Cardiovascular (heart) surgery is surgery on the heart or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease (for example, coronary artery bypass grafting), correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart disease and atherosclerosis. It also includes heart transplantation.
The development of cardiac surgery and cardiopulmonary bypass techniques has reduced the mortality rates of these surgeries to relatively low ranks. For instance, repairs of congenital heart defects are currently estimated to have 4–6% mortality rates. A major concern with cardiac surgery is the incidence of neurological damage. Stroke occurs in 2–3% of all people undergoing cardiac surgery, and is higher in patients at risk for stroke. A more subtle constellation of neurocognitive deficits attributed tocardiopulmonary bypass is known as postperfusion syndrome, sometimes called “pumphead”. The symptoms of postperfusion syndrome were initially felt to be permanent, but were shown to be transient with no permanent neurological impairment.
A 2012 Cochrane systematic review found evidence that preoperative physical therapy reduced postoperative pulmonary complications in patients undergoing elective cardiac surgery such as pneumonia and atelectasis. In addition, the researchers found that preoperative physical therapy decreased the length of hospital stay (on average by more than three days).
There is also evidence that quitting smoking at least four weeks before the date of a surgery may reduce the risk of postoperative complications.