Treating Cardiovascular Diseases in Wisconsin and Northern Illinois
Traditional heart surgery, also known as open-heart surgery, is performed to correct many problems affecting the blood vessels and structures within the heart. Some common reasons forheart surgery are to:
- Bypass blockages in the heart’s arteries so blood can get to all areas of the heart and prevent a heart attack (known as coronary artery bypass grafting (CABG)
- Fix problems with the aorta (the main artery taking blood away from the heart), including dissections (tears) and aneurysms (known as aortic repair surgery)
- Improve heart function
- Repair or replace valves, which help direct blood flow through the heart (known as valve repair or replacement surgery)
How to Prepare for an Open-Heart Surgery Procedure
In the days or weeks before surgery, your doctor is likely to request the following pre-operative tests:
- Cardiac catheterization to check for blockages in the blood vessels of the heart (if not recently done)
- Carotid ultrasound to check the arteries in your neck for blockages, which could potentially interfere with blood flow to the brain and increase your stroke risk
- Chest X-rays to help identify lung/heart abnormalities before your surgery
- Dental examination if you haven’t had one recently
- Echocardiogram (cardiac ultrasound testing) to check your heart muscle strength and the function of your heart valves
- Electrocardiograph testing (EKG) to check your heart rate and rhythm
- Lab testing to check your kidney function, liver function, blood count, urine, thyroid function and blood type (in case a transfusion is needed during your surgery)
On the day before surgery, you will be asked to:
- Refrain from taking certain medications on the day of surgery (Check for special instructions regarding medications for diabetes, medications that make your urinate more frequently, blood pressure medications and blood thinners)
- Wash your chest and legs using a special soap that helps kill bacteria to prevent infection. You may also be instructed to clip your chest and/or leg hair
On the morning of surgery, you will be asked to:
- Arrive at the hospital about 2 hours before your scheduled surgery time
- Bring all your medications with you to ensure that your home medication list is correct
- Have your blood pressure and vital signs checked when you are admitted
- Refrain from eating or drinking after midnight
- Take only those medications your doctor has allowed with only a sip of water
Immediately before surgery:
When you are ready for surgery, you will be taken to the pre-op holding area where you will meet the anesthesiologist. As you wait, a nurse will be available to answer any questions.
Before surgery, you will have an IV placed in your arm that will deliver antibiotics. The anesthesiologist will give you medicine to help you relax and make you sleepy.
You may feel cold when you are moved to the operating room. You will receive extra blankets to keep warm and will be transferred to a hard table. Once in position, you will receive anesthesia and be prepared for surgery.
What to Expect during the Heart Surgery
Once anesthesia is given, you will be completely asleep. Your anesthesiologist will put in a central line, which is a large IV for delivering medications. Another line will be used to monitor your heart function.
To help with breathing during the surgery, you will have a breathing tube that is connected to a ventilator (breathing machine). You will also have a bladder catheter.
In addition to your anesthesiologist and surgeon, you will have surgical assistants, nurses and a physician assistant helping with your procedure. Depending on the amount of work that needs to be done, your surgery is likely to take about 3 – 5 hours.
During open-heart surgery, your surgeon will make an incision down the middle of your breastbone, approximately 7 – 8 inches long. You will be connected to a heart-lung bypass machine, which allows the surgeon to stop your heart from beating and keeps your blood circulating while the heart is stopped.
After surgery is complete, your breastbone will be put back together with metal wires. Your skin will be closed with sutures and in some cases, staples. Drainage tubes will be put in your chest cavity to drain blood and fluid. Also, temporary pacemaker wires will be placed in case your heart rate becomes too slow or an abnormal rhythm develops.
Potential Open-Heart Surgery Complications
All surgeries have potential risks, and some risks are higher in older adults and people with other health concerns. Your doctor will explain your risks in greater detail. Potential risks may include:
- Breathing/kidney problems
- Heart arrhythmias (irregular heartbeat)
- Infection (including of surgical wounds, pneumonia, urinary infection from bladder catheter)
- Stroke (with possible short- or long-term effects, depending on its severity)
Recovering from Heart Surgery
After open-heart surgery, you will be taken from the operating room to the intensive care unit (ICU). You will have a breathing tube in place until you wake up from general anesthesia. Your blood pressure, oxygen levels, temperature and heart rhythm will be monitored. Medication adjustments will be made as necessary.
You will be able to move out of the ICU once your breathing tube is removed, your heart rhythm and blood pressure stablize, and special intravenous medications are no longer needed. You will be transitioned from intravenous pain medication to pain pills. These will be decreased as your pain improves.
You can expect to begin an exercise program the day after surgery. You will work with cardiac rehab and possibly physical and occupational therapy to increase your strength and mobility. This activity also helps to prevent complications like pneumonia and blood clots.
When you are deemed stable, your chest drainage tubes and temporary pacing wires can be removed. You can expect to remain in the hospital 4 – 6 days following surgery. You will be deemed ready to leave the hospital once you have a stable blood pressure, heart rate and rhythm, are able to ambulate safely, have adequate pain control and are weaned from oxygen.
Prescriptions, including pain medication, will be given at discharge.
Nationally Recognized for Performing Open-Heart Surgery
Aurora Health Care has a great deal of experience in performing open-heart surgeries. We use a team approach to surgery, which includes the surgeon, anesthesiologist, operating room nurses, surgical techs, physician assistants, nurse practitioners and nurses. Our teams are specially trained and experienced in open-heart surgery.
You will see members of your special team at your doctor’s visit before surgery, during your surgery and hospital stay and at follow-up visits. Our teams help make sure each patient gets the care they need before, during and after surgery.
Aurora has many surgeons who have been recognized for their work with patients having open-heart surgery. Our surgeons are involved in research and clinical trials to stay on the cutting edge of the technology and techniques used in open-heart procedures.
To take care of your other medical needs, Aurora surgeons work closely with other specialists, including cardiologists and doctors who specialize in diabetes and lung conditions. Because of their extensive experience, Aurora heart surgeons provide you with the best options for your needs.