Cardiac Surgery

Cardiac surgery covers the operations used to repair or replace structures inside the heart when medication and catheter-based treatment can no longer control a condition or prevent it from worsening. It is considered when the underlying problem is mechanical — a blocked artery, a failing valve, a hole between chambers, or a weakened vessel wall — and when correcting that structure offers a better outlook than continuing medical treatment alone.

Conditions treated

• Coronary artery disease — narrowing of the vessels supplying the heart muscle, treated with bypass grafting.
• Valve disease — valves that have become narrowed (stenosis) or leaky (regurgitation), treated by repair or replacement.
• Congenital heart defects — structural differences present from birth, including septal defects and more complex anomalies.
• Diseases of the aorta — aneurysm or dissection of the body's main artery.
• Complications of previous heart disease, such as damage following a heart attack or infection of a valve.

How the operation is carried out

Most open procedures are performed through the breastbone, with the heart temporarily supported by a heart–lung machine while the repair is completed. In selected patients, an operation can be performed on the beating heart, or through smaller incisions between the ribs rather than through the breastbone. Which approach suits a particular patient depends on the anatomy involved, the number of problems being corrected at once, previous operations, and general fitness.

Assessment before surgery

A decision is never taken on a single test. Assessment usually brings together echocardiography, coronary angiography or CT, blood tests, lung function where relevant, and a review of other medical conditions. The aim is to establish whether surgery is the right treatment, which operation gives the most durable result, and how risk can be reduced beforehand — for example by optimising diabetes, anaemia, or dental infection.

Recovery

Patients typically spend the first day or two in intensive care, followed by several days on a ward. Walking begins early, and breathing exercises are an important part of recovery. Returning to normal daily activity usually takes several weeks, with driving and heavier work resuming later, guided by how the breastbone is healing. Cardiac rehabilitation improves both recovery and long-term outcome, and is recommended wherever it is available.

Risks

All cardiac surgery carries risk, and that risk is individual. It depends on the operation itself, heart function, age, kidney and lung function, and other conditions. Risk is discussed openly and specifically during consultation, before consent is given, so that the expected benefit can be weighed against it.

This page describes cardiac surgery in general terms for educational purposes. It is not advice about your own case. Decisions about surgery should be made with your treating cardiologist and surgeon after a full assessment.