Closed Heart Surgery: Causes, Symptoms and Recovery

A heart surgery is typically required for the correction of a defect in the heart. While most of the major defects are treated with the help of open heart surgery, the minor ones can be corrected with the help of closed heart surgery.

A closed heart surgery procedure is performed on patients with minor heart defects. In most of the cases, this approach is used on pediatric patients. A majority of closed heart surgery procedures may involve the major blood vessels that carry blood to the heart and other parts of the body. Some of the examples of procedure performed using closed heart surgery approach include placement of a Blalock-Taussig shunt or pulmonary artery bands and repair of coarctation of the aorta.

Difference between open heart and close heart surgery

The main difference between a closed heart surgery and an open heart surgery is that the former does not require the support of a heart-lung bypass machine during the surgery. That is, a closed heart surgery can be performed on a beating heart, whereas an open heart surgery is performed on a non-beating heart.

Additionally, there is no need for the surgeons to open the chest to access the heart in the case of closed heart surgery. The heart can be accessed through a small hole in the chest (sternotomy) or in the side between the ribs (thoracotomy).

One month before the surgery

Undergo a physical exam advised by the doctor
Quit smoking, if applicable.
Make lifestyle changes to reduce the risk of future heart disease.

Three weeks before the surgery

Visit a dentist.
Stop taking drugs or alcohol, if applicable.
Make necessary arrangements for hospital transfer, preparation of meals after discharge, and other miscellaneous chores and tasks.

One week before the surgery

Undergo all the pre-operational tests recommended by the doctor, including ECG, chest X-ray, and blood tests.
Stop taking any natural or herbal remedies or supplements at least five days before the surgery.
Take aspirin until the day of the surgery, if advised by the doctor.
Stop taking antiplatelet medications and NSAIDs or take action as advised by the doctor.

One day before the surgery

Prepare a hospital bag with all the necessary clothes and medications.
Take medications as advised by the doctor.

The exact steps performed during a closed heart surgery actually depends on the type of procedure being conducted and the approach used to access the heart. The following are some of the major steps taken during closed heart surgery:

General anaesthesia is administered to put you into a deep sleep. This is done so that you remain unconscious during the surgery and do not experience any pain and discomfort.
Since a closed heart surgery is performed on a non-beating heart, the surgeon directly makes an incision or a hole in the chest or the side of the ribs to access the heart.
The surgeon then takes specific actions to perform the corrective surgery for the ailment that the patient is suffering from.
The incision or hole made to access the heart is closed as soon as the surgery is completed.

Closed heart surgery is not always performed as a corrective surgery. Sometimes, it may be performed as a palliative surgery as well. A palliative heart surgery is the one that is conducted to target the problems caused due to a heart defect rather than the defect itself. It is mostly performed when a series of surgeries are scheduled to be conducted for the correction of the heart defect such as a hole in the heart and ventricular septal defect.

Recovery after closed heart surgery depends on how well the surgery has been conducted and also on the overall health of the patient. Since closed heart surgery is conducted for the correction of minor heart defects, the overall recovery is good.

In case it is performed as a corrective surgery, the patient is typically discharged from the hospital within a day or two. In case closed heart surgery is performed as a palliative surgery, recovery may take some time and the patient may be kept in the hospital until other planned surgeries are conducted.

Careful monitoring in the intensive care unit (ICU) is required in some cases. The patient is administered pain control medications through an IV line is required. Complete recovery in case of a closed heart surgery may last for a few days.