heart surgery

overview

Traditional heart surgery, also known as open-heart surgery, is done to correct many problems affecting the blood vessels and structures of the heart. 

Common reasons for heart surgery include:

  • Bypassing blockages in the heart’s arteries so blood can get to all areas of the heart and prevent a heart attack, with coronary artery bypass grafting or CABG
  • Fixing problems with the main artery that takes blood away from the heart (aorta), including tears and bulges in artery walls that can burst (aneurysms). These problems are fixed with aortic repair surgery
  • Improving heart function
  • Repairing or replacing valves, which help direct blood flow through the heart, with valve repair or replacement surgery

evaluation

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)

what to expect

You’ll be asked to stop taking certain medications on the day of surgery. You may be given special instructions about medications for diabetes, urination and blood pressure, as well as blood thinners. 

The day before your surgery, you’ll be asked to 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. You’ll have to stop eating or drinking anything after midnight.

The morning of your surgery, you’ll be asked to arrive at the hospital about 2 hours before your scheduled surgery time, where you’ll have blood pressure and other vital signs checked. Bring your medications with you. If your doctor asks you to take any medications, do so with just a small sip of water.

When you’re ready for surgery, you will be taken to the pre-op holding area, where you’ll meet the anesthesiologist. As you wait, a nurse will be available to answer any questions. You’ll have an IV placed in your arm to deliver antibiotics. 

You’ll be put under general anesthesia so you’re completely asleep while prepped for surgery. 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. You’ll also be connected to a breathing machine, and a catheter will empty your bladder.

Your procedure is likely to take 3 to 5 hours, depending on what’s being done.

During open-heart surgery, your surgeon will make an incision down the middle of your breastbone, about 7 to 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.

recovery

When open-heart surgery is done, you’ll be taken to the intensive care unit (ICU). The breathing tube will stay in place until you wake up from the anesthesia. Your blood pressure, oxygen levels, temperature and heart rhythm will be monitored, and your medication will be adjusted as needed. After your breathing tube is removed, your heart rhythm and blood pressure have been stabilized, and some IV meds are no longer needed, you’ll move out ICU to a regular patient room. There, you’ll get pain pills rather than IV pain medication, and those will decrease as your pain lessens.
  
You can expect to begin an exercise program the day after surgery. Working with cardiac rehab and possibly physical and occupational therapy, your goal is to increase your strength and mobility. Activity is important to help prevent complications like pneumonia and blood clots.

You’ll probably be in the hospital for 4 to 6 days after surgery. During that time, when you’re stable, you’ll have the drainage tubes and temporary pacing wires removed. You’re ready to go home as soon as your heart rate and rhythm and blood pressure are stable, when you’re off oxygen, when you can control your pain with medications and when you can safely move around. You’ll get a prescription for pain medications when you’re discharged.

All surgeries have potential risks, and some risks are higher in older adults and people with other health concerns. Potential risks may include bleeding; breathing problems; kidney problems; irregular heartbeat (heart arrhythmias); infection (including of surgical wounds, pneumonia, urinary infection from bladder catheter); stroke (with possible short- or long-term effects, depending on its severity); or death.

why Aurora?

We have extensive experience in open-heart surgery. Our team approach – including a surgeon, anesthesiologist, operating room nurses, surgical techs, physician assistants, nurse practitioners and nurses – means you’ll get complete and comprehensive care. You’ll see those team members at your doctor’s office before surgery, during your surgery and hospital stay and at follow-up visits. Because our surgeons are involved in research and clinical trials, we’re on the cutting edge of technology and techniques used in open-heart procedures, all to be sure you get the very best care.

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