OPEN HEART the medical expression is 'open heart' and corresponds to the surgical intervention in which the 'jacketing' is made, that is, the chest is opened vertically through the center and the ribs are separated to the sides to reach a direct access to the heart muscle. Nowadays this traumatic surgery has been changed by a laparoscopic one and the valve changes are made by introducing tubes through the femoral to the heart itself where a reparative microsurgery is performed.