Heart Surgery

Memorial Health University Physicians -- CVT Surgery performs the following heart surgeries:

Cardiac surgery

• Conventional coronary bypass surgery (CABG)
• Off-pump coronary bypass surgery (OPCABG)

Valvular surgery

• Replacement
• Repair

Cardiac-related adult congenital surgery
Permanent pacemaker implantation

Initial Consult
Our physicians will discuss your upcoming surgery with you. The discussion includes the surgical procedure, when you will need to have it, your expected length of stay in the hospital, and the risks, benefits, and options for surgery.

Preparation at Home
You may be asked to discontinue certain medications before your admission to the hospital. Check with your doctor if you are currently using any of the following:

• Aspirin or any medications containing aspirin
• Anticoagulants (blood thinners)
• Any other prescription medications
• Cigarettes (the earlier you quit smoking before your operation, the better your heart and lungs will respond after the operation)

It is also important to let your doctor know if you have any sores, cuts, colds, or urine or bladder infections at the time of the operation.

The Night Before Surgery
You should eat a normal meal for dinner the night before your surgery, but do not eat or drink anything (including water) after midnight. You might be asked to shower with a special antibacterial soap before going to bed the night before your operation. This will reduce the risk of infection.

The Day of Surgery
On the morning of your surgery, a surgical technician will prepare you for surgery. Preparation involves shaving the area where the incisions are going to be made and washing the area with antibacterial soap.

The Surgery
During the surgery, chest tubes, intravenous catheters (IVs), urinary catheters, and breathing tubes may be inserted. Your heart will be monitored for rhythm, blood pressure, and oxygen levels. You will be given medication and fluids through the IVs. The surgeon will begin to prepare you for the incision in your chest, while the secondary surgeon begins to "harvest" the vein for the bypass. The physician will then perform the surgery.

After Surgery
After surgery, you will be taken to the Cardiovascular Intensive Care Unit (CVICU). Your family will be allowed to visit for short periods. Your diet will be minimal after the operation and gradually increased. Your appetite and energy level will also increase in the days to follow. You should note that your diet and activity level will be under careful instruction and will vary from patient to patient. Your cardiac rehab will consist of arm and leg exercises to promote circulation and normal lung function. The length of stay in the hospital is different for each patient and surgery. However, the length of stay is approximately four to six days, depending on how well you respond after surgery.

Walking is probably the single most important thing you can do to speed your recovery. It will help improve your lung function, muscle strength, appetite, nervous system, and blood circulation. A physical therapist or nurse will initially assist you to ensure your safety and to evaluate your progress. Because your breastbone won't be healed for about eight weeks, you shouldn't use your arms to try and get out of bed or lift anything heavy - you will be instructed on the proper technique.

Breathing Exercises
Following heart surgery, there is some degree of collapse in the small air sacs of your lungs. To re-expand these air sacs, you will be instructed to take slow, long, and deep breaths. In addition, you will be instructed on how to cough effectively.

Don't Worry If…

• You get fatigued during the days immediately following surgery. Being active will help you recover more quickly.
• You are constipated for a few days following surgery. This is a common result of anesthesia - walking will help with this problem.
• You run a mild fever. Walking should help alleviate this problem.
• You experience night sweats. As a result of being put on a heart-lung machine, you will probably sweat more than usual at night (for the first few nights).
• You experience mood swings or sadness following surgery. If they are prolonged, however, you should consult with your doctor.
• You have swelling in your legs. Elevating your legs and limiting your fluid intake should help with this problem.

General Instructions Upon Discharge

You will be instructed on activities you should and should not do after surgery, but here is a list to assist you.

• Avoid lifting anything more than 10 pounds or pushing/pulling anything with your arms. Your breastbone needs time to heal.
• You should avoid tub baths for four to six weeks or until your incisions are healed - a shower would be better. Do not use creams or lotions on your incisions until they have healed.
• You should avoid driving a car for approximately four weeks as your reaction time will be delayed due to weakness, fatigue, or the medications.
• To avoid putting pressure on the veins under your knees, you should not cross your legs while sitting or lying in bed.
• Your activities should be spaced throughout the day. You should also pace yourself during these activities - gradually get back into your original routine.
• You can climb stairs, but do not pull yourself up using the handrails.
• You will probably experience some degree of pain in your breastbone area from the incision. Pain medication should be used during these times.
• You should take your temperature every morning for about a week and notify the physician if it stays above 100 degrees for more than a day.
• If you have a sudden weight gain, notify the physician.

Heart surgery impacts not only the patient, but significant others as well. It is helpful to have your family's support during this time. Everyone involved needs to understand that changes are taking place, whether it is smoking cessation, diet, exercise, or emotional swings. A patient who has undergone heart surgery has a different outlook on life. This will be a challenging time for the patient and the family, and support is vital to recovery and healthier life.