Open-Heart Surgery

Your Heart Is in Experienced Hands at the DMC

The Detroit Medical Center’s (DMC) open-heart surgery program is made up of cardiovascular surgeons, critical care specialists, physician assistants, cardiac nurses, nurse practitioners and technicians.

When it comes to your heart, you need someone you can trust. The Heart and Vascular Institute at the DMC has delivered advanced cardiac care to our community for more than three decades. DMC Harper University Hospital is proud to be ranked by U.S. News and World Report for 2022-2023 as High Performing in Chronic Obstructive Pulmonary Disease, Heart Attack and Heart Failure.

Our range of services includes a comprehensive spectrum of diagnostic testing, which allows us to pinpoint a variety of conditions. We provide advanced cardiac care, including interventional cardiology procedures and open-heart surgery. Our care extends to the post-surgical period where we supervise cardiovascular rehabilitation and continue to monitor your heart health.

The DMC Rehabilitation Institute of Michigan provides physical medicine and rehabilitation services with more than 30 locations in southeast Michigan. Cardiac rehab is a medically supervised program which helps improve the health and well-being of people who have heart problems. The outpatient program includes customized exercise training, education on heart healthy living, and counseling to reduce stress and help you return to an active life. Cardiac Rehab is available at DMC Rehabilitation Institute of Michigan, DMC Sinai-Grace Hospital and DMC Huron Valley-Sinai Hospital.

What Is Open-Heart Surgery?

Approximately 500,000 people undergo open-heart surgery each year in the United States to correct various cardiovascular diseases. Open-heart surgery is a major operation where surgery is usually performed through a midline incision and division of the breast bone to provide surgeons full exposure of the heart muscle, valves, coronary arteries which supply blood to the heart, the aorta, and other large arteries connected to the heart.

During surgery, blood is rerouted through a heart-lung bypass machine which oxygenates and pumps the blood, thus doing the work of the heart and lungs. This allows the surgeon to operate on the heart while it’s not beating and empty of blood. Open-heart surgery is often the best therapy if medical and non-invasive approaches are not optimal for treating certain heart conditions.

Today’s technology allows doctors to perform the following surgical approaches to operate on the heart:

Off-pump heart surgery

This is a procedure which is like traditional open-heart surgery where the chest wall is opened to access the heart. The difference is the heart is not stopped during surgery and the patient is not connected to a heart-lung bypass machine. The surgeon uses a stabilizing device to keep the heart still in the precise spot where they are sewing. This procedure can avoid some complications in patients who are at higher risk.

Minimally invasive surgery

This is a type of surgical approach which involves making smaller incisions in the side of the chest between the ribs without having to open the breastbone to reach the heart. The most common example is robotic-assisted surgery where a surgeon uses a computer to control surgical tools on thin robotic arms to do complex and highly precise surgery. Surgery of this type is often specifically targeted to a small subgroup of valve surgery patients.

What Are the Reasons for Open-Heart Surgery?

Patients most commonly benefit from these procedures for the following purposes:

• Treat occlusive coronary heart disease
• Repair or replace heart valves which control blood flow through the heart
• Repair abnormal holes or damaged structures in the heart, often because of infection
• Implant medical devices to help control the heartbeat or support heart function and blood flow
• Replace a damaged heart with a healthy heart from a donor

What Are the Common Types of Open-Heart Surgery?

Coronary Artery Bypass Grafting

Coronary Artery Bypass Grafting (CABG) is the most common open-heart surgery procedure. It is used to treat people who have severe blockages of the coronary arteries. These blockages are caused by plaque which builds up inside the coronary arteries and blocks the supply of oxygen-rich blood to the heart.

During CABG, the surgeon takes healthy arteries or veins from other parts of the body and sews them to a normal part of the coronary artery past the blockage thereby “bypassing” the blockage. The grafted arteries or veins reroute the blood around the blocked portion of the artery to supply oxygen-rich blood to the heart muscle. A patient may undergo multiple bypass grafts depending on the number of clogged arteries.  

This procedure improves the supply of blood and oxygen to the heart, relieves chest pain, reduces the risk of a future heart attack, and improves the patient’s ability for physical activity that has been limited by the ability of the heart to maximize its pumping because of a lack of blood flow.

Heart valve repair or replacement

Healthy heart valves allow blood to precisely flow between different chambers and then out of the heart into large arteries. Each valve has a leaflet, which appropriately opens wide to allow the blood to pass unrestricted and then close tightly to stop the blood from going backwards.  Surgery is performed when these leaflets do not open as wide as they should or if they do not close tightly. To fix these problems, surgeons perform either valve repair of the existing leaflets or valve replacement using an artificial valve. Artificial valves can be mechanical or biological. Mechanical means they are made from carbon and graphite. A biological valve can be pig or human valves, or made from the sac surrounding a cow’s heart. In properly selected patients, this operation can dramatically improve both the quality and the longevity of the patient.

Corrective surgery for a heart defect present at birth

Congenital heart disease (CHD) is caused by defects in the heart and great vessel structures. They are the most common types of birth defects. Babies born with one or more heart defects have CHD. CHDs can affect the structure of a baby’s heart, the way it works, and how blood flows through the heart and out to the rest of the body. Corrective surgery can treat a heart defect that a child is born with. The number of surgeries to repair the heart or blood vessels depends on the type and severity of the defect. The most common surgery is to close holes between the heart chambers.

What Are the Risks of Open-Heart Surgery?

The risk of post-surgical complications increases as people age or if their procedure is urgent or an emergency. Patients that have multiple medical problems can be at higher risk for some debilitating complications such as a stroke or kidney failure.  Some people may experience transient memory loss and problems concentrating or thinking clearly after surgery. Other risks include:

• Bleeding
• Infection, fever, swelling and other signs of inflammation
• A reaction to the medicine used to make the patient sleep during the surgery
• Irregular heartbeats (arrhythmias)
• Damage to the tissues in the heart, kidneys, liver and lungs
• Stroke
• Death

Open-Heart Surgery at the DMC

We most commonly perform coronary artery bypass grafting surgery and various heart valve procedures. The list below encompasses many of the procedures we perform.

• Aortic Root Replacement
• Aortic Surgery
• Atrial Myxoma Resection
• Atrial Septal Defect Repair
• Carotid Endarterectomy
• Coronary Artery Bypass Surgery (CABG)
• Foramen Ovale Repair
• Heart Valve Repair/Replacement Surgery
• Minimally Invasive Aortic Valve Replacement
• Minimally Invasive Mitral Valve Repair or Replacement
• Off-Pump Coronary Artery Bypass Grafting
• Pacemaker Lead Extraction
• Pericardiectomy
• Repair Aortic Aneurysm/Dissection (Ascending & Descending)
• Repair Ventricular Aneurysm
• Valve Repair/Replacement
• Vascular Surgery
• Ventricular Septal Defect Repair