You should not stop taking any medication before the surgery without talking to your physician. Generally speaking, antiplatelet drugs like clopidogrel or ticagrelor should be stopped 7 days before the surgery. On the contrary, anticoagulation drugs based on coumadin should not be stopped at home, particularly in those with artificial valves or in atrial fibrillation. ASA (aspirin, cardiopirin, etc.) do not increase the bleeding in cardiac surgery patients, and patients could take it before the operation.
Patients have to complete any preoperative tests or exams according to hospital protocols. Patients have to perform the following tests before the surgery: chest x-ray, ECG, blood and urine tests, coagulation tests, blood type tests, and blood-transmissive diseases check-up. Carotid arteries color Doppler exam needs to be done as well. Patients who underwent valve surgery need to have dentist clearance for the operation.
Smoking is a severe health hazard, and you need to stop it immediately. Smokers risk serious lung complications during heart surgery, and any effort should be made to abandon it before hospital admission. Even more, smokers should consider respiratory care and exercise preoperatively to improve their lung function.
We do not recommend preoperative exercise for cardiac surgery patients. A mild everyday activity like walking is acceptable for stable patients.
Cardiac surgery procedures are demanding and generally long-lasting. Depending on the complexity, it lasts from 2 to 10 hours.
Depending on the surgery number of patients will be awake the same day and extubated after that. Sometimes mechanical ventilation could last till the next morning.
In most cases, patients stay in ICU from 24 to 48 hours after the surgery. In more complex cardiac surgeries, ICU stay could be longer.
Patients leave the hospital 5 – 7 days after the surgery, although hospital stay could be prolonged depending on the operation performed and on the disease severity.
Wounds need to be kept clean and dry after the surgery. Therefore, it is not recommended to wet your wounds seven days after the procedure. If it happens, just dry it with a towel, but do not rub it. After this period, you should take a short shower rather than a bath for the next two weeks.
In case your heart surgery is made through a median sternotomy, you have to sleep on your beck for the next six weeks to allow the chest bone to heal. Such a restriction is not necessary after the endoscopic or “port-access” surgery or after some minimally invasive aortic valve procedures.
11. What kind of physical activity is recoI could practice after being discharged from the hospital?
Depending on your general condition, only mild physical activity is recommended within 4 to 6 weeks after the operation. Everyday home activities and walking without trying to test your strength and stamina is all you should do during this period. After the first postoperative check-up, usually 30-days after the open-heart surgery, your physicians will recommend your rehabilitation program. That’s the best way to pace your exercises and regain full activity.
The vein blood drainage from your leg will be compromised for a while due to vein graft harvesting from it. That’s is why this leg is swelling after the surgery. The swelling will disappear eventually, and you arshould wear compressive stockings during this period to reduce the edema.
This kind of postoperative swelling is mainly a sign of volume overload due to a heart or kidney failure. You should visit your physician for a check-up, and generally, some diuretics (drugs to increase urine output) will fix the problem.
It is not recommended to resume your sexual activity within six weeks after the surgery 15.
You have to recover entirely to restart driving. Any attempt to drive if your vitals are not wholly stable is hazardous. Therefore, driving is not recommended before the first postoperative medical check-up, but generally not before six weeks after the surgery due to the chest bone healing process. Patients operated endoscopically don’t have chest bone cut and therefore recover faster. They could restart driving after the first postoperative medical check-up.
The surgeon needs to check your chest bone stability.
Fever, the red and painful or oozing wounds are signs of wound infection. You need to visit your surgeon.
Your postoperative condition depends on your disease and surgery, your age, and comorbidities. People react in a different way to surgery, and the recovery process could be quite individual, therefore. If you see no advance in postoperative recovery, it is better to visit your physician for check-up and medication adjustments.
Elevated body temperature is not uncommon postoperatively. If it persists or increases along with fever, some blood tests need to be done to exclude infection. Otherwise, NSAID drugs could be helpful for some low-degree temperature. Visit your doctor.
Hoarsens after the surgery are generally due to larynx irritation by an endotracheal tube placed in your lung during the operation. HoarsenesIshould disappears by itself, but if persists more the two weeks visit your doctor.
Urethral or Foley catheter is necessary to provide urine drainage during the surgery. The urethra is slightly irritated due to its presence and sometimes burns after that while urinating, and this burning will subside spontaneously. If persists or followed by a temperature, arrange a visit to your doctor.
These are probable signs of either severe arrhythmia or heart failure. In any case, you need to see your physician as soon as possible.
Minimally invasive surgery is a less traumatic surgical approach that provides less pain and trauma and faster recovery. Generally, such cardiac surgery is performed through small incisions.
Valves are the most frequently operated that way, even more, this is a treatment of choice in valve surgery today. Apart. From valves, coronary passes, tumor extraction, and some congenital disabilities could be done as well.
Mini-sternotomy. Or J-sternotomy is a partial upper sternotomy, mainly used for aortic valve surgery.
Endoscopic heart surgery is a minimally invasive surgical technique that is using an endoscopic view to operate the heart. The procedure is, therefore, video-assisted, and the surgeon is using a TV screen rather than a direct vision to work. Due to a small incision necessary for a ring or valve implantation, such a surgery is called the “port/access” or key-whole operation.
Less trauma and pain reduced blood loss, short hospital stay, and fast recovery are the key features of endoscopic or video/assisted cardiac surgery. Performed through small incision surgery provides superior esthetic results due to small and almost invisible scars.
Port-access mitral valve repair is a video-assisted mitral valve reconstruction. The patient benefits from mitral valvuloplasty, fast recovery, and superior esthetic effects due to small and almost invisible scars.