There is more to heart surgery than only open-heart surgery.
Open-heart surgery is one in which a specialist surgeon opens the chest to reach the heart. In order to To keep the patient alive during the time we are working on the heart, the blood circulation to the body is taken care of by a heart-lung machine. The heart-lung machine oxygenates and pumps the blood back to the body. It is only when we open the heart, that we can see and correct abnormalities in the structure of the heart. In general abnormalities are like holes, blocks, valve malfunction and abnormal interconnections.
Closed Heart surgery:
Closed-heart surgery is surgery in which a specialist surgeon opens the chest to reach the heart or great vessels and then operates on these structures from outside, without stopping or opening the heart. Examples are PDA ligation, Coarctation repair and BT shunt.
Heart Valve Repair or Replacement:
Some people are born with heart valves that do not open adequately and some that do not close well. Some develop disease that damages the valve leaflets later in life. In the past these valves were being replaced even in the USA. Now techniques to repair most of these valves are available in India also. There are advantages of repair over replacement and vice versa.
Coronary artery bypass grafting surgery is done for patients who have blocks in the blood vessels (coronary artery) supplying blood to the heart muscle. To do this, the chest of these patients is opened and the block is identified. Then a suitable artery from inside the chest wall or a vein from the leg is taken to carry blood from the Aorta to the heart muscle, beyond the block. This bypasses the block and brings required blood to the muscle. This prevents heart muscle dying from the lack of oxygen, which is commonly known as a heart attack.
When a person has a severe form of heart disease that cannot be treated either with medicines or surgery, he may need to have the entire heart replaced with a new one. The donor for heart transplant is a person who has had a severe illness or accident and whose brain is damaged irreversibly, also known as brain-death. This healthy heart is harvested (with consent from the close relatives) and surgically transplanted into the recipient in place of (after removing) the diseased heart. This heart functions normally and helps the recipient recover. Yet to protect the transplanted heart we need to keep the patient on medicines for life.