The heart pumps blood around the body. If the heart does not work as it should, a person may need to undergo a heart procedure as part of their treatment.
Some heart conditions are manageable with medications and lifestyle changes. Others, however, may require surgery.
There are many procedures that can help with heart conditions and save lives. They range from catheters that release narrowed arteries, to transplants, where a surgeon replaces someone’s heart with a donor organ.
In this article, we explore some standard heart procedures and why a doctor may recommend them.
Cardiac catheterization allows a doctor to see how well the heart is functioning and determine whether there is any disease of the heart muscle, valves, or coronary arteries.
Doctors use a right heart catheterization to look at the pressure and function of the heart. A left heart catheterization, on the other hand, helps doctors examine arteries.
The nurse will then clean and shave an area near an artery or vein. Depending on whether a doctor is performing a left or right catheterization, this may be on the groin, elbow, wrist, or neck.
A medical professional will administer a local anesthetic to the area to numb it. Next, a doctor will insert a straw-like tube into the chosen blood vessel. They will then guide the catheter through the tube and into the body. Using a video screen, they will lead the catheter through to the heart.
There are several procedures doctors can use cardiac catheterization for, such as:
- angiography, which allows them to see blockages in arteries
- biopsy, which involves taking a small tissue sample for examination
- stenting, which involves opening up narrow arteries using a small metal tube
- measuring pressure and oxygen levels
Recovery from this procedure takes only a few hours. If the catheter entered through a blood vessel in the groin, a person may need to stay lying down for a while afterward.
Once they leave the hospital, they must follow the doctor’s aftercare instructions and take any medications the doctor has recommended.
A pacemaker is a device that surgeons place in the chest. It sends an electrical signal to the heart to make it beat at the correct pace whenever it is beating irregularly or too slowly.
The entire pacemaker insertion procedure takes 1–2 hours to complete. There are two ways cardiologists can perform the procedure, with transvenous implantation being the more common one.
First, a healthcare professional will administer a local anesthetic and clean the skin below the left collarbone. A cardiologist will then make an incision and insert the pacemaker wires into a vein. Using an X-ray, they will guide the wires to a chamber of the heart.
The other end of these wires is connected to the pacemaker device, which the cardiologist will place between the skin and muscle in the upper chest.
Doctors can fit implantable cardioverter defibrillators in a similar way or place them beneath the skin on the left side of the chest.
In most cases, an individual stays in the hospital overnight after receiving a pacemaker and rests for 1 day.
People can often go back to their usual activities, such as working, within 1 week, depending on the nature of their job. They may need to avoid physical activities that involve reaching up, for 4–6 weeks.
A percutaneous coronary intervention (PCI) opens narrowed or blocked coronary arteries. Previously, health experts called this procedure an angioplasty with stent. A stent is a small metal mesh tube that prevents the artery from closing back up.
Before a PCI, a medical professional will provide a local anesthetic. A doctor will perform catheterization and then thread a small wire through the affected artery. The wire allows the doctor to place in the artery a balloon, which then inflates.
The pressure of the balloon pushes any fat deposits against the artery wall, opening up a larger space for blood to flow. If the doctor is also placing a stent, they will do this at the same time. The stent wraps around the balloon, expanding when the balloon expands, and then staying in place after the doctor deflates the balloon and removes it.
Overall, the procedure takes 30–120 minutes.
Recovery times can depend on the reason for having the PCI.
If a person had abnormal stress test results, they will typically go home on the day of the procedure or the day after. If they have had a heart attack, they will need to stay in the hospital for several days.
A person needs to avoid heavy lifting, driving, and strenuous exercise for at least 1 week after a PCI.
Catheter ablation helps treat arrhythmias, which are rapid or irregular heartbeats. Catheter ablation uses radiofrequency energy to destroy the heart tissue that causes arrhythmia. Afterward, the normal heart rhythm usually returns.
Doctors use this procedure when a person’s body does not tolerate medications for their condition or when the medications are ineffective.
The procedure for catheter ablation is similar to that for cardiac catheterization. However, after inserting the catheter through a blood vessel in the groin, a doctor will also insert wires, or electrode catheters.
When the electrode catheters reach the heart, the doctor will use them to find the tissue causing the irregular heartbeat. To do this, they will release a small electrical signal. Other catheters detect the impact this has on the heart tissues.
The doctor will then guide the catheter to the site of the tissue causing the problem and use painless radiofrequency energy to destroy it. The procedure takes
After catheter ablation, an individual needs to keep the leg with the incision straight for
It is common for a person to need to take aspirin or other blood thinner for 2–4 weeks to help prevent clot formation after this procedure.
People can typically resume regular activities after 24 hours from the procedure, but they may need to avoid strenuous activity for several days.
If an individual has heart failure because one or both ventricles are not functioning, they may need a heart transplant. This is a major operation during which surgeons replace the person’s heart with a donor organ.
Heart transplants involve a person undergoing general anesthesia, which makes them unconscious throughout the procedure. A heart-lung bypass machine replaces the heart during surgery, keeping oxygenated blood flowing around the body.
First, a surgeon will make an incision in the skin of the chest and cut through the breastbone, separating the ribs. They will then remove the patient’s heart by cutting across the aorta, the superior and inferior vena cava, and the main pulmonary artery.
Next, they will divide the left atrium, leaving its back wall in place with the pulmonary vein openings. The surgeon will connect the donor heart to the aorta, vena cava, and left atrium. The heart should then begin beating, at which point the heart-lung bypass machine is no longer necessary.
The surgeon will close the breastbone using metal wire to hold it in place, and use stitches to close the incision in the skin.
An individual who has received a heart transplant needs to spend some time in an intensive care unit.
They typically stay in the hospital for up to
Recovery takes several months, during which time a person will need regular checkups and monitoring.
Other types of heart surgery include heart bypass surgery and valve replacement or repair.
Doctors can perform various procedures on the heart to help with heart problems and restore good cardiac health.
Examples include angioplasty or stenting procedure that return normal blood flow to the heart and prevent arteries from narrowing again.
Other procedures involve implanting a device such as a pacemaker to assist with cardiac function. These devices help with arrhythmias by ensuring that the heart keeps a regular heartbeat.
Recovery time varies widely for each procedure. Some procedures allow for discharge the next day, while others require a few weeks’ stay in the hospital.