Recovery from cardiac surgery is an ongoing process.
Heart surgery is one of the marvels of modern healthcare. Doctors of the 1800s initially believed surgery on the heart was impossible and were hesitant to even try. Starting in the 1950s, thanks to determined and brilliant surgeons, open-heart surgeries became increasingly safer, more common, and more effective.
Despite the medical progress, patients and their loved ones are understandably anxious about their surgery date—and what their life will be like in the weeks and months following the procedure.
“Open-heart surgery” is actually a group of procedures. “We can do surgery on the heart for many different reasons,” says Michelle Weisfelner Bloom, MD, cardiologist at Stony Brook University Medical Center. “The most common surgery is coronary artery bypass grafting,” or CABG.
When Is Open-Heart Surgery Beneficial?
Patients might benefit from open-heart surgery for one of a few reasons, according to Dr. Weisfelner Bloom.
Blocked arteries: If stents or other less invasive treatment options are ineffective, doctors may choose a CABG instead “to take healthy vessels from elsewhere in the body and create routes for the blood to go through to bypass the blockage,” says Dr. Weisfelner Bloom.
Leaky or tight valves: The heart valves are like the doors to the heart muscle. Heart valve replacement surgery can replace valves that are allowing blood to flow backward into the heart or lungs, instead of out to the rest of the body. Valve replacement can come from man-made, durable materials, or from donor tissue.
Advanced heart failure: Patients suffering from heart failure could benefit from several types of open-heart surgeries, including CABG, heart valve replacement, and even heart transplants from a donor. Here’s more information about treatment for heart failure.
What to Expect After Open-Heart Surgery
After waking up from your surgery, you will likely feel confused and tired. You will be hooked up to wires and tubes and will be in the Intensive Care Unit with highly trained healthcare professionals. Your wrists may be gently strapped down to prevent you from accidentally pulling out any of the tubes.
Once you can breathe on your own, which may take a few hours, doctors will remove the breathing tube. As long as there are no complications, your time in the hospital may be shorter than you think.
Ideally, “by day two, you’re already up and walking,” says Satjit Bhusri, MD, cardiologist at Lenox Hill Hospital. “By day three and four, you’re with physical therapy, walking up and down the hallway, making sure there are no arrhythmias,” or abnormal heartbeats. You can expect to return to the comfort of your own home within a week.
“The first two weeks are the most important period after having open-heart surgery,” says Dr. Bhusri. The primary concern at this time is the incision from the surgery. “We have to make sure the incision stays clean and sterile.”
Recovering from Open-Heart Surgery
Although open-heart surgery can save your life and improve your long-term health, the recovery can be difficult. “You might not feel nearly a hundred percent sometimes for days, weeks, or even months after,” says Dr. Weisfelner Bloom.
You will get plenty of support from your doctors during this challenging time. “The biggest thing that you would benefit from is cardiac rehab,” says Rachel Bond, MD, cardiologist at Lenox Hill Hospital.
Cardiac rehab is an organized program under the supervision of medical professionals, and it empowers you with guidance in exercise, nutrition, and stress management. “Even if a patient is anxious about doing things on their own, this is a place where a professional is watching you,” says Dr. Weisfelner Bloom.
What Medications Are Needed After Open-Heart Surgery?
The medication that’s right for you depends on why you needed surgery in the first place. Some medications commonly prescribed after open-heart surgery include the following, according to Dr. Weisfelner Bloom:
Anti-platelet drugs, which help to prevent blood clots.
Statins, which lower the amount of cholesterol in the blood.
Blood pressure drugs to reduce the strain on your heart. Learn more about drugs to lower blood pressure here.
Open-heart surgery is a bit like a reset and a chance to start fresh, but it’s up to you to make the benefits last. “To avoid repeat symptoms or the need for repeat operation, [doctors] really tell people to take their medicine and start an active and healthy lifestyle,” says Nieca Goldberg, MD, medical director at NYU Langone Health, Joan H. Tisch Center for Women’s Health.
