Technical Editing Sample Anwesa Bagchi

8/2/2019 Technical Editing Sample Anwesa Bagchi

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Edited by Anwesa Bagchi

Human Heart ~ Heart Surgery ~ Pre& Post Care ~ Risks of Heart Surgery ~FAQ ~ Glossary & Other Sources


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July, Patients Guide to Open-Heart Surgery

I.HUMAN HEARTThe heart is the organ that pumps blood to the rest of the body. It is located on the left side, in the

chest cavity behind the breast bone. It is about the size of human fist and is made of cardiac

muscles.

A. Hearts function

All organs require blood in order to function

accurately. The right atrium receives the blood

from the organs after they have extracted the

needed oxygen. This blood is pumped into the

right ventricle, which then pumps the blood to thelungs. In the lung, the carbon dioxide present in

this blood is removed and new oxygen is added.

This oxygenated blood then reaches the left

ventricle via the left atrium. The left ventricle

then pumps this newly oxygenated blood back to

the bodys organs.

B. Nerve controls the heart

The heart is controlled by the autonomic nervous

system of the brain that tells the heart to speed up

or slow down depending on the bodys needs.

The heart functions non-stop throughout ones

life time.

1

Fig.1:Parts of a human heart

1

Fig.2: Blood vessels

1Heart Patient Guide. University of Southern Californiahttp://www.cts.usc.edu/hpg-index.html
http://www.cts.usc.edu/hpg-index.htmlhttp://www.cts.usc.edu/hpg-index.htmlhttp://www.cts.usc.edu/hpg-index.htmlhttp://www.cts.usc.edu/hpg-index.html


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II. HEART SURGERY

Heart surgery is performed to correct problems with the heart. More than half a million heart

surgeries are done each year in the United States for a variety of heart problems.2 Traditional

heart surgery, often referred to as Open-Heart Surgery, is performed by opening the chest wall to

operate on the heart. Open refers to the chest, not the heart. Open-heart surgery is used to bypass

blocked arteries in the heart, repair or replace heart valves, treat atrial fibrillation, and do heart

transplants.3

Open-Heart Surgery is performed under general anesthesia. A breathing tube is placed in the

lungs through the throat and then is connected to a ventilator (breathing machine). During the

surgery, the surgeon makes a 6- to 8-inch incision (cut) down the center of the patients chest

wall to open the rib cage so that the surgeon can get to the heart. The chest is opened by

cutting through the patients breastbone. Once the heart is exposed, the patient is connected to

a heart-lung bypass machine. The machine takes over the pumping action of the heart. The

bypass machine allows the cardiothoracic surgeon to operate on a heart that is static and not

full of blood.

Fig.3: Heart-Lung Bypass Machine working during surgery

2Diseases and Conditions Index. National Heart Lung and Blood Institute, U.S. Department of Health & Human Services

http://www.nhlbi.nih.gov/health/dci/Diseases/hs/hs_all.html

3Diseases and Conditions Index. National Heart Lung and Blood Institute, U.S. Department of Health & Human Services

http://www.nhlbi.nih.gov/health/dci/Diseases/hs/hs_all.html
http://www.nhlbi.nih.gov/health/dci/Diseases/hs/hs_all.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases/hs/hs_all.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases/hs/hs_all.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases/hs/hs_all.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases/hs/hs_all.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases/hs/hs_all.html


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III.PRE & POST CAREA. Patients Medical Evaluation before Surgery

The doctor will discuss:

The kind of heart problem patient has, the symptomsand how long the patient has had symptoms.

Patients history and past treatment of heart problems,including surgeries, procedures, and medicines as well

as other health problems and conditions, such as

diabetes or high blood pressure and Patients family

history of heart problems

Note: Blood tests, such as a complete blood count, alipoprotein panel (cholesterol test, may also be

needed).

B. Diagnostic tests

EKG (Electrocardiogram)

Stress Test & Echocardiography

Coronary Angiography

Aortogram & Chest X Ray

Cardiac Computed Tomography

Scan

Cardiac Magnetic Resonance

Imaging

C. Recovery in the Hospital

Depending on the type of heart surgery, the patient may spend a number of days in the hospital's

intensive care unit (ICU). He or she may have an intravenous (IV) needle inserted in a blood

vessel in his/her arm or chest to give fluids until the patient is ready to drink on their own. Extra

oxygen through a face mask or an endotracheal tube (breathing tube)4

can also be given. When

the patient leaves the ICU, he or she will be moved to another part of the hospital for several

days before going home. The entire time the patient is at the hospital, doctors and nurses will

closely watch his or her heart rate, blood pressure, breathing, vital signs, and incision site(s).

