Open about risks
Complications after heart surgery: how we manage risk
No one wants to talk about this. But complications do happen, and we owe you honesty. We know how much this question concerns you and your family, so we speak about complications openly.
Text reviewed by Dmitriy Shmatov, cardiac surgeon
Sudden worsening? Do not wait for a scheduled appointment — call an ambulance, Warning signs
Can a complication occur? How great is the risk? What will the doctors do if recovery is harder than expected? You can, and should, ask these questions.
Before surgery it matters to know not only what it can achieve, but also what risks it carries. Our task is to explain the planned treatment, assess your individual risks together and help you understand what support you can count on.
Complication and mortality rates at the Center
Every day the Clinic performs open cardiac surgery, vascular procedures, arrhythmia procedures and endovascular interventions. We continuously assess treatment outcomes, including complications and deaths.
- mortality
- under 0.5%
- complications
- 1–1.5%
- of the Center’s work
- 14 years
How a complication differs from a fatal outcome
Mortality and complications are different measures. A complication may require extra treatment, tests or a longer hospital stay and still end in the patient’s recovery. When discussing your operation, your doctor always considers the specific condition, the planned treatment and your overall health.
These figures are not a guarantee of an individual result. Statistics help show how the team performs, but they cannot determine the risk for one particular person.
What determines your individual risk in heart surgery
The same operation can carry a different risk for patients whose heart, kidneys, lungs and general health differ. What matters:
- coexisting diseases
- neurological status
- how urgent the procedure is
- the need to perform several procedures at once
Before treatment, discuss not only the risks of the operation but also the consequences of the disease itself: what may happen if the procedure is postponed or declined. When choosing a strategy, doctors always weigh the expected benefit against the possible harm.
Questions to ask your doctor about surgical risks
At your consultation you can ask:
- Which complications are most likely for me specifically?
- What increases my risk, and can it be reduced?
- What treatment options are there?
- What are the risks of waiting or declining surgery?
- What will the team do if a complication occurs?
How the Center manages risk
One team brings together:
- cardiovascular surgeons
- cardiologists
- arrhythmologists
- interventional treatment specialists
- functional diagnostics specialists
- cardiac anesthesiologists
- intensive care physicians
- perfusionists
We choose the treatment for the individual patient
The principle shared by the whole team is to choose a suitable method in light of the whole clinical picture. Open surgery, a procedure through a small access, catheter-based or combined treatment each have their indications and limitations. The size of the incision is only one characteristic of an intervention. The decision is made with safety and the expected result in mind.
We prepare for surgery together
Pre-operative tests help assess the condition of the heart, vessels and other organs and identify circumstances that may affect treatment. That is why it is important to tell the team about all the medications you take, allergic reactions, past illnesses and any new symptoms.
If you develop a fever, cough or other signs of infection before admission, contact us without delay. Changing or stopping your medication before surgery is allowed only on a doctor’s instructions.
Preparing for hospitalizationWe monitor you after the procedure
After open heart surgery, observation in intensive care is a planned stage of treatment. Being there does not in itself mean a complication has occurred. The team monitors the patient and decides when it is safe to reduce the level of support, start getting the patient moving and transfer them back to the cardiac surgery ward.
We plan the follow-up contact
Before discharge we make sure the patient understands the recommendations on medication, wound care, permitted activity and follow-up tests. Further follow-up helps assess recovery, keep it under control, notice changes in time and preserve the result of the operation for many years. Your doctor will advise on the best follow-up schedule and how often to visit.
Possible complications after heart surgery
The set of risks depends on the procedure. Below are the main groups of complications discussed in surgical treatment of the heart.
Bleeding
May require additional treatment, transfusion of blood products or a repeat procedure.
Infection and poor wound healing
Sometimes dressings, antibiotic therapy or surgical treatment are needed.
Heart rhythm disturbances
Arrhythmias can occur after surgery. Treatment depends on their nature and their effect on the patient’s condition.
Impaired kidney function
It may be temporary; in severe cases dialysis is sometimes required.
Heart attack and stroke
These are serious complications that need emergency care.
Breathing complications
Sometimes longer breathing support is needed after surgery.
Confusion, or postoperative delirium
A person may temporarily lose orientation, become unusually agitated or sluggish. Such changes need to be assessed by the medical team.
After catheter procedures
After catheter procedures, bleeding and damage to the vessel at the access site, a reaction to contrast agent and other complications related to the specific procedure are possible. The absence of a large incision does not rule out risks.
Risk of death
There is also a risk of death. Discuss your individual risk assessment with your doctor before surgery.
What happens if a complication occurs in hospital
A complication can change the original recovery plan. Sometimes it calls for:
- additional tests
- a change in treatment strategy
- a longer stay under observation in intensive care
- a repeat operation
Depending on the problem, the necessary specialists join in the treatment. The team explains to the patient and, with their consent, to their family what is happening, what is being done and what the next stage will be.
