First of all, you are not alone. More than seventeen million Americans have some form of heart disease. The majority of these people, about eleven million, have coronary artery disease (blockage of the arteries in your heart). About five million have problems with the valves of the heart and about one million are born with abnormalities of the heart. So diseases of heart and blood vessels represent America’s number one health problem.

 
According the American Heart Association nearly 700,000 heart surgeries were performed in the United States last year. Below is the breakdown by type of heart surgery.

 

  

 Heart surgery encompasses additional risks not seen in non-cardiac surgeries. For this reason, the anesthesia for heart surgery requires more advanced and specialized monitoring, medications, and techniques. Your cardiac anesthesiologist will typically place a specialized catheter into an artery to monitor your blood pressure continuously under anesthesia. He may also place a large IV into the veins in your neck or chest (central line) that passes into your heart to allow a continuous assessment of your heart’s function during surgery.   Sometimes your cardiac anesthesiologist will need to view your heart with ultrasound (an echocardiogram) during surgery. The ultrasound probe will be placed into your esophagus after you are asleep.

 
The anesthetic medications and techniques we use are also quite specific for heart surgery.  Because this surgery places additional strain on the entire cardiovascular system (heart and blood vessels), special medicines to help the heart pump and the blood flow efficiently may be used.

  
For many heart surgeries the “heart and lung machine” may be required. This is known as the cardiopulmonary bypass machine. This machine will allow your heart to stop beating during the surgery, allowing your surgeon to operate on a “still” heart.   The cardiopulmonary bypass machine will take the blood out of your body, purify it, and then send it back to your body, essentially doing the job of your heart and lungs while your surgeon operates.

 

Patients undergoing heart surgery will be completely asleep (general anesthesia).   Under general anesthesia a breathing tube is placed after you are asleep, allowing the anesthesiologist to breathe for you with oxygen and anesthetic gases.   Following heart surgery, most people are not strong enough to breath on their own. In this case, you will be sedated and the breathing tube left in place. When you are strong enough and awake enough to breathe on your own, a specialist will be there to assist you and remove the breathing tube.

 

 Your cardiac anesthesiologist will obtain a careful medical and history. He will obtain the results of all your medical tests including the diagnostic studies of your heart and lungs. Your anesthesiologist will need to a list of all of your medications, both prescription and over-the-counter, including herbal and vitamin supplements. He will inform you of which medicines you should take on the morning of surgery and which ones you should stop taking.   We will ask about your experience with anesthesia and previous surgeries A family history of problems with anesthesia is also important.

 

 Advances in both the surgical and anesthesia specialties continued to make surgery safer for patients. For the majority of healthy people undergoing non-cardiac surgery the risks are very low. Patients undergoing heart surgery however, are at higher risk than people having non-heart surgery for two main reasons. First, heart surgery is very complex. Second, if you are having heart surgery you have some form of heart disease which puts you at higher risk of having a heart complication. The specific risks will be discussed with you by your cardiac surgeon and anesthesiologist.  

 

 There is a greater chance of needing a blood transfusion during heart surgery than with other types of surgery.   Blood transfusions are common during heart surgery primarily due to the complexity of the surgery and the blood thinners used during the procedure.   Blood transfusions are safer now than ever. The risk of getting HIV from a blood transfusion is about 1 in a million. Hepatitis is about 1 in 30,000. Your cardiac anesthesiologist will only give you a blood transfusion if absolutely necessary. For more information on blood transfusions visit       http://www.aabb.org/Content/About_Blood/FAQ/bloodfaqs.htm  

 

Society of Cardiovascular Anesthesiologist

 

American Heart Association – heart disease statistics