D. Recovery at Home

Each person responds differently to heart surgery. After-effects of heart surgery are normal.

They may include muscle pain, chest pain, or swelling. Other after-effects may include loss of

appetite, problems sleeping, constipation, and mood swings and depression. After-effects usually

4Heart Patient Guide. University of Southern Californiahttp://www.cts.usc.edu/hpg-index.html
http://www.cts.usc.edu/hpg-index.htmlhttp://www.cts.usc.edu/hpg-index.htmlhttp://www.cts.usc.edu/hpg-index.htmlhttp://www.cts.usc.edu/hpg-index.html


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go away over time. Recovery time varies for different types of heart surgery. Full recovery from

traditional open-heart coronary artery bypass graft (CABG) may take 6 to 12 weeks or more.

IV. Risks of Heart Surgery

Heart surgery has risks, even though its results often are excellent.A.General Risks

Bleeding Infection, fever, swelling, and other signs of

inflammation

Reaction to the medicine used to temporarilyput you to sleep during surgery

Arrhythmias (irregular heartbeats) Memory loss and problems concentrating or

thinking clearly

Damage to tissues in the heart, kidneys, andlungs

B.High Risks

Are older than 70 Have had previous heart surgeries Have diseases or conditions such as high

blood pressure, diabetes, kidney disease,

lung disease, or peripheral arterial disease

Mortality (Heart surgery is more likely to belife threatening in people with pre-existing

conditions.)

Sometimes patients need to be readmitted due post-operative complications.

Table 1: Top 10 Causes of Readmission 30 Days after CABG Surgery Was Performed, 20015

Primary Diagnosis Number of Patients Readmitted % of Readmitted Patients

Other Post Operative

Infections

167 12.7

Congestive Heart Failure 141 10.7

Coronary Atherosclerosis of

Native Coronary Artery

84 6.4

Atrial Fibrillation 48 3.6

Functional Disturbances

Following Cardiac Surgery

40 3.0

Cardiac Complications 39 3.0

Respiratory Complications 38 2.9

Unspecified Pleural Effusion 36 2.7

5 A SUMMARY REPORT ON NEW JERSEY HOSPITAL READMISSIONS 30 DAYS AFTER CABG

SURGERY 1999-2001. Health Care Quality Assessment Division of Health Care Quality & Oversight

http://www.state.nj.us/health/healthcarequality/documents/cabg_readmissions99-01.pdf
http://www.state.nj.us/health/healthcarequality/documents/cabg_readmissions99-01.pdfhttp://www.state.nj.us/health/healthcarequality/documents/cabg_readmissions99-01.pdfhttp://www.state.nj.us/health/healthcarequality/documents/cabg_readmissions99-01.pdf


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Pneumonia 33 2.5

Other Chest Pain 24 2.3

V. FAQ

1. When can I go home following open-heart surgery?

Not before five to seven days following the surgery.

2. Does minimally invasive surgery reduce the amount of pain from

conventional open-heart surgery?

One of the advantages of minimally invasive surgery is a smaller incision, which

means one can heal faster. However, you will still experience some pain at the

incision and at the surgical site.

3. When can I return to work following open-heart surgery?

In about two months. If your job requires a lot of physical effort, such as heavy

lifting, it could be as long as three months.

4. How does diabetes affect heart surgery?The healing process for diabetics may be affected, i.e. slower healing time or

increased chance for infection. However, nearly one-third of all of cardiac patients

are diabetic.

5. Will I receive blood during surgery?If your blood count is normal before undergoing the procedure, then it is highly

unlikely that you will need blood. Approximately, 10 percent of patients do receive

blood based on their blood counts during the remainder of their hospital stay.

6. How active can I be after surgery?Most people will walk within one to two days after heart surgery. You will most likely

be up to a normal 10-12 hour day during the second month of recovery.

7. When will I be able to drive?You will be able to drive for short periods of time in two to four weeks after the

procedure.


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8. Is bypass surgery considered open-heart surgery?Anybody requiring cardiopulmonary bypass is considered to have had open-heart

surgery.

9. How far can I travel after I have had surgery?It is recommended that any trip that is more than two to three hours long should

not be taken for at least four to six weeks after your procedure.

10.Does Medicare pay for heart surgery?Yes, at least 80 percent.

VI. Glossary

Autonomic Nervous System: a part of the peripheral

nervous system that affects heart rate, digestion,

respiration rate, salivation, perspiration, diameter of

the pupils, urination, and sexual arousal.

