The experience of having heart surgery can be quite stressful, particularly if you are unaware of it beforehand. This article aims to help you understand open heart surgery vs bypass surgeryโ and all the basics you need to know!
What Is Open Heart Surgery?
Open heart surgery is a type of surgery in which a large incision is made in the chest in order to access the heart. Surgeons are able to execute a variety of complex cardiac treatments due to this procedure’s direct view and access to the heart.
When is Open Heart Surgery Needed?
Open Heart Surgery may be done in a number of cases. Some of them include:
- Valvular heart disease – Repair or replacement of the heart valves
- Infective endocarditis – Removal of abnormal tissue growth in the heart
- Heart transplant – Replacement of the non-functioning heart
- Aneurysm – Repair of abnormal blood vessels
- Multiple blockages in the heart – Opening up the blood vessels or inserting new vessel grafts
- Heart tumors – Removal of abnormal tumor growths in the heart
The procedure of Open Heart Surgery
In open heart surgery, the heart is momentarily stopped, and blood flow is redirected away from the heart and lungs.
A heart-lung machine is utilized to continue oxygenation and blood circulation. By taking over the heart’s and lungs’ functions, the machine allows the surgeon to operate on the heart as needed.
In order to access the heart during open heart surgery, a large incision must be made through the breastbone or sternum.
What Are The Risks Of Open Heart Surgery?
Because open heart surgery is more intrusive and requires a heart-lung machine, there is a greater chance of some risks.
Infection, bleeding, blood clots, stroke, abnormal heartbeats, or lung issues are a few possible risks.
Nonetheless, the hazards are typically controlled by thorough preoperative evaluation, excellent surgical technique, and postoperative care.
What Is Bypass Surgery?
This procedure, also called Coronary Artery Bypass Graft surgery (CABG), involves attaching a graft (vein or artery) in order to bypass the blocked coronary artery. This enables blood to flow to the heart muscle by bypassing the blocked coronary artery and taking blood straight from the aorta.
Depending on the number of diseased arteries, one or multiple bypass grafts may be utilized.
When is Bypass Surgery Needed?
Bypass surgery is majorly required in cases of heart vessel diseases in order to combat the blockages in these vessels.
This includes cases of:
- Left main artery diseaseย
- Two-vessel disease
- Three-vessel disease
Bypass surgery may also be performed in case of:
- Failure of angioplasty procedureย
- Post Myocardial Infarction (Heart Attack) complicationsย
- Cardiogenic shock
- Artery disease with ischemia
The procedure of Bypass Surgery
Bypass surgery involves creating a bypass for blood flow around occluded coronary arteries. This is achieved by connecting a conduit to the blood supply upstream
What Are The Complications Of Bypass Surgery?
Bypass surgery is a less extensive surgery which is why the complications are few and have lower chances of occuring.
- Haemorrhage.
- Infection of the wound.
- Heartbeat irregularities (arrhythmia)
- Kidney failure.
- Fluid build-up in the lungs (pleural effusion)
- Blood clots in the leg veins (thrombosis)
- Stroke
Difference between bypass and open heart surgeryโ
Now let us understand open heart surgery vs bypass surgeryโ by looking at the differences between them.
| Open heart surgery | Bypass surgery |
| Involves accessing the heart by opening the chest through a large incision. | Uses grafts to open “new pathways” for blood to flow around constricted or blocked coronary arteries. |
| Keeps the blood flowing by using a heart-lung machine. | The use of a heart-lung machine may or may not be required. |
| Involves making a large chest incision. | Small incisions are necessary for inserting the graft. |
| Longer recovery time as a result of the procedure’s invasiveness. | The recovery time can range from a few weeks to many months. |
| Suitable for a variety of complex cardiac procedures. | Utilized specifically to bypass blocked or constricted coronary arteries. |
| Longer hospital stay as it is a complex surgery. | Hospital stay may vary from a few days to a few weeks. |
| Larger scar. | Smaller scar. |
How much do Open Heart Surgery and Bypass Surgery Cost?
