Open-heart surgery permits the treatment of many previously inoperable conditions that were potentially fatal, or which made the patient chronically disabled. CORONARY ARTERY VEIN BYPASS GRAFTING (CAVBG), used to remedy obstruction of the arteries supplying the heart muscle, was first carried out in the mid–1960s and is widely practised. Constricted heart valves today are routinely dilated by techniques of MINIMALLY INVASIVE SURGERY (MIS), such as ANGIOPLASTY and laser treatment, and faulty valves can be replaced with mechanical alternatives (see VALVULOPLASTY).
Replacement of a person's unhealthy heart with a normal heart from a healthy donor. The donor's heart needs to be removed immediately after death and kept chilled in saline before rapid transport to the recipient. Heart transplants are technically demanding operations used to treat patients with progressive and untreatable heart disease but whose other body systems are in good shape. They usually have advanced coronary artery disease and/or damaged heart muscle (CARDIOMYOPATHY). Apart from the technical difficulties of the operation, preventing rejection of the transplanted heart by the recipient's immune system requires complex drug treatment. But once the patient has passed the immediate post-operative phase, the chances of five-year survival are as high as 80 per cent in some cardiac centres. A key difficulty is a serious shortage of donor organs.