Whenever a celebrity has a medical condition or undergoes surgery, the lay press seems to go wild. And, as 75-year-old Mick Jagger, the long-rocking front man for the Rolling Stones, might tell you, no one is immune to the ravages of time (or lifestyle). But, when it was announced recently that he was to undergo open heart surgery, many people not in the medical profession displayed their true ignorance as to what that actually means.
Does “open heart surgery” always mean the doctors literally “open the heart,” or can it mean they open the chest to get to the heart? Well, that depends on the procedure, the doctor, the health of the patient and the technology available.
Basically, “open heart surgery” (where cardiopulmonary bypass, better known merely as “bypass,” is or isn’t used) usually refers to two major types of heart surgery: valvular or artery. Sometimes, doctors perform both.
With our Western lifestyles and diets, our coronary arteries, the vessels that supply the blood and therefore oxygen to the heart muscle to keep it vital and healthy, can become blocked with plaque, a gritty, fatty material derived from cholesterol and clotting elements. Doctors, for decades, have honed their skills in building new highways of blood flow around these blocked areas by using bypass grafts, which are usually vessels taken from the leg or chest. In this way, new pathways are formed to revitalize ailing heart muscle. This can be done, depending on specifics, either the “old” way by splitting the sternum (or breastbone) or by going through the spaces between the ribs, so-called “minimally invasive” techniques.
The heart has four valves: aortic, mitral, tricuspid and pulmonic, and these can have varying states of disease from diverse causes. The causes can be infectious, genetic, traumatic or related to a host of medical conditions. When replacing or repairing valves, cardiac surgeons use prosthetic valves, derived from naturally occurring or synthetic products. Valve surgery can be done through the sternum or the spaces between the ribs, depending on factors listed above, and be performed, if necessary, concomitantly with coronary artery bypass surgery.
Lesser-publicized surgeries in the heart involve the closure of passageways between the chambers that, through anatomic variation or disease, cause a disruption of heart function.
Jagger is reported to have had a heart valve replacement done via a minimally invasive procedure called transcatheter aortic valve replacement (TAVR), which involves by passing the new valve through a catheter that has been threaded through an artery in the leg to the heart.
So, when talking about “open heart surgery,” be sure to know the what, how, where and why before you jump to conclusions. A good reference is this Mayo Clinic link, to learn more.
Also realize that cardiopulmonary bypass (where the heart is stopped, the ventilation is stopped, and the blood is oxygenated by a machine outside of the body) is not always used. Check with your doctor about this if and when the topic comes up.
Since so many baby boomers will be reaching Mick’s age, I hope this article might be of help. So, keep moving, eat right, don’t smoke (tell Keith Richards that!), rock-on and know the facts before you use the term “open heart.”
For more with Dr. Sherer, click here for his podcast and video interviews, or purchase his memoir, The House of Black and White: My Life with and Search for Louise Johnson Morris.