Heart Surgery: Types of Surgery, Procedures, Risks, and Patient Recovery

20 August 2025 4 min read

By: dr. Widya Trianita Suwatri, Sp.BTKV, Subsp. JD (K)

Common Types of Heart Surgery

Coronary Artery Bypass Grafting (CABG)
A coronary artery bypass grafting procedure opens an alternative pathway when the heart's blood vessels are blocked by more than 70%. It is also known as bypass surgery to prevent further heart attacks.
Heart Valve Surgery
Includes repairing or replacing damaged heart valves, such as the aortic or mitral valve, using an open or minimally invasive approach.
Correction of Congenital Heart Defects
Includes treating congenital structural conditions such as ASD, VSD, and Tetralogy of Fallot, using open surgical techniques with heart-lung support.
Mechanical Circulatory Support (MCS)
Includes ECMO (Extracorporeal Membrane Oxygenation) and LVAD (Left Ventricular Assist Device), used as a bridge of support in patients with severe heart failure. ECMO is available in veno-arterial (VA-ECMO) format for systemic circulation.
Minimally Invasive Cardiac Surgery (MICS)
Techniques such as MICS CABG or MIDCAB allow surgery through small incisions without dividing the sternum—reducing pain, the risk of infection, and speeding recovery.
Hybrid Surgery
Combining surgical procedures and catheter interventions in a dedicated operating room for more efficient results and real-time intraoperative imaging.

Patient Preparation Before Heart Surgery

Comprehensive medical examination: blood tests, chest X-ray, EKG, echocardiogram, coronary angiography
Evaluation by a multidisciplinary team—involving specialists in internal medicine, pulmonology, neurology, dentistry, ENT, and anesthesia.
Treatment of focal infections such as cavities is required before valve surgery.
Smoking cessation at least one month before surgery.
Discontinuation of anticoagulant medications as directed by the doctor.
Maintaining a healthy lifestyle to reduce the risk of pre-operative infection.

When is Coronary Artery Bypass (CABG) Needed?

Coronary Artery Bypass Grafting (CABG) is a surgical procedure to create new blood flow by bypassing blocked or narrowed coronary arteries, improving blood flow to the heart muscle. This procedure involves taking a healthy blood vessel (artery or vein) from another part of the body (usually the leg, chest, or arm) and connecting it to the blocked coronary artery, creating a "bypass" for blood flow to the heart muscle.

This procedure is performed if:

Multi-vascular or complex coronary heart disease
Hemodynamic instability after a heart attack
Severe coronary artery stenosis (>70%)
Severe chest pain (angina) that does not respond to treatment
Failure of non-surgical therapy/interventions such as stenting

The Difference Between Open and Minimally Invasive Heart Surgery

Differences	Open Surgery	Minimally Invasive
Incisions	Large, middle sternotomy	Small, without dividing the sternum
Recovery	6–12 weeks	2–4 weeks
Risk of Infection	Higher	Lower

Heart Surgery Risks That Patients Need to Know

All surgical procedures carry risks, which will be explained in detail in the informed consent. However, in general, the risk of complications is quite small and will be discussed before surgery.

Common risks include:

Bleeding
Surgical site infection
Arrhythmia (irregular heart rhythm)
Stroke
Kidney, liver, or respiratory system complications

Post-Heart Surgery Recovery Process

in Hospital:

ICU stay (1–2 days)
Intermediate room (1–2 days)
Regular hospitalization (3–5 days)
Pain control and wound monitoring
Physiotherapy/cardiac rehabilitation

Continuation (1–3 months):

Gradual activity as tolerated
Monitoring wounds and complications

Conclusion

Cardiac surgery offers life-saving solutions—from bypass grafts to minimally invasive surgery and mechanical support like ECMO. Thorough preparation, proper technique, and post-operative rehabilitation are key to optimal recovery. Risks exist, but with collaboration between the patient and the medical team, the chances of a good outcome are high.