Most Common Open-Heart Surgery Complications

Coronary bypass surgery is a complex procedure.  Like any major surgery, it can lead to a number of life-threatening complications. This is especially true if the proper precautions are not taken.

With the rise of both heart disease and heart failure, more and more coronary artery bypass surgeries are taking place every year. This increase has led to the greater possibility of severe and even life-threatening side effects, from chest pain to sternal wound infection.

With that in mind, here are some of the most common complications after open-heart surgery. If you or a loved one experiences any of these after having a heart operation, seek medical help immediately.

Post-Operative Bleeding

With any type of major surgical procedure, the risk of bleeding is very high. Post-surgical bleeding is so common that doctors will typically leave two small drains in the chest that allow blood to be collected in a bag until the bleeding subsides. Without these drains, blood could remain in the aortic cavity and cause problems with the heart rhythm. This, in turn, could affect the patient's blood pressure.

The bleeding generally comes from the sutures (stitches) that hold blood vessels in place. Typically, the bleeding will stop within a couple hours of surgery. The drains will then be removed. However, in some cases, the bleeding is so severe that it will require doctors to reopen the incision and attempt to fix the cause of the bleeding.

Post-operative bleeding can also be caused by injury to the wound while the incision is still healing. Stitches may come loose or fall out, causing the incision to reopen, This is known as dehiscence. If this occurs, it is important to contact your doctor right away to examine the incision and close it again as necessary.

Blood Clots

Most surgeries come with a high risk of developing blood clots (also called thromboembolism). Clots tend to form in the legs. This is a condition known as deep-vein thrombosis. From there, blood clots can move to the lungs, brain, or heart, causing serious problems as they block the blood flow. In fact, some heart surgeries are performed in order to remove blood clots and avoid serious adverse events.

Coronary surgeries often use a vein from the patient's leg as a coronary artery bypass graft. As a result, the patient's leg often swells, increasing the potential for a blood clot to form. Common preventative measures include wearing compression stockings, propping the legs up, and taking a blood thinner such as Pradaxa or Xarelto.

However, blood thinners can cause problems as well. The manufacturers of Pradaxa and Xarelto have both faced lawsuits because of complications from the drugs.

Bacterial Infections

Bacterial infection after heart surgery is a serious problem for many people. A study published in the Journal of Cardiothoracic Vascular Anesthesia found infection after open-heart surgery occurs in as many as 1 out of every 5 patients. Nearly half of those infections required the individual to remain in the hospital for two weeks or more.

Bacterial infection increases the possibility of further adverse side effects. It can also increase the risk of a fatal postoperative complication.

Hospitals themselves are sometimes the cause of post-heart surgery infections. These are known as nosocomial infections in the medical industry. Nosocomial infections can be caused by a number of factors:

• Unsterile tools
• Unsterile operating rooms
• Malfunctioning equipment
• Inadequate hygiene by medical professionals

Infection risk is also higher in patients who are older, obese, or in poor health.

In recent years, a device known as a heater-cooler unit has been the source of many bacterial infections after open-heart surgery. The Sorin Stöckert 3T Heater-Cooler device was contaminated with a form of nontuberculous mycobacteria (NTM) at the manufacturing plant in Germany.

As a result, there has been a high number of NTM infections among heart surgery patients. These patients have experienced side effects like sudden weight loss, muscle aches and night sweats. In some cases, the infections have led to more severe health problems and even death.

The U.S. Centers for Disease Control and Prevention (CDC) estimated that as many as 250 million people in the United States undergo cardiothoracic surgery using heater-cooler devices each year. Due to the possibility of infection or other serious side effects, the U.S. Food and Drug Administration (FDA) has issued warnings about the devices.

Atrial Fibrillation

Another significant side effect of cardiopulmonary bypass surgery is atrial fibrillation or afib. This is the most common type of irregular heart rhythm. It can lead to other serious health problems, such as blood clots or mitral valve issues. According to one study in BMJ, atrial fibrillation has been seen in as many as 64% of coronary artery bypass grafting surgery patients.

Even with such a high risk, there are things that patients can do to reduce their chance of post-operative afib:

• Patients can reduce their chances of post-operative afib by following a healthy diet and exercise routine.
• Patients can reduce their chances of post-operative afib by managing their levels of iron, electrolytes, and blood sugar.
• Patients can reduce their chances of post-operative afib by limiting or reducing stress.

Because atrial fibrillation can lead to other complications, such as blood clots, it is important to treat it as soon as possible. The most common way to treat afib is with medication. In some cases, treatment might also include applying electricity (known as electrical cardioversion) to the heart to shock it into the correct rhythm.

Monitor Side Effects Closely

As we have mentioned, there are plenty of things that could go wrong after open-heart surgery. Some of these, like bleeding, may be immediately noticeable. Others may develop slowly over time such as blood clots and NTM infections.

Your doctor will schedule follow-up visits after your surgery to check for signs of potential problems such as a high heart rate or high blood pressure. However, if you suspect you are suffering from one of these complications after having heart surgery, seek medical help immediately, especially if accompanied by chest pain.

If you cannot get a hold of your healthcare provider, call 911 to have emergency responders sent to your location right away. In some cases, you may not have much time, and even a few seconds could save your life.