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Recovering from Heart Surgery

Heart surgery is a method to treat a variety of heart diseases, including heart failure, valve problems, arrhythmia, coronary artery disease (CAD) and other cardiovascular disorders. According to the Centers for Disease Control and Prevention, CAD is the most common type of heart disease in the United States. Recovering from heart surgery is different for everyone and undergoing this procedure could be precarious. There are things you can do to prepare for heart surgery and to understand what to expect afterwards.

How to Prepare for Heart Surgery

Guidance will be given from your healthcare provider to prepare you for your procedure. This could include information on:

Medications: The doctor could discontinue blood thinners that prevent blood clots, such as Warfarin, Eliquis, Plavix, Aspirin and non-steroidal anti-inflammatory drugs (NSAIDS) to reduce the risk of bleeding during surgery.

Lifestyle: The following lifestyle habits need to be put in place in preparation for heart surgery to aid in healing and reduce the risk of complications:

• Reduce alcohol intake
• Quit smoking
• Consider preoperative rehabilitation under clinical supervision from a trained physical therapist

Preparing for the procedure: For the surgical team to better plan for the procedure, you may expect the following:

• Diagnostic tests such as chest X-ray, electrocardiogram (EKG) or urinalysis
• An intravenous (IV) line to deliver medications
• Shower with antibacterial soap before the surgery
• Fasting is advised before the surgery to prevent nausea and the risk of getting food or drink into the lungs. Anesthesia also works better on an empty stomach.

What Happens During Heart Surgery?

For conditions such as atrial fibrillation, septal defects (hole in the heart), heart failure, CAD, valve diseases and an aortic aneurysm, open-heart surgery may be advised if you are deemed medically stable enough to tolerate it.

Heart surgeries are complex procedures and may take six hours or longer. You will be given general anesthesia and will be asleep during the procedure. A 6- to 8-inch cut is made through the breastbone (sternum) and ribs are widened to access the heart. During the repair, the heart may or may not be connected to the heart-lung machine. After the repair, the sternum is closed using wires and the skin is sutured.

Alternatively, a less invasive surgery may be performed involving a smaller incision, which may or may not go through the breastbone. For example, the entry may be between the ribs on the right side of the chest. There are three different approaches:

• Catheter-based: A thin hollow tube is inserted into the heart through which a balloon or a stent may be threaded to replace a valve or perform angioplasty.
• Video-assisted thoracic surgery: A video camera guides the surgeon and his surgical instruments through multiple small incisions on the chest to repair valves or put in a pacemaker.
• Robotic-assisted technology: This could be used for repairs including, but not limited to, septal defects, cardiac tumors and valve diseases.

What to Expect Directly after Heart Surgery

You may remain in the intensive care unit (ICU) under round-the-clock medical supervision for a day or two. Once stabilized, you will be moved to a regular room. You will also be given certain medications, such as blood thinners to prevent blood clots and pain medications to help manage post-operative pain.

Recovering from Heart surgery and Side Effects

Recovery depends on the extent and type of the procedure, complications, overall health and functional level prior to the operation. Six to 12 weeks is the average length of recovery time, but it could be longer for some. Depending on the severity of the procedure, driving is not allowed for four to six weeks after surgery. Rely on public transportation or caregivers to get you around in the meantime.

The following are some of the symptoms you might experience after heart surgery:

Loss of appetite: Losing appetite or feeling too exhausted to eat is common, so consider eating frequent small meals rich in protein (egg, dairy, nuts, beans, fish) and low in fat, cholesterol and sodium. A dietician may be consulted for guidance on diet options.

Insomnia: Not being able to sleep could be a result of discomfort from the incision, pain or change in daily routine. Your care team can teach you bed positioning strategies, relaxation techniques and how to use a heart pillow. Avoid taking more than a 20-minute nap during daytime, and consider taking your pain medications 30 to 40 minutes before bedtime. Avoid caffeinated beverages and chocolate in the evenings.

Depression: Heart surgery can be emotionally and physically challenging; it’s normal to feel blue. Having a strong support system, ample rest, taking up a new hobby or resuming hobbies and social activities can help.

Edema: During your surgery, veins may be removed from the legs, which can lead to edema, or swelling. Compression stockings, elevating your legs above your heart and ankle toe movements may be advised by your care team to reduce the swelling and discomfort.

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