The fact of a complication does not mean that treatment has failed. The further outlook depends on the nature of the complication, the patient’s condition and the response to care.
Complications after discharge: telling normal recovery from warning signs
After major surgery, tiredness, reduced appetite and soreness around the surgical site are possible. Discuss these sensations with your doctor and compare them with your individual recommendations.
Do not try to work out the cause of a new symptom yourself. It is especially important to seek help if you feel worse, or if new complaints appear after an improvement.
Call an ambulance immediately
Do not wait for a reply to a message or for a scheduled appointment if you have:
- sudden severe or pressing chest pain that does not go away, especially with cold sweat, nausea or shortness of breath
- severe difficulty breathing, loss of consciousness
- sudden speech disturbance, facial drooping, weakness in an arm or leg
- heavy bleeding
If you suspect a heart attack or stroke, help is needed immediately. Do not drive yourself.
See a cardiologist near your home without delay
These need medical assessment:
- fever or chills
- increasing redness, swelling or pain around the wound
- discharge from the wound, or the wound edges coming apart
- new or worsening palpitations
Also tell your doctor about increasing swelling, shortness of breath, rapid weight gain or unusually severe weakness. If you suddenly get worse, call an ambulance.
How to contact the Clinic after discharge
Use the medical contacts and procedure given in your discharge summary. If you need an urgent examination and you are in another region, seek medical help where you are.
To arrange a scheduled contact with the Center
When you get in touch, have ready:
- your discharge summary
- a list of your medications
- a short description of the changes: when they started and how they are developing
Scheduled online conversations help you make sense of your recommendations and follow-up questions, and reduce risks. If a complication is suspected, an in-person examination may be needed; an online conversation does not replace emergency care.
Complications after heart surgery: frequently asked questions
The main groups of complications discussed in surgical treatment of the heart are bleeding, infection and poor wound healing, heart rhythm disturbances, impaired kidney function, heart attack and stroke, breathing complications and postoperative delirium. The set of risks depends on the procedure, so your doctor will go through the list for your case with you before surgery.
Over the Center’s 14 years of work, mortality has been under 0.5% and complications 1–1.5%. These figures do not guarantee an individual result: the risk for a particular person depends on the disease, the treatment method, the condition of the heart, kidneys and lungs, and coexisting diseases.
No. After open heart surgery, observation in intensive care is a planned stage of treatment. The team monitors the patient and decides when it is safe to reduce the level of support, start getting the patient moving and transfer them back to the cardiac surgery ward.
Depending on the problem, the necessary specialists join in the treatment. Sometimes additional tests, a change in treatment strategy, a longer stay under observation in intensive care or a repeat operation are needed. The team explains to the patient and, with their consent, to their family what is happening and what the next stage will be. The fact of a complication does not mean that treatment has failed.
Call an ambulance (103 or 112) for sudden severe or pressing chest pain that does not go away, severe difficulty breathing, loss of consciousness, sudden speech disturbance, facial drooping, weakness in an arm or leg, or heavy bleeding. If you suspect a heart attack or stroke, help is needed immediately; do not drive yourself.
See a cardiologist near your home without delay for fever or chills, increasing redness, swelling or pain around the wound, discharge from the wound or wound edges coming apart, or new or worsening palpitations. Also tell your doctor about increasing swelling, shortness of breath, rapid weight gain or unusually severe weakness.
See also
- Recovery after heart surgeryThe first weeks at home, recovery times and cardiology follow-up.Learn more
- Preparing for hospitalizationThe main steps of preparing for admission and pre-operative tests.Learn more
- How to get treatmentA step-by-step route for the patient: documents, quota and admission booking.Learn more
Operations at our Center
- Coronary artery stentingMinimally invasive surgery that restores blood flow in the arteries of the heart, preventing heart attacks and other complications.Learn more
- Coronary artery bypass graftingRestores blood flow to the heart, bypassing narrowed arteries, improving the condition of coronary heart disease.Learn more
- Minimally invasive valve replacementA low-traumatic heart valve replacement surgery that accelerates recovery and reduces pain.Learn more
- Pacemaker implantationInstallation of a heart rate monitoring device in patients with bradycardia.Learn more
- Carotid endarterectomyRemoval of atherosclerotic plaques from the carotid artery, prevents stroke.Learn more
- Radiofrequency ablationMinimally invasive treatment of arrhythmias that restores a normal heart rhythm.Learn more
- Transcatheter aortic valve implantationMinimally invasive aortic valve replacement recommended for high-risk patients.Learn more
- Aortic prosthesisSurgery to replace the affected area of the aorta, preventing rupture of the aneurysm.Learn more
Risks can be discussed calmly and directly
Risks are not yours alone. They are shared, because a patient’s recovery is a team effort for which every member of the team is responsible.
Knowing about complications means understanding your treatment better and seeking help in time.
We are ready to discuss our results, assess your individual risks and answer any questions.