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We can do surgery on the heart for
many different reasons.
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The most common surgery is
coronary artery bypass grafting.
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One reason could be if a person has
blockages in the arteries that can't
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be fixed with stents.
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Then we would do something called
a coronary artery bypass graft to take
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healthy vessels from elsewhere in
the body and create routes for
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the blood to go through
to bypass the blockage.
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Patients that have
problems with the valves,
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which are sort of the doors that connect
the different parts of the heart,
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either the valves can be very leaky or
the valves can be tight or stenotic.
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Those patients might benefit
from open heart surgery.
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Another reason why we might recommend
surgery for a patient is in
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advanced heart failure, very extreme
cases of a weakening of the heart.
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In an ideal situation,
you have a surgery.
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The next morning, they wake you up.
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They remove the tube from your throat.
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You're breathing on your own.
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By day two, you're already up and walking.
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By day three and four, you're with
physical therapy walking up and
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down the hallway,
making sure there's no arrhythmias.
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And by the end of the week,
you're out the door.
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The first two weeks are the most important
period after having open heart surgery.
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And it's not because of the surgery,
as it is more because of the incision.
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We have to make sure the incision
stays clean and sterile.
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When you have open heart surgery,
it's a difficult recovery.
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You might not feel nearly 100% sometimes
for days, weeks, or even months after.
00:01:41,620 --> 00:01:44,140
If you're a patient that
had open heart surgery,
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I think the biggest thing that you
would benefit from is cardiac rehab.
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The goals are really to get a patient
back to feeling comfortable with
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their level of activity, and
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perhaps even bumping them up
to the next level of activity.
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So even if a patient is anxious
about doing things on their own,
00:02:00,305 --> 00:02:03,315
this is a place where
a professional is watching you.
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The medications that we
use after cardiac surgery
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really depend on the type
of surgery you had.
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For the most part, if a person is having
a bypass surgery, that person can be
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expected to be going home on an aspirin,
perhaps another anti-platelet as well.
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Generally a cholesterol lowering medicine,
like a statin, and
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also medications to control
their blood pressure.
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To avoid repeat symptoms or
need for repeat operation, or
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even repeat stents,
we really tell people to take their
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medicine and start an active and
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Cardiac procedures and surgeries. Dallas, TX: American Heart Association, 2017. (Accessed on April 20, 2018 at http://www.heart.org/HEARTORG/Conditions/HeartAttack/TreatmentofaHeartAttack/Cardiac-Procedures-and-Surgeries_UCM_303939_Article.jsp#.Wtn505M-fVo.)
Devices and surgical procedures to treat heart failure. Dallas, TX: American Heart Association, 2017. (Accessed on April 20, 2018 at http://www.heart.org/HEARTORG/Conditions/HeartFailure/TreatmentOptionsForHeartFailure/Devices-and-Surgical-Procedures-to-Treat-Heart-Failure_UCM_306354_Article.jsp#.WtoD0ZM-fVo.)
Hawkes AL, Nowak M, Bidstrup B, Speare R. Outcomes of coronary artery bypass graft surgery. Vasc Health Risk Manag. 2006 Dec;2(4):477-84.
Heart surgery. Bethesda, MD: National Heart, Lung, and Blood Institute. (Accessed on April 20, 2018 at https://www.nhlbi.nih.gov/health-topics/heart-surgery.)
Options for heart valve replacement. Dallas, TX: American Heart Association, 2018. (Accessed on April 20, 2018 at http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/Options-for-Heart-Valve-Replacement_UCM_450816_Article.jsp#.WtoC2ZM-fVo.)
Weisse AB. Cardiac surgery: a century of progress. Tex Heart Inst J. 2011;38(5):486-90.
What happens after heart surgery? Dallas, TX: American Heart Association. (Accessed on April 20, 2018 at https://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300445.pdf.)