heart failure. Most surgeries risk the occurrence of blood clots, breathing problems, infection or blood loss. With any type of heart surgery or operation, like open heart bypass, the aforementioned risks apply in addition to the following:
- Heart attack or stroke. Oftentimes following cardiac bypass, the risk of further damage to the heart is still present. This is why the patient is closely monitored for severe chest pain and other symptoms of heart attack or stroke. This risk is caused by possible trauma to the heart and surrounding tissues during the operation itself.
- Sternal wound infection. To determine if the patient has acquired a sternal (chest) infection, the site is inspected for redness, excessive swelling or tenderness. If there is pus or other discharge from the wound or a foul smell, then it is definitely infected. This commonly occurs in patients who are obese or those who have had previous coronary bypass surgery.
- Post-pericardiotomy syndrome. This is a group of symptoms that is caused by uncertain factors. The manifestations of this syndrome are fever, malaise (weakness), arthralgias (muscle pain), dyspnea (difficulty of breathing), pericardial effusion (abnormally excessive fluid around the heart), pleural effusion (accumulation of fluid around the lungs), friction rub (it's presence is determined audibly and is an extra heart sound).
- Memory loss or loss of mental clarity. This involves disorientation to time and place, and impaired memory or judgment. It includes the patient having "fuzzy thinking", even paranoid delusions or visual and auditory hallucinations. This is commonly caused by sleep deprivation, increased sensory input, age, etc. To avoid the severity of this symptom, the patient must be constantly reminded of what is expected of him, and explanations as to what is happening must be given repeatedly.
- Heart rhythm problems. Cardiac arrhythmias have been known to occur following heart bypass, so the ECG monitor must be monitored closely. The most frequent arrhythmias that occur following coronary bypass surgery are premature ventricular contractions.
The risks during the postoperative period are great, but the incidence of recovery is great as well. Early ambulation is encouraged to prevent pulmonary complications. Proper health education for the patient and his caregivers also greatly contributes to the patient's speedy recovery. The focus of postoperative home care should be for the patient to assume a normal life as quickly as possible. Activities are increased gradually within limits, and it should be ensured that these activities do not cause pain or discomfort. The patient's diet should be limited to small meals, with limited salt and caffeine intake. Cigarette smoking should be avoided. Extremes in temperature should be avoided, and walking against the wind should not be done because it will cause chest pain. Sexual relations may be resumed upon the advice of a physician, and the patient must be informed to notify the doctor if the following symptoms occur: chest pressure or pain, shortness of breath, unusual fatigue, swelling of feet and ankles, fainting, dizziness and heartbeat irregularities.