All about heart surgery

February is Heart Month, which is dedicated to raising awareness about various heart diseases. Hopefully it’s unnecessary, but if you or your loved one needs heart surgery, here is a general overview of what to expect before, during and after the procedure.

Before heart surgery

1. Medical evaluation: You will be asked to provide information regarding your medical history, a list of medications you currently are taking, any allergies and a surgical history. You will undergo a thorough medical evaluation. This includes a physical exam, blood tests and imaging studies (such as an echocardiogram or heart catheterization).
2. Preoperative preparation: Your healthcare team will provide instructions on preparing for surgery, including arrival time, location, guidelines on eating and drinking and if you should stop taking certain medications.
3. Anesthesia consultation: You will meet with an anesthesiologist to discuss the type of anesthesia to be used, the risks and benefits associated with the use of anesthesia, allergies or prior reactions to anesthesia use and to address any questions or concerns you may have.

During heart surgery

1. Anesthesia: You will be administered anesthesia to ensure you are unconscious and pain free during the surgery. The type of anesthesia may vary based on the specific procedure.
2. Breathing tube and ventilator: An endotracheal tube, often called a breathing tube, is a medical device placed through the mouth and connected to a mechanical ventilator. These devices help with breathing while you are asleep during surgery.
3. Incision: The surgeon makes an incision to access the heart, usually in the chest or breastbone area. In some cases, minimally invasive techniques (smaller incisions) may be used.
4. Heart-lung bypass machine: This may temporarily take over blood pumping and oxygenate it, allowing the surgeon to work on the heart.
5. Surgery: The surgeon performs the necessary repairs or procedures as discussed during your consultation. This could involve heart valve repair or replacement, coronary artery bypass grafting (CABG), aortic aneurysm repair or other interventions as necessary.
6. Monitoring: The team closely monitors your vital signs (heart rate, blood pressure and oxygen levels) throughout your procedure.
7. Closure: Once the surgery is complete, the surgeon closes the incision, and you are gradually weaned off the anesthesia and the heart-lung bypass machine (if used).

After Heart Surgery

1. Recovery in the intensive care unit (ICU): After the surgery, you will be transferred to an ICU for continuous close monitoring during the initial recovery period.
2. Ventilation: You may initially remain on the mechanical ventilator to assist with breathing, but this is gradually reduced as your condition stabilizes.
3. Pain management: Pain control is important in postoperative care. The team will assess your pain level throughout your hospitalization. Be ready to provide a pain scale rating, describe/characterize your pain, the location and if it radiates or is localized.
4. Monitoring and testing: Various tests, such as echocardiography and blood tests, will assess the heart’s function and overall recovery.
5. Mobility and rehabilitation: Early mobilization and rehabilitation are encouraged to prevent complications and promote recovery.
6. Hospital stay: The length of your hospital stay can vary, but many patients are discharged within a week or two, depending on the type of surgery and individual recovery.
7. Follow-up care: Your healthcare team will schedule regular follow-up appointments to monitor your progress and address any concerns.

It’s important to note that since an individual’s experience with heart surgery is unique, the recovery process can vary. Complications are possible, and your healthcare team will guide you through postoperative care, medications, lifestyle changes and any necessary rehabilitation. Open communication with your healthcare providers and following their recommendations are crucial for a successful recovery.

Learn more about cardiovascular medicine. 

By Gilda Martinez, instructor and nurse practitioner in the Department of Surgery – Division of Cardiothoracic Surgery