Aorta: the large single artery arising from the left

ventricle carrying blood to the systemic circulation

Atrium: a chamber affording entrance to another

structure or organ;

Right. atrium the upper right cardiac chamber that

receives blood from the venae cavae and delivers

blood to the right ventricle

Left. atrium the upper left cardiac chamber that

receives blood from the pulmonary veins and delivers

blood to the left ventricle (pleural form is atria)

Artery: a blood vessel that carries blood away from

the heart; arteries usually carry oxygenated blood

Arrhythmia: irregularity or loss of rhythm of the

heartbeat

Atrial: of or referring to the atrium or atria

Breast bone: also known as sternum is a long

flat bone shaped like a capital 'T' located in the

center of the thorax (chest).

CABG: coronary artery bypass graft; vein or

artery grafted surgically to permit blood to travel

from the aorta to a branch of the coronary artery

at a point past an obstruction

Cardiac: of or referring to the heart

Ventricle : a small cavity or chamber, as in the

brain or heart

Right v. the lower chamber of the right side of

the heart, which pumps venous blood through

the pulmonary trunk and arteries to the capillaries

of the lung

Left v. the lower chamber of the left side of theheart, which pumps oxygenated blood out

through the aorta to all the tissues of the body


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VII. Other Sources

1. Click:What Happens After Heart Surgery?2. Click:Heart Surgery Terms3. Click:Open Heart Surgery4. Click:Healthy Eating5. Click:Heart bypass surgery - discharge6. Click:Patient's Guide to Heart Surgery7. Click:Life after Open-Heart Surgery8. Click:Heart Disease Prevention Tips
http://www.americanheart.org/downloadable/heart/110080657690951%20WhtHppnsAftrHrtSrgry.pdfhttp://www.americanheart.org/downloadable/heart/110080657690951%20WhtHppnsAftrHrtSrgry.pdfhttp://www.americanheart.org/downloadable/heart/110080657690951%20WhtHppnsAftrHrtSrgry.pdfhttp://www.sts.org/sections/patientinformation/otherresources/heartsurgterms/http://www.sts.org/sections/patientinformation/otherresources/heartsurgterms/http://www.sts.org/sections/patientinformation/otherresources/heartsurgterms/http://www.noah-health.org/en/blood/disease/care/procedures/openheart.htmlhttp://www.noah-health.org/en/blood/disease/care/procedures/openheart.htmlhttp://www.noah-health.org/en/blood/disease/care/procedures/openheart.htmlhttp://hp2010.nhlbihin.net/healthyeating/%28X%281%29S%28ymqehm55jnodi045jc0t3fqd%29%29/Default.aspx?AspxAutoDetectCookieSupport=1http://hp2010.nhlbihin.net/healthyeating/%28X%281%29S%28ymqehm55jnodi045jc0t3fqd%29%29/Default.aspx?AspxAutoDetectCookieSupport=1http://hp2010.nhlbihin.net/healthyeating/%28X%281%29S%28ymqehm55jnodi045jc0t3fqd%29%29/Default.aspx?AspxAutoDetectCookieSupport=1http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000102.htmhttp://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000102.htmhttp://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000102.htmhttp://www.cts.usc.edu/hpg-index.htmlhttp://www.cts.usc.edu/hpg-index.htmlhttp://www.cts.usc.edu/hpg-index.htmlhttp://www.heartsurgeons.com/ed5.htmlhttp://www.heartsurgeons.com/ed5.htmlhttp://www.heartsurgeons.com/ed5.htmlhttp://www.oconnorhospital.org/patients_visitors/services/heart_care/Pages/Prevention.aspxhttp://www.oconnorhospital.org/patients_visitors/services/heart_care/Pages/Prevention.aspxhttp://www.oconnorhospital.org/patients_visitors/services/heart_care/Pages/Prevention.aspxhttp://www.oconnorhospital.org/patients_visitors/services/heart_care/Pages/Prevention.aspxhttp://www.heartsurgeons.com/ed5.htmlhttp://www.cts.usc.edu/hpg-index.htmlhttp://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000102.htmhttp://hp2010.nhlbihin.net/healthyeating/%28X%281%29S%28ymqehm55jnodi045jc0t3fqd%29%29/Default.aspx?AspxAutoDetectCookieSupport=1http://www.noah-health.org/en/blood/disease/care/procedures/openheart.htmlhttp://www.sts.org/sections/patientinformation/otherresources/heartsurgterms/http://www.americanheart.org/downloadable/heart/110080657690951%20WhtHppnsAftrHrtSrgry.pdf

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Technical Editing Sample Anwesa Bagchi