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Open Heart - The Surgery

Your surgery will take about four to six hours. You'll leave your family two hours before surgery and they will be able to see you when you are settled in the Critical Care Observation Unit (CCOU), about 90 minutes after the surgery is complete. Your family will be informed of your progress about every 60 to 90 minutes. Your family may wait for you in the Surgery Waiting Room.

 

Before Your Surgery

 

Some patients are in the hospital the night before surgery and others come in the morning of surgery. This will need to be discussed with your doctor. Regardless of where you spend the night, preparation will be the same.

  • You will be shaved and showered before surgery. Both arms, your chest and your legs will need to be free of hair. 
  • Your nurse will assist you in to the shower. You will wash the areas where your incisions will be with a special soap.
  • After your shower you will be placed on a cart and you will be taken to the pre-op area. Before you leave for pre-op, you will be placed on oxygen.
  • Once in the pre-op holding area, one of the anesthesia nurses will start your I.V.s. These I.V.s will be placed using lidocaine, which numbs the skin.

Preparing for Surgery in the O.R.

  • Once in the O.R., nurses will assist you onto the operating table and the anesthesiologist will place an oxygen mask on your face. He/she will put medicine in your I.V. that will make you go to sleep.
  • You will have a tube placed in your windpipe so that you can be placed on a ventilator. 
  • A special I.V. called a Swan-Ganz catheter will be placed in your neck to monitor the pressures in your heart.
  • A probe called a transesophageal echocardiogram will be placed down the back of your throat to enable the surgeon to look at the inside of your heart as well as the outside.
  • An antibiotic will be administered through your IV, and the incision area will be washed with special soap and draped to help prevent an infection.

During Your Surgery

 

  • The surgeon will make an incision down the front of your chest through your breastbone or sternum.
    *  If you are having bypass surgery, the surgeon will now harvest the IMA (internal mammary artery) while surgical assistants harvest the veins from your legs or the arteries in your arms. Endoscopic vein harvesting is a minimally invasive technique to significantly reduce the length of your leg incisions. The surgeon will sew the new vessels onto your heart, bypassing the blocked vessels.
  • In order for the delicate surgery to be done, your heart may need to be stopped. In this situation, medication will be given to stop your heart and your blood will be oxygenated and circulated with a heart-lung machine.         Once your surgery is over, your heart and lungs will take this function back.*
  • If you are having valve surgery, the surgeon will either repair or replace the      defective valve. This type of surgery cannot be done off-pump.

    * Staff from the operating room will update your family regularly during the surgery.

    *   If you are having Off Pump Beating Heart Surgery, it will not be necessary to stop your heart. You will not be placed on a heart-lung machine. Your heart and lungs will continue to function normally.

After Your Surgery

 

At the end of the surgery, your surgeon will update your family on your progress. Immediately after the surgery you will be taken from the operating room to the Critical Care Observation Unit. Critical care nurses, respiratory therapists and other medical professionals will monitor your progress, record your blood pressure and pulse, and perform various other tasks. As soon as possible your family will be allowed to see you.

 

What to Expect After Surgery

  • When you first wake up from surgery, you may feel groggy, thirsty, and cold. This is normal and will not last long.
  • You will not be able to speak with the breathing tube in. The nurses are monitoring your pain and giving you pain medication before you are even able to tell them about your pain. As soon as you can follow commands, they will remove the breathing tubes and you will be able to speak.
  • Surgery patients are usually connected to many tubes and wires. These include:
    • chest tubes that collect blood and drainage from around your heart
    • heart monitors and blood pressure monitors
    • a ventilator
    • a catheter in the bladder, to drain urine
    • intravenous tubes providing essential medications, blood and fluid
    • temporary pacemaker wires.  

Important things for families to know

  • Your loved one will be unconscious or very groggy right after surgery.
  • He or she may appear pale and swollen after surgery.
  • He or she will be connected to many tubes, which can be overwhelming. Remember that each of these tubes has a function in his or her recovery.

Your Recovery

 

When you no longer need intensive care, you will be moved to the Progressive Care Unit (PCU). This can happen within 24 hours of your surgery or up to a few days after your surgery depending on the medications you need and how quickly you progress after the surgery. This unit is a step down from the Intensive Care Unit, but still provides continuous care.

 

Participating in Your Recovery

 

You will be asked to participate in your recovery by getting out of bed, walking with assistance several times each day, eating your meals in a chair and other activities. These are all important steps toward going home. Many people will visit you at this time, including dietitians, x-ray technicians, lab personnel, and respiratory therapists. Your cardiologist and cardiac surgeon will visit with you every day as well as your family doctor if he/she is in Kearney. If your doctor is in     another community, he or she will be informed of your progress and will care for you when you return home.

 

 Related Information
 Your Surgery
 Going Home - Discharge Instructions
 Daily Activities
 When to Call the Doctor
Cardiac (Heart) Anatomy 
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Cardiac (Heart) Procedures 
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Cardiovascular Diagnostic Test
(Non-Invasive) 
 Arterial Ultrasound
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Carotid Ultrasound

CCTA
Echocardiogram
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Event Recorders
 
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