Open Heart Surgery: Types, Causes and Nursing Care Intervention

Definition of Open Heart Surgery:

Heart surgery is any surgery done on the heart muscle, valves, arteries, or the aorta and other large arteries connected to the heart. The term “open heart surgery” means that the patient is connected to a heart-lung bypass machine, or bypass pump during surgery. The heart is stopped while patient is connected to this machine. This machine does the work of the heart and lungs while patient heart is stopped for the surgery.

Open heart surgery nursing care
Fig: Open heart surgery nursing care

Definition of Cardio Thoracic Surgery:

Cardiothoracic surgery is the field of medicine involved in surgical treatment of organs inside the thorax (the chest)-generally treatment of conditions of the heart (heart disease) and lungs (lung disease).

Types of Open Heart Surgery:

Common types include-

  1. Heart bypass surgery (coronary artery bypass graft – CABG),
  2. Heart valve surgery,
  3. Surgery to correct heart defect present at birth.

Causes of Cardio Thoracic Surgery or Open Heart Surgery:

It includes-

  • Treat heart failure and coronary heart disease (CHD),
  • Fix heart valves that don’t work well,
  • Control abnormal heart rhythms,
  • Place medical devices,
  • Replace a damaged heart with a healthy one.

Nursing Intervention of Open Heart Surgery or Cardiac Surgery:

Nursing care of cardiac surgery may include-

  1. Pre-operative care,
  2. Post-operative care.

Preoperative Nursing Care Open Heart Surgery/Cardiac Surgery:

It includes-

  • At first receive the patient in the surgical ward.
  • Provide comfortable bed and all the vital signs should be measured.
  • Take history from the patient.
  • Collect all the investigation report and prepare a pre-operative file.
  • The patient should be kept on nothing by mouth usually -8 hours before surgery according to doctor’s order.
  • Sedative as well as laxative should be given.
  • All jewelers, false teeth, hearing aids should be removed.
  • Shave and clean the respective area of operation.
  • Written consent should be collected from the patient or patient relatives.
  • Encourage the patient to empty the bladder.
  • If necessary catheter may be introduced.
  • Administer pre-operative medication and send the pt to the operative room with his file.

Post-Operative Nursing Intervention Open Heart Surgery/Cardiac Surgery:

It includes-

  • Proper monitoring and ICU care is essential.
  • ECG, temperature, BP, cardiac monitoring, strictly
  • Provide oxygen therapy if needed.
  • Patient should keep on nothing by mouth.
  • Urine output has to be assessed to regular intervals
  • Acidosis and hypocalcaemia to be corrected early.
  • Give narcotic analgesia every 3 hours during first 24 hours then as needed
  • Give frequent mouth care
  • Provide back care
  • Plan activities to permit periods of sleep
  • Drains from pericardium, mediastinum should assess carefully.
  • Dopamine, dobutamine, isoproterenol are the drug used when there is low cardiac output.
  • Care of endotracheal tube, suctioning, checking the parameters in intermittent positive pressure ventilation.
  • Strict aseptic technique should be maintained
  • Resume diet, at first provide liquid diet then semi solid and then solid.
  • Teaching-
  • Progressive return to the physical activities.
  • Rehabilitation exercise programme.
  • Sexual activity usually permitted in 3 to 4 weeks.
  • Eat a balance diet.
  • Need for ongoing medical care.

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