Open-Heart Surgery: What To Expect At The Hospital And At Home

What Is Open-Heart Surgery?

Open-heart surgery means that the chest cavity will be opened to allow surgeons to correct a variety of conditions. It often requires the use of a  heart/lung machine which takes over the blood-pumping and oxygenation of the blood performed by the heart and lungs. Procedures last from four to 14 hours or more.

What To Expect Immediately After Open-Heart Surgery

Many people are surprised to learn that they have been under continuing sedation for two to three days. This is to allow your body to heal and avoid movements or falls that will compromise recently stitched tissue. You will be in a bit of a panic as you realize a large breathing tube in your mouth and down your throat has been turned off.  The medical staff will remove this tube quickly and insert a suction tube into your mouth. Purse your lips around this just like you would do at the dentist and all fluids will be suctioned.

Day One After Awakening

You will be heavily sedated and linked to many monitoring devices, IV's and other equipment.  You may or may not remember conversations you have with people.  You will be moved to a sitting position in bed and frequently checked and tested by medical staff. 

Diet At The Hospital

Your first meal will probably be gelatin or fruit juice.  Slowly you'll be introduced to the foods you're accustomed to.  You will be encouraged to eat a broad range of foods to help healing bones, muscle and to boost your immune system.  Follow the recommendations and eat wisely. 

Days Two Through Hospital Release

As you continue to recover you will notice clear plastic tubes emerging from your abdomen.  These are to drain fluids that build up in your chest cavity.  They don't hurt but are connected to a collection box which will limit your movement.

Regardless, you will be asked to move.  You may or may not spend a day or two in cardiac ICU (intensive care unit) depending on your condition.

On The Move At The Hospital

You'll be grateful to be able to go to the bathroom rather than using a bedpan, but you will be very constipated.  Make sure a stool softener and laxative is part of your medication regimen.  You'll also be encouraged to take accompanied walks.  This is much easier to do without the chest tubes and plastic box but you'll probably do some preliminary walks carrying the boxes with the tubes still inserted.  

Open-Heart Surgery And Infection

A primary concern for anyone undergoing a surgical procedure is the risk of infection. This is particularly true with open-heart surgery due to the duration of the operation, the invasiveness of the procedures, and the numerous incisions from the chest to the legs if a bypass was needed. There also incisions from chest tubes and numerous entry points for various IV's, catheters and a breathing tube.

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Staph And MRSA

The first symptoms of an infection include oozing from an incision, inflammation, redness, blisters, pain and fever. The most common type of infection is Staph although an antibiotic resistant variation of Staph known as MRSA has also appeared.

Open-Heart Surgery: The Road To Recovery

Antibiotic And Antiseptic Treatments

Treatments vary although a course of oral antibiotics is usually the first step in addition cleansing of infected incisions with regular wipes of iodine usually four times a day. You will also be expected to visit your doctor or surgeon with greater frequency and to call if there are any adverse changes.

Intravenous Solutions

In extreme cases intravenous antibiotics are administered in addition to possible direct injections into a localized site such as an incision. You will also be given regular blood tests while treating the infection to assess the course of the infection and the progress of the treatment.  

Going Home

Someone will give you a long list of instructions. Follow them carefully. You'll also be given a list of prescription pain medications. Have someone pick them up as soon as possible. You'll be wheeled out to the curb in a wheelchair and probably be a bit shaky in the legs.  When you get home, take your time and move slowly and carefully. A bad fall will have you back in the hospital.  You should have an area setup where you can sleep, rest and eat comfortably. The closer to a washroom the better if you're on a diuretic or laxative. 

Help At Home

It's wise to have friends and family members present during your first week at home.  They can assist you with basic tasks and help in the event of an emergency. 

Danger signs once you're home include:

• Pain in your chest
• Shortness of breath
• Pain in your legs
• Oozing or redness around incisions
• Swelling in the feet or ankles
• Fever
• Blisters around incisions
• Heavy wheezing or coughing

Most people are generally mobile at home 2 weeks after surgery, many can drive and do routine activities after 4 weeks. Some can return to work after 6 weeks, but the total time for a return to normalcy is about three months. Cardiac Rehab helps.

Cardiac Rehab

Your cardiologist will probably recommend cardiac rehab. It's a six to 12 week course of supervised and monitored exercise designed to help you rehabilitate fundamental muscle groups. It's a good idea and they manage you carefully. You can usually begin this after four to six weeks following your surgery.

Follow-Up Tests And Appointments

You will have numerous follow-up tests and appointments with your surgeon, your cardiologist and your doctor or general practitioner.  You will also have tests such as CT scans or MRI's to evaluate the success of the surgery and your progress. The frequency of these tests and appointments will diminish after about three months following surgery, but you will probably be asked to do annual follow-ups. 

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Going back to your normal routine will take time. However, most people are enthusiastic and surprised at how much better they feel once they can return to a normal routine. Any heart condition affects both physical and emotional well-being and a successful surgery and recovery will leave you feeling better than before.