Our Summary

This research paper discusses the evolution of minimally invasive heart surgery techniques. These techniques started with procedures for bypassing blocked coronary arteries and replacing aortic valves without opening the chest entirely. They have further developed to address more complex heart conditions, including repairing mitral and tricuspid valves. While these procedures were initially used for high-risk patients, their success has led to their use being recommended for patients with moderate risk as well. The paper aims to improve nurses’ understanding of these minimally invasive procedures, discussing various current techniques and their associated risks and benefits.

FAQs

  1. What are the origins of minimally invasive cardiac surgery options?
  2. Who are the primary candidates for minimally invasive cardiac procedures?
  3. What are the associated risks and benefits of minimally invasive cardiac surgeries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sternotomy is to follow post-operative care instructions closely to aid in proper healing and recovery. This may include avoiding strenuous activities, taking prescribed medications as directed, and attending follow-up appointments with healthcare providers. It is also important to notify your doctor of any concerning symptoms or changes in your condition after undergoing sternotomy surgery.

Suitable For

Patients who are typically recommended sternotomy include those with complex conditions such as mitral and tricuspid valve repair, as well as high-risk and intermediate-risk patient populations. These patients may benefit from minimally invasive cardiac surgery options, which have shown favorable outcomes in terms of patient recovery and overall outcomes.

Timeline

Before sternotomy:

  1. Patient undergoes preoperative evaluation and tests to determine the need for cardiac surgery.
  2. Patient may be advised on lifestyle changes, medication management, and other interventions to improve heart health.
  3. Surgical team discusses the procedure, risks, benefits, and potential outcomes with the patient.
  4. Patient is prepared for surgery, including fasting and receiving anesthesia.

After sternotomy:

  1. Surgical team performs the sternotomy, which involves a vertical incision through the breastbone to access the heart.
  2. Patient is placed on cardiopulmonary bypass to maintain circulation during the procedure.
  3. Surgeon performs the necessary cardiac repairs or procedures, such as coronary artery bypass grafting or valve repair/replacement.
  4. Once the procedure is completed, the sternum is closed using wires or sutures.
  5. Patient is transferred to the intensive care unit for monitoring and recovery.
  6. Postoperative care includes pain management, monitoring for complications, and rehabilitation to regain strength and function.
  7. Patient undergoes follow-up evaluations and cardiac rehabilitation to optimize recovery and long-term outcomes.

What to Ask Your Doctor

  1. What is a sternotomy and why is it necessary for my procedure?
  2. What are the potential risks and complications associated with a sternotomy?
  3. How long is the recovery period after a sternotomy?
  4. Are there any alternative surgical techniques that could be used instead of a sternotomy?
  5. What steps can I take to help promote healing and prevent complications after a sternotomy?
  6. How often do patients experience complications or adverse outcomes following a sternotomy?
  7. What will my post-operative care and follow-up appointments entail after a sternotomy?
  8. Are there any specific activities or movements I should avoid during the recovery period following a sternotomy?
  9. How long will it take for me to fully recover and regain normal function after a sternotomy?
  10. Are there any long-term effects or considerations to be aware of following a sternotomy?

Reference

Authors: Wahl S. Journal: Crit Care Nurse. 2020 Feb 1;40(1):66-73. doi: 10.4037/ccn2020258. PMID: 32006037