It's Topic Tuesday!

Good morning, Aortic Hope community! Today, we will continue with our monthly theme of tackling common myths and misconceptions about aortic disease. The myth for today is “Your heart is removed from your body when you undergo heart surgery”. 

Where does this myth come from? 

When people think about getting heart surgery, they may imagine a dramatic scene where the surgeon opens the chest, completely removes the heart from the body, performs surgery on the heart, and then sews the repaired heart back in place. This sounds quite daunting from a patient perspective, but this is a myth. 

What actually happens during heart surgery? 

In most heart surgeries, the heart stays securely inside your chest cavity the entire time. So, what actually happens if the heart isn’t being removed? 

Before surgery, the patient is placed under general anesthesia, meaning they are completely asleep and do not feel the procedure. During the operation, the surgeon typically makes an incision down the middle of the chest through the breastbone, called a sternotomy, in order to access the heart.

The heart itself stays in the chest, but many types of heart surgery require the heart to be temporarily stopped so that the surgeon can safely perform the operation. A heart-lung machine (cardiopulmonary bypass) is used to temporarily perform the functions of the heart and lungs during the procedure. This machine pumps blood, adds oxygen, removes carbon dioxide, and keeps blood flowing to the rest of the body while the real heart is stopped. Think of this as temporarily putting the heart and lungs on pause while the surgical team works. Once the operation is complete, blood flow to the heart is restored, and the heart begins beating again. 

It is important to note that not every heart surgery requires the heart to be stopped or a heart-lung machine to be used. Some procedures can be performed while the heart is still beating. The approach depends on the specific surgery and the patient's condition. There are also certain specialized procedures in which the heart may be partially lifted or repositioned within the chest to give the surgeon better access. However, this is very different from completely removing the heart.

The Exception

There is one exception - heart transplants. In cases when the heart is severely diseased and can not be repaired, patients require a transplant to receive a new heart. In these procedures, most of the patient’s original heart is taken out of the chest, apart from a small portion of the atria. Then, the healthy donor heart is put into the empty space and sewed to leftover parts of the old atria and main blood vessels. 

Conclusion

The idea that the heart is routinely removed during heart surgery may stem from the fact that heart surgery is complex and involves temporarily taking over some of the heart and lungs' normal functions. However, in reality, the heart generally stays exactly where it belongs - inside the chest.

Modern heart surgery relies on highly sophisticated techniques, technology, and a coordinated surgical team to protect the heart and the rest of the body throughout the procedure. What may sound like a simple question - “Do they actually take your heart out?” - actually opens the door to understanding just how remarkable cardiac surgery really is.

That’s all for today! Next week we will be discussing a common myth about aortic dissections! 

Take care,

Anita Zahiri 

Brown Medical Student