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Heart Surgery

Years ago, many doctors thought that heart surgery was a dream. Surgeons during World War II had learned how to operate on the heart, but they could not carry out what they had learned because it was hard to operate on a beating, moving heart. Also, the heart could not be stopped for more than a few minutes without causing brain damage.

 

Years ago, many doctors thought that heart surgery was a dream. Surgeons during World War II had learned how to operate on the heart, but they could not carry out what they had learned because it was hard to operate on a beating, moving heart.

 

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What To Expect Before Heart Surgery

There are many types of heart surgery. The type you need depends on your situation. One person's experience before surgery can be very different from another's.

 

Some people carefully plan their surgeries with their doctors. They know exactly when and how their surgeries will happen. Other people need emergency heart surgery. Others are diagnosed with blocked coronary arteries and are admitted to the hospital right away for surgery as soon as possible.

 

If you're having a planned surgery, you may be admitted to the hospital the afternoon or morning before your surgery. Your doctors and others on your health care team will meet with you to explain what will happen. They'll give you instructions on how to prepare for the surgery.

 

You also may need to have some tests, such as an EKG, chest x ray, or blood tests. An intravenous line will be placed into a blood vessel in your arm or chest to give you fluids and medicines.

 

Hair near the incision site may be shaved. Your skin may be washed with special soap to reduce the risk of infection.

 

Just before the surgery, you'll be moved to the operating room. You'll be given medicine so that you fall asleep and feel no pain during the surgery.

 

What to ask your cardiologist...

 

  • - What is coronary artery disease? How many heart vessels are blocked?
  • - What are my treatment options and what are the risks and benefits of each?
  • - Why are you recommending this treatment over the others?
  • - What lifestyle changes will I need to make and what community resources are available to help?
  • - If I decide not to have open-heart surgery, will you support my decision?
  • - Will I be given some time to put my affairs in order prior to the heart surgery?
  • - Should I complete an Advance Directive?
  • - Should I avoid caffeine and other stimulants for 48 hours prior to surgery?
  • - (If diabetic) How often should I be monitoring my blood sugar?
  • - If I opt to have surgery, will I need to take medication afterwards? If so, for how long?

 

What to ask your heart surgeon...

 

  • - What are the risks and complications associated with this surgery?
  • - What are my specific risks? How risky is my surgery?
  • - Did I have a heart attack? If so, how will this affect my surgery?
  • - How many other have you operated on with my same condition and what were their outcomes?
  • - How many patients do you operate on each year? How many of your patients were women?
  • - Can my chest and leg scars be minimized or can vessels be taken from a less visible location?
  • - How long is my expected recovery? When will I be able to resume normal activities? Drive a car? Return to work? Have sex? Be independent in activities of daily living? Make plans for help in the home for the first full two weeks following your discharge from the hospital. Ask for a social service referral to help assist your family with sharing duties.
  • - What is your fee? Will you accept my insurance as payment in full?
  • - If I decide not to have blood products administered, does the hospital follow Bloodless Care Protocols?
  • - What accommodations are available for my family's stay on the hospital campus so that they can support me throughout the operation?

Tell your heart surgeon...

 

  • - If you want bloodless care;
  • - If you want your Advance Directives postponed during surgery. This is the usual procedure. It will be reinstated after you are stable and transferred to intensive care;
  • - If you have had a vein stripping operation. The doctor will need to look elsewhere for vessels;
  • - If you would like to hear reassurances during the operation that "all is going well";
  • - If you would like to employ holistic measures to help you relax, for example therapeutic massage, aroma therapy, reflexology, bio-feedback or music therapy.
  • - If you would like to play a relaxing CD during the surgery. You may need to bring in your own headphones and CD player, but this may be well worth the trouble.

 

Discuss with your anesthesiologist any health history that could affect how you respond to anesthesia, for example, if you…

 

  • - Have panic attacks
  • - Experience chest pains not related to activity
  • - Take medication for anxiety
  • - Excessively drink, binge drink or do weekend drinking
  • - Take herbal supplements
  • - If you or a family member (blood relative) has ever had a serious reaction to anesthesia;
  • - If you have a drug allergy or sensitivity or you are allergic to latex.

 

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What To Expect After Heart Surgery

Recovery in the Hospital

Depending on the type of heart surgery, you may spend a day or more in the hospital's intensive care unit. You may have an intravenous needle inserted in a blood vessel in your arm or chest to give you fluids until you're ready to drink on your own.

 

You also may be given extra oxygen through a face mask or nasal prongs that fit just inside your nose. These pieces of equipment are removed when you no longer need them.

 

When you leave the ICU, you'll be moved to another part of the hospital for several days before you go home. The entire time you're at the hospital, doctors and nurses will closely watch your heart rate, blood pressure, breathing, vital signs, and incision site(s).

 

Recovery at Home

Each person responds differently to heart surgery. Your recovery at home will depend on what kind of heart problem and surgery you had. Your doctor will give you specific instructions about how to:

 

  • Care for your healing incisions
  • Recognize signs of infection or other complications
  • Cope with after-effects of surgery

 

You also will get information about followup appointments, medicines, and situations when you should call your doctor right away.

 

After-effects of heart surgery are normal. They may include muscle pain, chest pain, or swelling .

 

Other after-effects may include loss of appetite, problems sleeping, constipation, and mood swings and depression. After-effects usually go away over time.

 

Recovery time varies for different types of heart surgery. Full recovery from traditional open-heart CABG may take 6 to 12 weeks or more. Less recovery time is needed for off-pump heart surgery and minimally invasive heart surgery.

 

Your doctor will let you know when you can go back to your daily activities, such as working, driving, and physical activity.

 

Ongoing Care

Care after your surgery may include periodic checkups with your doctor. During these visits, you may have blood tests, an EKG, echocardiography, or a stress test. These tests will show how your heart is working after the surgery.

 

Your doctor also may talk with you about lifestyle changes and medicines to help you stay healthy. Lifestyle changes may include quitting smoking, making changes to your diet, doing physical activity regularly, and reducing and managing stress.

 

You doctor may refer you to a cardiac rehabilitation program. Cardiac rehab includes counseling, education, and exercise training to help you recover. The program also will help you learn how to make choices that can lower your risk of future heart problems.