Open-heart surgeries treat heart problems including heart failure, congenital heart defects, arrhythmias, aneurysms and coronary artery disease. During the procedure, a surgeon cuts through the breastbone and spreads the ribcage to access the heart. Open-heart surgery may include CABG (bypass surgery), heart transplant and valve replacement.
Heart surgery is a procedure to treat heart problems. Open-heart surgery is one way surgeons can reach the heart.
Open-heart surgery requires opening the chest wall to make the heart easier for the surgeon to reach. To access the heart, surgeons cut through the sternum (breastbone) and spread the ribs. Sometimes people call this cracking the chest.
Open-heart surgery is a reliable way for surgeons to perform heart surgery. Your surgeon may recommend an open procedure if you are strong enough to tolerate it.
It's possible to do many kinds of heart surgery through smaller, less invasive incisions, including small incisions between the ribs on the right side of the chest.
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You may need open-heart surgery if you have one of these heart conditions:
Certain procedures require direct access to the heart and surrounding blood vessels. Sometimes, these procedures can take place using less invasive techniques. Your surgeon will assess your health to choose the best treatment approach.
These procedures may take place during open-heart surgery:
Sometimes, surgeons place pacemakers or implantable cardioverter defibrillators (ICDs) during open-heart surgery while performing other procedures. Ablation procedures to treat arrhythmias may also occur in the same procedure.
There are two ways to perform open-heart surgery:
To prepare for open-heart surgery, you should follow your healthcare provider’s recommendations about:
Before open-heart surgery, you can expect to have:
Heart surgery is complex. Some surgeries may take six hours or longer. You will receive anesthesia and be asleep during the procedure.
Surgery steps vary depending on the heart condition and procedure. In general, your surgeon:
Depending on the procedure, you may stay in the hospital intensive care unit (ICU) for a day or longer. When you’re ready, you will move to a regular hospital room.
You can expect to stay several days in the hospital. Your heart care team will explain how to care for your incision. You may have a special firm pillow to protect your chest when you cough, sneeze or get out of bed.
After surgery, you may experience:
Open-heart surgery is a major surgical procedure. Like all surgeries, there are risks.
The risk of complications is greater if you have health problems like diabetes or obesity. Lung conditions like chronic obstructive pulmonary disease (COPD) also raise your risk. People who smoke are more prone to surgical and postsurgical issues.
Surgery risks include:
Thanks to medical advancements, many procedures that once required opening the chest can now take place using minimally invasive heart surgery or with small incisions. The surgeon sometimes still needs to cut through part of the breastbone (partial sternotomy).
Depending on your situation, your surgeon may be able to use these methods:
Recovery time varies depending on the surgery type, complications and your overall health before surgery. It can take 6 to 12 weeks (and sometimes longer) to recover from an open-heart procedure.
Your surgeon will let you know when you can return to work and other activities. Typically, you shouldn’t drive or lift anything heavy for the first six weeks.
Some people need to take blood thinners after heart surgery to prevent blood clots. Your healthcare provider may also recommend cardiac rehabilitation. This medically supervised program can help you regain strength and stamina and improve overall heart health.
You should call your healthcare provider if you experience:
A note from Cleveland Clinic
Open-heart surgery is a life-saving procedure. But it is also a major surgery. Recovery can be long. When possible, you should take steps to improve your health — like exercising, losing weight and quitting smoking — before surgery. These actions may make recovery easier. It’s normal to have concerns before undergoing a heart procedure. Don’t hesitate to share questions and concerns with your healthcare provider.
Last reviewed by a Cleveland Clinic medical professional on 03/25/2021.
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