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Writer's pictureLiana C.

Open VS. Closed Heart Surgery

Updated: Nov 22, 2020

Written by: Bahar Madani

Heart surgery has been around for years. Whether it is to fix a broken valve or to correct circulation to the heart muscle, the advances seen in heart surgery have been tremendous. When it comes to heart surgery though, there appears to be a fair bit of confusion over the types of surgeries. When an individual has blockages in the heart arteries, one option of treatment other than medicines and stents is bypass surgery. Bypass surgery is sometimes called open-heart surgery. But what is closed heart surgery? This is a bit of a misnomer, mostly because in closed heart surgery as well, the chest cavity needs to be “opened.’’


In open-heart surgery, the chest wall is opened when the heart is operated upon. This surgery could include operations directly on the blood vessels, on the muscle of the heart itself or the valves. The most common type of open-heart surgery that is performed in clinical practice is a Coronary Artery Bypass Graft surgery, also called a CABG. This type of surgery is performed in those individuals who have blocked or narrowed arteries. New blood vessels are attached to the diseased arteries to allow for normal blood supply to be restored to the heart muscle.


The term open-heart surgery is actually a misnomer as well. The use of the phrase ‘open-heart’ does not really mean that the heart muscle is open completely. In fact, the only thing that is opened during the surgery is the chest wall to access the heart muscle.


Open-Heart Surgery

Open-heart surgery can be performed for a number of different reasons. As mentioned earlier, the most common indication is to attach new blood vessels to the diseased old blood vessels to restore normal blood flow to the heart muscle. This is called coronary artery bypass graft or CABG surgery. In addition to CABG, open-heart surgery may also be done to repair or replace heart valves. Sometimes, heart valves can be destroyed due to aging processes or from certain birth defects.


Open-heart surgery is also performed in cases where a part of the heart muscle is permanently damaged. While this is a rare indication, it is now being performed more and more in those who have either thickened heart muscles or bulged out heart muscle (also called left ventricular aneurysm).


Closed Heart Surgery

In closed heart surgery, the chest wall is opened and the heart muscle is accessed to be repaired. Generally, closed heart surgery is performed in children rather than adults. There is not much difference between how a closed heart and open-heart surgery performed. However, the only advantage that close heart surgery has all open-heart surgery is that the former does not require the use of a heart-lung bypass machine. This means that the stay in the hospital can be significantly shorter and recovery times are a lot faster.


Children who are born with certain heart defects can undergo closed heart surgery. There are two different approaches to this kind of surgery – palliative or corrective. In palliative surgery, the procedure is only performed to get rid of certain symptoms or certain associated problems from a main cardiac problem. However, in corrective surgery, the defect itself that is the cause of all the problems is fixed. The choice of whether a patient should undergo closed heart surgery or palliative surgery will be decided upon by the cardiologist. Palliative surgery may also be performed as a part of a staged approach to correcting a heart defect.


Open heart surgery is more commonly performed in adults, while closed heart surgery is more often performed in children. Both have their own role in correcting heart disease.

Source:

Baliga, Vivek. “All about Open Heart Surgery vs. Closed Heart Surgery.” Medlife, 26 Apr. 2018, www.medlife.com/blog/open-vs-closed-heart-surgery.



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