The cardiac surgery

THE DIFFERENT STAGES OF THE CARDIAC SURGERY

- Opening the thorax and accessing to the heart
- The extra corporeal circulation
- Stopping the heart: cardioplegia
- The operation
- Stoppage of the extra corporeal circulation and resumption of the cardiac activity
- The post-operative intensive care
- The stay in hospital
- Convalescence and re-education

These different stages are: opening, starting up of the extra corporeal circulation (ECC), surgery in itself (the surgical gesture), stoppage of the extra corporeal circulation and closing.

Opening the thorax and accessing to the heart

This is achieved by cutting the sternum lengthwise. This gesture is called a “median sternotomy”.

Concretely, the surgeon cuts the sternum with the help of a saw from its lower part (the sternal manubrium situated at the level of the hollow of the stomach) up to its upper part (under the chin).

Sometimes, the thorax is opened directly.

- Accessing to the heart

The surgeon then arrives directly on contact of the patient's heart, and more especially at the level of the external layer of the heart.

Then he opens this external tunica, named the pericardium, which allows him to assess the size of the heart cavities and coronary arteries.

However, the surgeon cannot operate the heart easily because of the existence of cardiac contractions and respiratory movements.

Therefore, he must either slow down the cardiac frequency, either stop the heart. However, this situation is incompatible with life because then the organs are not irrigated by blood any longer; therefore they are not oxygenated.

A solution has been found for solving this problem: the extra corporeal circulation.

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File last reviewed on dec 18, 2011