Bypass Surgery on the Open Heart: Control and Closure of the Chest


Bypass surgery on the open heart is a complex procedure that involves rerouting blood flow around a blocked or narrowed artery. This surgical intervention is often necessary to restore proper blood flow to the heart and prevent further complications. However, one crucial aspect of this procedure that is often overlooked is the control and closure of the chest after the surgery. In this article, we will explore the importance of chest control and closure in bypass surgery and its impact on patient outcomes.

The Role of Chest Control

During bypass surgery, the chest is opened to access the heart. This requires the sternum, or breastbone, to be divided, allowing the surgeon to reach the heart and perform the necessary procedures. However, leaving the chest open indefinitely is not an option, as it can lead to numerous complications and increase the risk of infection.

Chest control involves the use of specialized techniques and devices to keep the chest closed during and after the surgery. This ensures that the heart is protected and allows for proper healing of the surgical incision. Additionally, chest control helps maintain the structural integrity of the chest, preventing any potential deformities or complications.

Methods of Chest Closure

There are several methods of chest closure that can be employed after bypass surgery. The most common technique involves the use of stainless steel wires to bring the divided sternum back together. These wires are placed around the sternum and tightened to secure the chest. This method provides stability and allows for proper healing.

Another method of chest closure is the use of sternal plates. These plates are made of titanium and are fixed to the sternum using screws. This technique provides additional support and stability, especially in patients with weakened or fragile sternums.

In recent years, the use of absorbable plates and sutures has gained popularity. These materials gradually dissolve over time, eliminating the need for a second surgery to remove the hardware. This approach reduces the risk of infection and provides a more comfortable recovery for the patient.

Benefits of Proper Chest Closure

Proper chest closure plays a crucial role in the overall success of bypass surgery. It offers several benefits that contribute to improved patient outcomes:

  1. Reduced risk of infection: A securely closed chest minimizes the risk of infection, as it prevents bacteria from entering the surgical site.
  2. Improved healing: Chest closure techniques promote proper healing of the surgical incision, allowing for faster recovery and reduced pain.
  3. Enhanced structural integrity: By maintaining the structural integrity of the chest, proper closure reduces the risk of chest deformities and complications.
  4. Increased patient comfort: The use of absorbable materials for chest closure eliminates the discomfort associated with the presence of hardware and reduces the need for a second surgery.

Postoperative Care and Monitoring

After bypass surgery, proper postoperative care and monitoring are essential to ensure the success of the procedure. This includes regular check-ups, wound care, and monitoring for any signs of infection or complications.

Patients who have undergone bypass surgery should follow their surgeon’s instructions regarding wound care. This typically involves keeping the incision clean and dry, avoiding strenuous activities, and taking prescribed medications as directed.

Regular follow-up appointments allow the surgeon to assess the progress of the healing process and address any concerns or complications that may arise. It is important for patients to attend these appointments and communicate any changes in their symptoms or overall health.


Bypass surgery on the open heart is a complex procedure that requires meticulous attention to detail, including the control and closure of the chest. Proper chest closure techniques play a vital role in ensuring the success of the surgery and improving patient outcomes. By reducing the risk of infection, promoting healing, maintaining structural integrity, and enhancing patient comfort, chest closure techniques contribute to a smoother recovery process. Patients who have undergone bypass surgery should closely follow their surgeon’s instructions for postoperative care and attend regular follow-up appointments to ensure optimal healing and long-term success.