From Hollywood films to the most valid scientific conferences there is reference to “open heart interventions”. This well -known expression is perhaps the most misunderstood expression of cardiac surgery. The most common wrong impression is that the expression refers to an operation where the sternum is opened or to surgery where the heart comes out of the body (which is done only in transplants).

Historical reference

To explain what this expression means we must also refer to the history of cardiac surgery. Prior to today’s technological developments that allow the heart to be safely performed, there was hesitation in attempting any surgeon in the heart.

Famous German surgeon Billroth had stated in the 19th century that any surgeon who attempted heart surgery would immediately lose respect for his colleagues. Due to the blood flow within the heart, the first interventions were on the surface of the heart for stapling wounds.

The first interventions of the heart valves, which are inside the heart, were performed by a “closed heart” method. Without opening his heart, the surgeon blinded his finger inside the heart through a suture that quickly tied it to avoid much blood loss.

The variety of heart surgeries has increased dramatically with the invention of the IVF machine. This machine replaces the function of the heart during surgery and allows the surgeon to intervene inside the heart without the presence of blood that prevents vision.

So open heart surgery is an operation in which the surgeon opens the interior of the heart, usually with the help of the IVF machine.

What interventions are considered open heart surgery

Aortic bypass, better known as bypass, is an operation in which the cardiac surgeon uses arteries and veins from other parts of the patient’s body to bypass narrowing in arteries that feed the heart muscle with blood. Because the arteries of the heart are on the surface of the heart, bypass surgery typically does not meet the criteria to be considered an open heart surgery. However, because it is the most common heart surgery, it is often placed in the same category as other open heart surgery.

Most other heart interventions are considered formal open heart surgery because they take part in some extent within the inner heart. These interventions include aortic valve, mitral valve, pulmonary valve, valve, valve, aortic aneurysm (aortic root, aortic, aortic arc), various tumors of the heart (myxomas) , and myectomy for hypertrophic cardiomyopathy.

What does a little invasive, robotic endoscopic or thoracic cardiac surgery mean? Do these interventions belong to “open heart surgery”?

Around the 1980s, the first attempts to intervene without the opening of the sternum began. These interventions usually use some incision between the sides with or without the use of a camera or robot. These procedures are typically considered open heart surgery because the procedure differs only in the surgical incision and not in the intervention in the heart. The majority of cardiac surgery can be carried out without sternum but not to all patients. The surgeon will decide whether the patient’s anatomical and clinical characteristics allow the surgery without sternum.

What has changed in heart surgery and why does the expression “open heart surgery” belong to the past?

As the latest medical specialty, cardiac surgery has seen impressive technical developments in the 70th anniversary of the first open heart surgery. The initial era of cardiac surgery has been difficult for technical problems that led to high -risk interventions with a dubious result. Since 1953, when the first “open” heart surgery, there have been developments in machinery and medicines as well as international protocols to carry out interventions resulting in the dramatically reduced risk of surgery. The expression “open heart surgery” belongs to a time when there were “closed heart interventions” almost a whole century ago. Today there are simply “heart interventions” that come to give a quick and effective solution to the biggest threat to humans: heart disease.

Conclusions

The expression “open heart surgery” was formed at a time when cardiac surgery was in the early stages of evolution with many technical difficulties. Today this expression belongs to the books of History and reminds us of the difficulties that the pioneering colleagues have surpassed to enjoy our patients the excellent results we have today.