From the moment of birth until death, a human heart beats more than two and a half billion times without even pausing to rest. Unfortunately, for a variety of reasons, the vessels supplying blood to the heart can become clogged. When that happens, open-heart surgery may be the best answer.

What happens during open-heart surgery? What heart problems require surgery vs. other types of treatment for heart disease? We'll follow a typical patient through diagnosis, treatment, surgery, and recuperation to give you an inside glimpse of the open-heart surgery which will be done at Danville Regional Medican Center beginning in late March.

The typical open-heart surgical patient comes to us following a heart attack or when an examination reveals extensive blockage of the coronary arteries," says Henry Tripp, Jr., M.D., Danville's new cardiovascular surgeon. "Typically, the patient will have three or more arteries significantly blocked in many areas, a condition hard to repair with cardiac catheterization alone." About 85 percent of open-heart surgeries involve blocked arteries; another 15 percent involve replacement of heart valves which have been damaged by disease.

The bypass surgery procedure is called a Coronary Arterial Bypass Graph, or CABG (often called "cabbage"). The operation replaces arteries on the front side (anterior) and/or the back side (posterior) of the heart, depending where the blockages have occurred.

On the morning of the surgery, the patient is given sedation before being placed under anesthesia. Usually there are at least seven medical staff in the operating room: the surgeon, a physician's assistant who helps with suturing and preparing the vessels, three nurses, an anesthesiologist, and a perfusion technician who carefully monitors the pressure and temperature of the blood traveling through the heart-lung machine.

An incision is made through the breastbone, and the ribcage is spread apart to reveal the heart. One by one, the new vessels, usually mammary arteries, are attached above and below the clogged coronary arteries, bypassing the blockages and rerouting the blood flow. In the typical CABG procedure, between one and five vessels are replaced, often referred to as "jumps."

The heart is stopped and the graphs are completed while the pumping duties are taken over by the external heart pump. Here blood is oxygenated and kept at the correct temperature before being returned to the body under controlled pressure.

Once the bypasses are complete, the heart is once again started. The sutures are checked for any minor leaks, then the ribcage and chest wall are closed. "The procedure can take between three and five hours, depending upon the complexity," says Dr. Tripp.

Once the surgery is complete, recuperation begins. It is important for the patient to be as mobile as possible to encourage good circulation and to clear the lungs of any fluid. Respiratory therapy and cardiac rehabilitation are important components to a complete recovery.

Patients return home, usually within a week following surgery. Counselors are available to help the patient and family return to normal routines. Exercise and proper nutrition are encouraged to help keep the "new" heart in great condition for years to come.