Cardiothoracic surgery is derived from two words: cardio, meaning heart, and thoracic, meaning chest. It encompasses two main subspecialties: cardiac surgery, which focuses on the heart and the blood vessels connected to it, and thoracic surgery, which focuses on the lungs, the oesophagus, and other structures in the chest cavity. Cardiothoracic surgery’s importance lies in its ability to treat life-threatening or debilitating diseases such as coronary artery disease, heart valve disease, heart failure, chest trauma, etc. Cardiothoracic surgery can also improve the quality of life and survival of patients who need organ transplants, such as heart or lung transplants. In this comprehensive guide, we will cover some of the most important aspects of cardiothoracic surgery, such as the types of procedures, the preoperative and postoperative care, the recovery process, the potential complications, and the outlook for patients.
Types of cardiothoracic surgery:
There are many different types of cardiothoracic surgery, depending on the organ involved, the disease being treated, and the technique used. Dr. Ranjit Jagtap tells us about some of the most prevalent types are:
- Open-heart surgery: This is a type of cardiac surgery that involves opening the chest wall and operating on the heart while it is stopped and connected to a heart-lung machine. This machine takes over the function of pumping blood and oxygenating it while the surgeon repairs or replaces parts of the heart, such as the valves, the arteries, or the chambers. Open-heart surgery is used to treat conditions such as coronary artery disease, heart valve disease, congenital heart defects, or aneurysms.
- Minimally invasive heart surgery: Minimally invasive heart surgery involves small incisions in the chest wall, inserted thin instruments, and a camera to operate on the heart without stopping it. It can perform valve repair, bypass grafting, or ablation of abnormal heart rhythms. It offers advantages over open-heart surgery, such as less pain, bleeding, infection risk, and recovery time. However, it may not be suitable for everyone and may have limitations or complications depending on the case.
- Thoracic surgery: Thoracic surgery involves operating on organs in the chest cavity, such as the lungs, esophagus, or chest wall. Common procedures include lung resection, esophagectomy, lobectomy, pneumonectomy, thoracotomy, thoracoscopy, mediastinoscopy, or pleurodesis. It is used to treat conditions like lung cancer, esophageal cancer, emphysema, pleural effusion, or chest trauma.
- Pain management: Cardiothoracic surgery often causes pain, which can be managed with medication like opioids or NSAIDs. Non-pharmacological methods like ice packs, heat pads, massage, relaxation techniques, or distraction can also help reduce pain. Patients should report their pain level to healthcare providers and follow instructions for safe medication use.
- Wound care: Wound care is crucial for preventing infection and promoting healing in surgical sites. It involves maintaining cleanliness, changing dressings, inspecting for signs of infection, and avoiding scratching or touching. Patients should follow their surgeon’s advice on wound care and removal of sutures or staples.
- Rehabilitation: Rehabilitation is crucial for recovery after cardiothoracic surgery, restoring heart, lungs, and other affected organs and muscles. It may involve physical, respiratory, cardiac, occupational, or speech therapy. Patients should follow their rehabilitation plan and goals, participating in suitable exercises and activities for their condition and progress.
- Recovery: The recovery process after cardiothoracic surgery varies depending on the procedure, patient health, and complications. Patients may stay in the hospital for a few days to weeks and may require support devices like breathing tubes, chest tubes, urinary catheters, or IV lines. At home, recovery may take weeks to months. Patients should follow discharge instructions, visit surgeons and primary care providers regularly, monitor vital signs, and report any abnormal symptoms to healthcare providers.
- Eating Healthy: Patients should eat a balanced and nutritious diet that is low in salt, fat, cholesterol, and sugar, and high in protein, fiber, vitamins, and minerals. Patients should also drink plenty of fluids, such as water, juice, or milk, to stay hydrated and prevent constipation. Patients should avoid alcohol, caffeine, or tobacco, as they can interfere with healing and cause complications.
- Proper Rest: Patients should get adequate sleep and rest to aid in body recovery and healing. Sleep on the back or side with an elevated head, avoid sleeping on the stomach or chest, and avoid napping during the day to not disrupt sleep cycle at night.
- Light Physical Activity: Patients should start walking and moving as soon as possible after the surgery to improve their blood circulation, lung function, muscle tone, and mood. Patients should walk slowly and gradually increase their distance and speed as they feel comfortable. Patients should avoid lifting heavy objects, pushing or pulling anything, or reaching above their head for at least six weeks after the surgery. Patients should also avoid driving until they are cleared by their surgeon.