The cost variation of open heart surgery vs bypass surgeryโ largely depends on how extensive the surgery will be, severity of the heart disease, expertise required to perform the surgery as well as the equipment and tools required during the surgery.
The average cost of open heart surgery vs bypass surgery is as follows: open heart surgery costs between 1.5 lakhs to 5 lakhs in India while bypass surgery costs around 2-3 lakhs.
Additional costs of open heart surgery and bypass surgeryโ comprise ICU stay and hospital stay costs.
Open Heart Surgery and Bypass Surgery Side Effects
If we compare the side effects of open heart surgery vs bypass surgeryโ, we can see that both have inherent side effects of their own. They also have a few side effects in common.
| Open heart surgery | Bypass surgery |
| Muscle pain of the chest | Less pain |
| Limited movement and mobility after surgery | More movements possible with only slight limitation |
Difficulty with bowel movements Loss of appetite Mood changes Fatigue (tiredness) A lump/swelling at the site of the incision Irregular heartbeat (arrhythmia) | |
What Is the Survival Rate of Open Heart vs Bypass?
Open heart surgery has variable survival rates, which depends largely on whether complications occurred during or after the surgery. About 2.7 – 13.7% of patients die after open heart surgery, particularly due to infections.
Open heart surgery survival rates is 86.3 – 97.3
Bypass surgery has successful survival rates. Only 1.7 – 3.5% of cases result in death, usually in patients who are considered as โhigh-riskโ. High-risk includes patients who undergo emergency bypass surgery or those who have been re-operated.Bypass surgery survival rates is 96.5 – 98.3%
Conclusion
Open heart surgery and bypass surgery are both surgeries performed for patients suffering from heart problems. They differ in terms of the procedure, heart condition, costs and risks involved. While bypass surgery is relatively safer and less costly, open heart surgery may be necessary when the heart disease is severe to save the patient’s life.
For more information on open heart surgery vs bypass surgeryโ, book a consultation with Dr. Nikhil P.J.Theckumparampil, Heart Specialist & Cardiac-Surgeon, at Heart360 Care.
Frequently Asked Questions
Open heart surgery includes operations on the chest, such as the heart’s muscles, valves, or arteries. Bypass surgery includes inserting a graft of artery to bypass the constricted or blocked coronary artery.
The average life expectancy after Bypass surgery is 10-20 years and is the same in men and women. The life expectancy is longer in those who undergo multiple artery grafts compared to single artery grafts during bypass.ย
There is a higher risk of death after Bypass surgery with the increasing age of the patient.
Bypass Surgery is a life-saving procedure which involves inserting grafts of arteries to combat the blockage in coronary arteries. It is a less invasive surgery compared to open heart surgery.
References
- Karunarathna, I., Hapuarachchi, T., Gunasena, P., Aluthge, P., Perera, N., Gunathilake, S., De Alvis, K., Gunawardana, K., Rajapaksha, S., Warnakulasooriya, A., Athulgama, P., Dius, S., Ranwala, R., Bandara, S., Godage, S., Rodrigo, P. N., Jayawardana, A., Vidanagama, U., Fernando, C., & Ekanayake, U. (2024). CABG vs. PCI: A comprehensive analysis. Uva Clinical Anaesthesia and Intensive Care, 1.
- Pรฉrez-Granda, M. J., Barrio, J. M., Cuerpo, G., et al. (2024). Infectious complications following major heart surgery from the day of the surgery to hospital discharge. BMC Infectious Diseases, 24(73).
- Hirnle, G., Stankiewicz, A., Mitrosz, M., Aboul-Hassan, S. S., Kocaลda, S., Deja, M., Rogowski, J., Cichoล, R., Pawliszak, W., Bugajski, P., Tobota, Z., Maruszewski, B., Knapik, P., Krejca, M., Cisowski, M., & Hrapkowicz, T., on behalf of KROK Investigators. (2024). Does the Coronary Artery Bypass Grafting Impact the Survival of Men and Women Equally Compared to General Population? Results from KROK Registry and Polish Central Statistical Office. Journal of Clinical Medicine, 13(23), 7440.
