Prof. Dr. Ali Serdar Fak
Cardiac SurgeryVerified
- 29+years exp.
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Heart Surgery
Open heart surgery
What open heart surgery means, which operations it covers (bypass, valve repair or replacement, congenital repairs), how the heart-lung machine and breastbone approach work, when stents or keyhole surgery are alternatives, approximate costs in Turkey against the UK, US and Germany, hospital stay, recovery and risks.
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Dr. Bülent İlçöl
Cardiac SurgeryVerified
- 25+years exp.
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Open heart surgery in Turkey: what it is and how it works
Open heart surgery is any operation in which the chest is opened and the surgeon works directly on the heart or the large vessels around it. It is a family of operations, not one procedure: the most common are coronary artery bypass grafting (CABG) for blocked heart arteries, repair or replacement of a heart valve, repair of a hole or other congenital defect, and surgery on the aorta. In most cases the chest is opened through the breastbone (median sternotomy), the heart is stopped for a time, and a heart-lung machine takes over circulation of blood and oxygen while the surgeon works.
Turkey has a large number of cardiac surgery centres, and heart surgery is among the most often requested medical treatments by international patients. Because the operation is serious, the decision to travel should be based on a full diagnosis, up-to-date tests and a written surgical plan. This guide explains what each operation does, how it compares with alternatives such as stents, what it costs in comparison with the UK, US and Germany, how long you stay in hospital and what the risks are. For the wider range of heart treatments see our cardiology treatments in Turkey.
Which heart conditions need open heart surgery?
The operation is advised when a heart problem cannot be controlled enough by medicines or by catheter procedures, or when the anatomy suits surgery better. The usual groups are these.
- Coronary artery disease. Several narrowed arteries, a narrowing in the left main artery, or disease in a person with diabetes often favour bypass grafting, in which healthy vessels from the chest wall, arm or leg carry blood around the blockage.
- Valve disease. A valve that is too narrow (stenosis) or leaks (regurgitation) can be repaired or replaced with a mechanical or tissue valve. See our page on aortic valve replacement.
- Congenital defects, such as holes between heart chambers or abnormal vessels, in children and adults.
- Aortic aneurysm or dissection where the main artery is widened or torn.
- Heart rhythm and other surgery, for example removing a tumour or treating atrial fibrillation during another operation.
Your cardiologist and cardiac surgeon decide together which of these applies to you, usually with an angiogram, an echocardiogram and sometimes a CT or MRI scan.
How is open heart surgery done, step by step?
The operation takes place under general anaesthesia and usually lasts three to six hours. The surgeon opens the breastbone, connects tubes to the heart and to the heart-lung machine, and cools or stops the heart with a special solution. In bypass surgery grafts are sewn from the aorta to the arteries beyond the blockage; in valve surgery the damaged valve is repaired or replaced; in congenital repairs the defect is closed with a patch or stitches. The heart is then restarted, the machine is withdrawn, the breastbone is closed with wires and the skin is stitched. You wake in the intensive care unit with a breathing tube for a few hours, drains in the chest and a heart monitor.
Some bypass operations are done without the heart-lung machine ("off-pump"), and some valve and defect repairs can be done through smaller cuts between the ribs. These approaches suit selected patients and are not always better; the surgeon should say why they recommend one or the other.
Does open heart surgery work? What the evidence says
For well-chosen patients the evidence is strong. Bypass surgery relieves chest pain and, in people with multi-vessel disease, diabetes or left main disease, improves long-term survival compared with medicine alone or with stents. Valve surgery restores function and prevents heart failure in severe valve disease. Large registries such as those of the Society of Thoracic Surgeons in the United States and the National Institute for Cardiovascular Outcomes Research in the UK report that, in experienced centres, the risk of dying in hospital after elective bypass is low, in the range of 1 to 3 percent, though it rises with age, emergency surgery, weak heart function and other illnesses. Individual risk is calculated with scores such as EuroSCORE II, and a surgeon should explain yours.
No operation can cure heart disease itself: bypass grafts and valves need lifelong care of blood pressure, cholesterol, diabetes, smoking and exercise, and tissue valves or grafts can wear with time.
Open heart surgery cost in Turkey compared with the UK, US and Germany
These are approximate ranges for a standard operation including hospital stay, intensive care and surgeon and anaesthetist fees. They are not hospital quotes, and complex cases (several valves, aortic surgery, emergency surgery) cost more.
| Country | Approximate cost range |
|---|---|
| Turkey | €8,000 – €25,000 |
| United Kingdom | €20,000 – €55,000 |
| United States | €60,000 – €180,000 |
| Germany | €20,000 – €50,000 |
The price depends on the type of operation (single bypass, multiple grafts, valve repair or replacement, combined operations), the kind of valve chosen (a mechanical valve and a tissue valve differ in price and in future needs), the days in intensive care and in the ward, blood products and complications. A package should state the pre-operative tests, the operation, the intensive care stay, medication, hospital days and any rehabilitation. Always ask what happens, and who pays, if you need extra days or a second operation.
Open heart surgery, stents or keyhole valve procedures: which fits?
