Download Open Heart Surgery

Open Heart Surgery at
Shafa Heart and Vascular Subspecialized Hospital
Introduction
Patients who doesn’t have serious heart disease usually do the paraclinical issues one or two days
prior to the surgery such as tests,chest imaging and ECG.Due to the fear existing in patients because
of the operation,the prerequisite affairs before the operation like training about operation would face
some dificulties.
What is Coronary artery bypass grafting (CABG)
In this kind of operation doctors would make an bypass route for transfering blood from the heart to
the body by taking out some arteries from leg or hand.
Reasons of coronary artery disease
Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced
"cabbage") surgery, and colloquially heart bypass or bypass surgery, is a surgical procedure consisting
of either diverting the left internal thoracic artery (left internal mammary artery or "LIMA") to the left
anterior descending (LAD) branch of the left main coronary artery; or a harvested great saphenous
vein of the leg, attaching the proximal end to the aorta or one of its major branches, and the distal end
to immediately beyond a partially obstructed coronary artery (the "target vessel") - usually a 50% to
99% obstruction. The purpose is to restore normal blood flow to that partially obstructed coronary
artery. It is performed to relieve angina unsatisfactorily controlled by maximum tolerated antiischemic medication, prevent or relieve left ventricular dysfunction, and/or reduce the risk of death. It
does not prevent heart attacks. This surgery is usually performed with the heart stopped, necessitating
the usage of cardiopulmonary bypass; however, two alternative techniques are also available allowing
CABG to be performed on a beating heart either without using the cardiopulmonary bypass deemed as
"off-pump" surgery or performing beating surgery using partial assistance of the cardiopulmonary
bypass called as "on-pump beating" surgery. The latter gathers the advantages of the on-pump stopped
and off-pump while minimizing their respective side-effects.
The obstruction being bypassed is due to arteriosclerosis, atherosclerosis, or both. Arteriosclerosis is
characterized by thickening, loss of elasticity, and calcification of the arterial wall, most often
resulting in a generalized narrowing in the affected coronary artery. Atherosclerosis is characterized
by yellowish plaques of cholesterol, lipids, and cellular debris deposited into the inner layer of the
wall of a large or medium-sized coronary artery, most often resulting in a focal partial obstruction in
the affected artery, Each can limit blood flow if it causes a cross-sectional narrowing of at least 50%.
Tips for Patients and Families in ICU
The Intensive Care Unit (ICU) is a very "intense" area and can create a great deal of tension
and stress for patients and families. Effective and appropriate communication is an important part of
the healing process, not only for the patient, but also for the family. The following are suggestions for
family members on how to communicate with a loved one in the ICU:

Speak in a calm, clear manner. Make short positive statements. Many family members assume
because their loved one is on a ventilator they cannot hear and so they speak loudly, don't worry
they can hear you.

Acknowledge and recognize any discomfort your loved one may be experiencing. For example,
you may tell them, "You're are in the ICU and you have a tube to help you breath. This is just
temporary and we will get the nurse to give you some medication to make you more
comfortable, you are doing great and making progress."

Do not ask the patient questions that cannot be answered. Use a board so the patient can point to
a word such as "pain," this allows your loved one to make his need known. Most ICU's have
these boards available or will make one for you. It is not unusual for patients to be angry,
frustrated, or not be interested in communicating. Be patient with them, the frustration level will
decrease and perhaps another method of communication will work better for them.

Provide a small board for the patient to write on. Many patients can write just enough so you
know what they want. The hospital should provide this, however, these boards can also be
purchased at a drug store or art supply store.

Offer short phrases that offer support and reassurance. For example, "Mom, its Maureen, I'm
here with you and you are doing much better. Everyone is taking good care of you."

Simple hand gestures may work as well, such as thumbs up = "good"; and thumbs down = "pain"
or "I need something."

Remind your loved one that "this is just temporary and they are making good progress." Flood
them with faith and hope.

Hold your loved one's hand or touch them gently (be sure to check with the ICU staff first). For
example, rubbing lotion on their hands or feet may not be allowed.

Orient your loved one to the surroundings, for example, the date and time of day. You may want
to make a sign each day with the date on it and place it where they can easily see it (for example,
on the wall at the foot of their bed). Describe what the different noises are to help ease any fear
or anxiety they may have about them.

Read your loved one's favorite prayers, poems, books, stories, or bible verses.

Music may be allowed in the ICU when appropriate. Again be sure to check with the ICU staff
for guidance.

Finally, just ask — the ICU staff may have the perfect suggestion for you to assist you in
communicating with your loved one.