Most Common Complications After Open-Heart Surgery

Coronary bypass surgery is a complex procedure, and it can lead to a number of life-threatening complications, especially if the proper precautions are not taken. Unfortunately, with the rise of both heart disease and heart failure, more and more coronary artery bypass surgeries are taking place every year, leading to the possibility of severe and even life-threatening side effects, including everything 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. In fact, 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. Allowing the blood to remain in the aortic cavity could cause problems with the heart rhythm, affecting blood pressure.

The bleeding comes from the sutures (stitches) that hold blood vessels in place. Typically, the bleeding will stop within a couple hours of surgery, at which time the drains will 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. In such a case, stitches may come loose or even fall out, causing the incision to reopen – a situation 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, a condition known as deep-vein thrombosis, and they can move from there 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 such a clot in the first place.

The higher risk comes from the fact that coronary surgeries often use a vein from the patient’s leg as a coronary artery bypass graft. As a result, the patient’s leg will often swell, 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 – although these drugs can cause problems of their own, according to lawsuits filed against the makers of both 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 that infection after open-heart surgery occurs in as many as 1 out of 5 patients. Nearly half of those infections required the individual to remain in the hospital for two weeks or more, perhaps in the intensive care unit (ICU). This increases not only the possibility of further complications but also the chances of dying due to a post-operative problem.

Unfortunately, hospitals themselves are sometimes the cause of post-heart surgery infections. Nosocomial infections, as they are known in the medical industry, can be caused by everything from unsterile tools or operating rooms to malfunctioning equipment or even 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. In particular, the Sorin Stöckert 3T Heater-Cooler device was identified as having been contaminated with a form of nontuberculous mycobacteria (NTM) known as Mycobacterium chimaera at the LivaNova manufacturing plant in Germany. As a result, there has been a high number of NTM infections among heart surgery patients, causing side effects like sudden weight loss, muscle aches and night sweats. In some cases, the infections have led to severe health problems, and even death.

The U.S. Centers for Disease Control and Prevention (CDC) have estimated that as many as 250 million people in the United States undergo cardiothoracic surgery using heater-cooler devices each year. The U.S. Food and Drug Administration (FDA) has also issued warnings about the devices.

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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 and can itself lead to other problems, such as blood clots or mitral valve issues. According to at least 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 percentage of people at risk, there are things that patients can do to reduce their chance of post-operative afib. As with so many things, a healthy diet and exercise are both important. Managing your levels of iron, electrolytes, and blood sugar are another important factor. Finally, limiting or reducing stress has been shown to improve a number of heart-related medical conditions.

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, but in some cases it might also include applying electricity (known as electrical cardioversion) to the heart to shock it into the correct rhythm.

Monitor Side Effects Closely

If you cannot get a hold of your doctor, call 911 to have emergency responders sent to your location right away.

While there are plenty of other things that could go wrong after open-heart surgery – including kidney problems, urinary problems, stroke, and cognitive issues – the three above are the most common complications, and potentially the most dangerous. Some of these, like bleeding, may be immediately noticeable, while others may develop slowly over time, including both blood clots and NTM infections, the latter of which could exhibit problems even months later.

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!