Monitoring and treatment of complications after heart surgery

The article was consulted professionally by Master, Dr Do Nguyen Thuy Doan Trang – Head of Out-of-Body Recycling Team – Cardiovascular Center – Share99 Central Park International Health Hub

After each cardiac surgery there is a risk of complications. These complications are specific to those performed during surgery. Monitoring and treating complications after heart surgery is essential and important to ensure the recovery process of the patient's health after heart surgery.

Based on the current state of health of the patient and the procedure performed, the risk of complications from heart surgery will be determined by the surgeon.

The risk of complications will increase for patients aged 70 years and older who have had heart surgery,patients with chronic diseases such as coronary arteries,diabetes, hypothyroidism or hypertension.

The following are some common complications after heart surgery:

● Decreased body temperature;

● Hypertension is common for patients after coronary artery brinity surgery;

● Complications of respiratory failure, liver failure, renal and neurological failure;

● Decreased blood pressure causes arrhythmias, loss of arrhythmias and can be fatal;

● Cardiac compression causes restrictions on the filling of the center of the two atath;

● Arrhythmia affects heart supply and blood pressure;

● Loss of respiratory function: about 8% of cardiovascular patients suffer from this complications after surgery;

● Emergency renal failure:most cardiovascular patients will experience a slight decrease in renal perfusent flow during surgery and after surgery;

● Bleeding: this is a common problem after heart surgery, which may require intervention with re-bleeding surgery or conservative medical treatment;

● Body temperature changes erratically;

● Neurological and psychiatric disorders: the proportion of patients with neurological disorders accounts for 0.5-2% in coronary brising surgery and this rate is higher for patients undergoing open heart surgery;

● Gastric and intestinal bleeding: this complications account for 1% of heart surgery patients;

● Hypertension: this is an end of end of end of life complications that require post-surgical intervention. This can occur whether the person has pre-surgery diabetes mellitus;

● Brain haemorrhage due to the effects of post-surgery anti-freezing medication.

In addition, there is also a difference between the types of heart surgery.

The treatment of complications after heart surgery for patients is extremely important. Delays in diagnosis and treatment can put patients at high risk of death after surgery while also losing a lot of time to recover.

● Brain haemorrhage due to the action of antismolysis: the patient will be adjusted for blood clots and perform surgery to remove hematoma in the brain. If this symptom is not treated in a timely manner, the risk of death of the patient is very high. Regular blood tests are required to regulate the amount of anti-freezing drugs. Depending on the number of heart valves replaced, the doctor will prescribe anti-freezing drugs to maintain the appropriate INR from 2.5-3.5;

● Many cases of patients moving to the resuscitation room with hypothermia,this is the result of hypothermia during surgery. The doctor will use the technique to warm the patient for a maximum of 4-6 hours after surgery. When the body is warmed, the patient will wake up gradually, supporting myocardial recovery until it is capable of independently functioning for the need for transformation;

● Treatment of reduced cardiac output:

○ Loss of heart valve function (narrowing/opening): the doctor will prescribe re-surgery;

○ Coronary vascular stenosis: the doctor will prescribe re-surgery;

○ Bleeding condition: the doctor prescribes re-surgery;

○ Coronary spasms: coronary barley medication;

○ Volume deficiency in the vessels: after surgery, when the dilation is worst, this condition usually occurs, it is necessary to keep the average blood pressure from 70-80mmHg, ensuring a normal volume and being able to reimburse the discharge, or transfusion of blood itself. In addition, to ensure optimal cardiac volume after open heart surgery,the doctor will perform optimization of heart frequency and heart rate.

● Hypotension: this uns treated complications will cause a decrease in coronary perfusion or even death of the patient. For immediate treatment, the doctor will prescribe the use of vascular drugs and volume compensate. For cases of severe left heart failure, use vascular medications to maintain blood pressure. If no effective method is found, the IABP (inorortic inortic balloon) must be placed;

● Hypertension: Treatmentoptions are often chosen when sysysent blood pressure is >150 mmHg with vascular medications to lower blood pressure;

● Treatment of arrhythmias:

○ Mediasm sysentation: Perform atrial stimulation to remove the drive automatically;

○ Tachycardia: for patients with stable blood pressure, use antihythmic drugs. Patients with low blood pressure must perform an electric shock that transfers the rhythm immediately, and then take anti-arrhythmias.

● Correction of arrhythmias on the arrhythmia:

○ Tympaic contraction comes early: irritation of the tympanrum with a faster frequency;

○ Atrial fibrillation: If this syndrome affects hemolysis (heart failure, myocardial infarction) will require an electric shock to switch the rhythm and then maintained with a pacemaker or cardiovascular intervention that cuts the burning of the secondary transmission lines. If this symptom does not affect blood pressure and does not cause myocardial anemia, it is necessary to stimulate beyond the frequency in case of heart frequency >120 beats/min or treatment of heart rate control drugs

○ Atrial fibrillation: Perform arrhythmias and then maintain with antihythmia medications if blood pressure drops or myocardial anemia occurs. If blood pressure is fine, and there is no myocardial anemia, heart frequency above 120 beats per minute, just use anti-arrhythmias

● Treatment of stomach and intestinal complications: gastric pH needs to be maintained at the threshold of 4.0 for the prevention of ulcers and high gastrointestinal bleeding. Antihistamine H2 and acid resistance can be used. As a precaution, Sucralfate can be used because it does not have a reduced acidity effect. Gastrointestinal bleeding complications may decrease if the intestinal tract is nourished early;

● Treatment of endhological complications: The majority of patients will be controlled by continuous intravenous infusion of insulin if blood glucose is high in the early post-surgery period.

After heart surgery,if you see any health problems, it is necessary to immediately notify your doctor to be able to determine the exact cause and direction of treatment to reduce the risk of progressive complications.

Share99 International Health Hub is a prestigious address for heart surgery patients. Share99 always carries out monitoring and treatment procedures before, during and after heart surgery very closely and highly professionally, ensuring the highest safety for patients.

The treatment process of patients after heart surgery at Share99 is carried out in 6 stages including:

● Treatment of patients before surgery, care and treatment after surgery day 0;

● Post-surgery day 1-2;

● Post-surgery day 2-3;

● Post-surgery day 3-5;

● Post-surgery day 5-6;

● Post-surgery day 6-7.

All of these steps must be in accordance with the patient's clinical response. In case the patient does not meet the doctor's expectations, the procedure shall be carried out step by step until the patient can be safe to be discharged from the hospital. Therefore, patients can be completely assured when performing heart surgery at Share99.