How doctors determine when heart surgery is necessary
When doctors are deciding whether surgery is necessary, they will weigh the risks and benefits of surgery and the risks of not performing surgery.
Some factors that heart surgeons and cardiologists will consider when determining whether surgery is necessary are:
- Overall health
- Lifestyle factors (smoking, obesity, diet and sedentary lifestyle)
- Severity of the heart condition
- How symptoms are affecting quality of life
- The risks of having or not having surgery
Ultimately, it’s up to each patient whether surgery is the right option for them.
Risks to surgery
Most people’s risk of complications during or after a planned heart bypass surgery is low. Your surgeon will take steps to reduce the risk of complications, but there are some possible complications during and after the procedure. Some of the more common risks are:
- Blood clots pulmonary embolism (PE) or deep venous thrombosis (DVT)
- Stroke or heart attack
- Kidney dysfunction
- Memory loss or difficulty thinking clearly
If you have emergency heart bypass surgery or you have additional health conditions, your risk of complications may be higher than normal. Talk to your surgeon about what your specific risks are.
Heart surgeries and procedures
There are many different heart procedures performed to correct different types of heart conditions. The most common heart surgery performed is coronary artery bypass graft (CABG). In addition, our cardiac surgeons and cardiologists perform many different complex procedures, including:
- valve repair or replacement, including transcatheter aortic valve replacement (TAVR) / transcatheter aortic valve implantation (TAVI) and transcatheter mitral valve replacement (TMVR)
- multiple valve replacements
- aortic surgery to repair aneurysms or dissections including open and endovascular aorta repair
- combined operations such as "aortic or mitral valve replacement or CABG" or "aortic arch repair with endovascular extensions"
- removal of myxoma, tumor of the heart
- MAZE procedure to correct arrhythmia
- surgery to correct congenital (genetic) heart defects such as atrial septal defect or patent foramen ovale
- left ventricular remodeling
Survival rates for heart surgery
There are websites that compile outcome data for hospitals and types of surgery, and that data sometimes includes mortality rate (the percentage of people who die from the surgery).
Survival rates are calculated by type of procedure. For example, the average mortality rate is about 1.7 percent for heart valve surgery. That means fewer than two people out of every 100 who have heart valve surgery in the United States will die from the surgery.
Recovery and rehabilitation
Heart surgery can take a toll on your body and mind, but you can take steps to reduce your recovery period and have a successful rehabilitation. Your work starts right after surgery. Here are some tips:
- Follow your discharge instructions – It’s important to follow your post-surgery instructions. You may have both restrictions and recommendations. Remember, if you have any concerns, call your doctor.
- Take care of your incision – This is especially important with larger incisions, but it’s important any time a surgeon makes an incision in your skin. To help avoid infection, keep your incision site dry. If you notice any signs of infection, contact your doctor right away. These signs include:
- Increased oozing or draining from the incision site
- Gaping or opening of the site
- Manage your pain – Pain isn’t something to ignore. If you have severe pain, it can impede your recovery. If you manage your pain, your risk of certain complications goes down. Make sure you follow your doctor’s instructions related to pain medication.
- Sleep – Your body needs rest after surgery. Let yourself sleep as much as you can. Talk to your doctor if you’re having trouble sleeping.
- Take it easy – If you start feeling better, you may be tempted to get back to work or to tackle projects around the house. Make sure you follow your doctor’s instructions about when it’s okay to resume activity, and don’t overdo it. Listen to your body, and give yourself permission to rest and relax.
- Take care of your mental health – Heart surgery can be difficult physically and emotionally. Some people experience anxiety and depression after surgery. If you feel depressed or anxious, you may want to talk with a therapist, psychologist, or psychiatrist. If you don’t have one, ask your doctor for a referral.
Most of our heart surgery patients will benefit from a cardiac rehabilitation program. Talk to your doctor about when you should start participating.
Cardiac rehabilitation is a comprehensive program where the specialized clinicians will guide you with an individualized exercise plan to meet your goals to reduce your risk factors and to provide you with emotional support post-surgery.