Not every heart problem needs the chest to be opened. The table compares the main options.
| Option | Best suited to | Typical limits |
|---|---|---|
| Open heart surgery (bypass or valve) | Multi-vessel or left main disease, diabetes, valve disease that needs repair, complex defects | Longer recovery; breastbone healing; greater operation risk than a stent |
| Coronary stenting | One or two simple blockages, emergency heart attacks | Re-narrowing risk; less durable in complex disease |
| Transcatheter or keyhole valve procedures | Selected older or higher-risk patients with valve disease | Not suitable for every valve problem; long-term data shorter |
The right option depends on your anatomy and general health, and the plan should come from a heart team of cardiologist and surgeon, not from a sales conversation. If a clinic proposes surgery before looking at your angiogram, treat that as a warning sign.
Who is a good candidate, and who is not?
Candidates are people whose cardiologist has confirmed that surgery will bring more benefit than medicines or a stent, and whose general health allows a long anaesthetic. Higher risk comes with a very weak heart, recent heart attack, kidney failure, severe lung disease, previous heart surgery, infection, uncontrolled diabetes and advanced age. High risk does not always rule out surgery, but it changes the plan, the hospital and the need for an intensive care team on site. You should not travel if you are unstable, have chest pain at rest or have had a recent heart attack; ask the surgeon whether it is safe to fly and when.
Hospital stay, intensive care and recovery milestones
After surgery you spend one to three days in intensive care and then about five to seven days on the ward. You start walking within a day or two, do breathing exercises and take blood-thinning or heart medicines. Because the breastbone needs about six to eight weeks to knit, you avoid lifting, pushing and pulling heavy objects, and you hold a pillow against the chest when coughing. Most people feel tired for weeks. Desk work can resume after four to eight weeks and heavier work and driving after six to twelve weeks, as the surgeon advises.
For international patients the usual plan is a stay of 10 to 14 days in Turkey, so that the surgeon can check the wound, heart rhythm, blood tests and an echocardiogram before the flight. Cardiac rehabilitation, which is a supervised exercise and education programme, is strongly advised and should be arranged with your doctor at home. Flights are usually allowed after the surgeon's clearance, with compression stockings and regular walking.
What are the risks of open heart surgery?
Common effects are pain, tiredness, low mood, poor sleep, temporary changes in heart rhythm (atrial fibrillation) and wound discomfort. More serious complications include bleeding needing a return to theatre, infection of the chest wound or breastbone, stroke, kidney problems, breathing problems, memory or concentration changes and, rarely, death. The British Heart Foundation and the NHS describe these risks and note that the individual risk depends on age, the operation and other illnesses. A surgeon should review your personal risk score and the hospital's own results for the same operation, and you should receive a written consent form in a language you understand.
How to choose a cardiac hospital, and red flags
Look for a hospital with its own dedicated cardiac surgery team, a cardiac intensive care unit, 24-hour anaesthesia and perfusion staff, blood bank and an emergency plan, and ask how many operations of your type are done each year. Check that the surgeon will review your angiogram or scans before giving a price. Red flags include a fixed price promised without any medical records, a guarantee of success, pressure to travel quickly when you are unstable, and no description of what happens in a complication. Read how our process works and send your reports through the free quote page for a written plan.
- Which operation exactly do you propose, and why not a stent or medicines?
- What is my individual risk score?
- How many operations like mine does the surgeon and the hospital do each year?
- Which valve or graft will be used, and what does it mean for blood thinners in future?
- How many days in intensive care and in hospital are included?
- What happens, and who pays, if I need more days or another operation?
Hospitals with Cardiac Surgery in Turkey
Frequently asked questions
Open heart surgery is any operation in which the chest is opened to work directly on the heart or its main vessels. It includes bypass grafting, valve repair or replacement, congenital defect repair and aortic surgery.
In experienced centres, the risk of dying in hospital after elective bypass is generally low, though it rises with age, weak heart function and other illnesses. A surgeon should calculate your personal risk with a recognised score.
Approximate ranges are €8,000 to €25,000 in Turkey, against about €20,000 to €55,000 in the UK. The price depends on the operation, the valve or grafts used and the days in intensive care. The hospital confirms it in a written quote.
Hospital stay is about one week, and the breastbone needs six to eight weeks to heal. Desk work can resume after four to eight weeks and heavier work or driving after about six to twelve weeks.
It depends on your arteries. Surgery tends to suit several blocked arteries, left main disease or diabetes, while a stent suits one or two simple blockages. Your heart team should explain the reasons.
Some bypass and valve operations can be done through smaller cuts between the ribs, but they suit selected patients. Your surgeon will explain whether a smaller approach is suitable for your heart.
Most operations take about three to six hours, depending on the number of grafts or the complexity of the valve or defect repair. You then spend a day or more in intensive care.
You are under general anaesthesia during the operation. Afterwards chest, shoulder and wound pain are common and are managed with painkillers, and breathing exercises and coughing with a pillow reduce discomfort.
Risks include bleeding, infection, stroke, rhythm problems, kidney or lung problems and, rarely, death. The risk depends on your age, heart function, other illnesses and whether the operation is planned or urgent.
Usually 10 to 14 days, so the surgeon can check the wound, rhythm and tests and clear you to fly. Complicated operations may need longer, and you should arrange cardiac rehabilitation at home.
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