Open Heart Surgery – Being admitted to the hospital for open heart surgery

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You will usually be admitted to the hospital the day before your surgery. Simply check in at the hospital admissions desk. The hospital should have a record of your pre-admission tests and forms that you completed.

If you did not go through pre-admission procedures, you will need to have the tests and complete the forms explained in the Pre-admission procedures section of this booklet. Some hospitals will admit you the morning of your surgery, therefore the timing of the steps in this booklet may change

Someone from the admissions desk will escort you to your room. A nurse will take your temperature, pulse, breathing rate and blood pressure and record it on your chart.

Make sure you tell the nurse about:

  • any medicines you are currently taking (bring a written list with you) allergies you have and allergic reactions
  • any other health problems (e.g., eye or hearing problems, dentures)
  • how to contact your family
  • who to contact in case of emergency
  • anything else that will help them care for you

The nurse will let you know if the doctor left any special orders for you to get ready for surgery (e.g., enema or suppository, antibiotic, sleeping pill, etc.). Feel free to ask questions about the hospital, your room and the equipment in it, location of bathrooms, the intensive care unit (ICU) (where you’ll be right after surgery), visiting hours, etc.

Make sure your family asks the nurse about:

  • the time of your surgery and how long it might take
  • where they should wait for news during and after the surgery
  • where the ICU is located and how long they can visit you in ICU
  • how and what should they take (e.g., clothes, toiletries, glasses, etc.) to the ICU after your surgery

The night before surgery

Usually, your and the anesthesiologist will visit you the night before or early the morning of your surgery. Your doctor will confirm the time of the operation, review your medical history and do a final physical exam. Now is your chance to ask any last-minute questions or voice any concerns. The anesthesiologist will explain about the anesthesia that will be used during surgery and how the respirator works.

Sometime that evening, you will need to shower or wash with a special cleansing soap. Then you will be shaved at your surgical site. Shaving rids the body of as many germs as possible and prevents discomfort when bandages are removed. Do not put on any powder or lotion after you wash. And remember, if you feel tired or have some pain or discomfort while washing, stop and call a nurse to help you.

Last, but not least, you must stop eating and drinking by mid-night, since anesthesia is safer on an empty stomach.

The day of surgery

  • Before surgery
    In the morning before surgery, you can wash your face and hands, brush your teeth, shave and put on your operating room gown. You may not eat or drink anything before surgery. Also, you will be asked to remove makeup, jewelry, hair pins, dentures, nail polish, contact lenses or artificial limbs. You will probably be given medicine that will make you a little drowsy and relaxed before you are wheeled to the surgical suite. When you leave your room for surgery, your family or friends should go to the surgical waiting area.
  • The operation

In the surgical suite, first you will be given a local anesthetic so that an intravenous (IV) catheter (tube) can be inserted. This IV tube will supply your body with the general anesthesia that puts you to sleep during surgery and any other necessary medicines. In fact, almost as soon as you begin receiving the anesthesia through this tube you will be asleep. There are many other electrodes, catheters and tubes that are attached to or inserted in your body. These help to monitor your body’s functions, to remove excess fluid or to help you breathe during the surgery.

Open-heart surgery requires the surgeon to make an incision lengthwise down your breastbone, called the sternum, or crosswise between your ribs. The breastbone is then pried apart. When surgery is done, the breastbone is wired back together and your skin is sewn together. If you are having bypass surgery, you may also have an incision in your leg where your leg vein was removed. Your incision(s) may be painful for a few days, then sore for a while afterward. Ask for pain medicine if you need it.

When you are placed on the heart-lung machine, the surgeon can make the repair(s) to your heart while it remains still. Usually, when the major part of the surgery is over (when the repair(s) are done, you are removed from the heart-lung machine and your heart begins working on its own) your family will be told. You will probably stay in the surgical suite for another hour or two for a total of several hours for the surgery and observation period. Then you will be moved to the ICU.

  • In the intensive care unit (ICU) (Sometimes called CCU – Cardiac Care Unit)

When you are moved to the ICU, a member of the surgical team will advise your family about the surgery and your condition. You will be groggy from the anesthesia and unable to speak because of the breathing tube in your throat. You may hear sounds from all of the equipment around you and hear voices that sound far away. It may be your nurse or a family member telling you your surgery is over. You will still have many other tubes, catheters and monitors attached to or inserted into your body from the surgery. This equipment provides the ICU staff with continuous information on how your body is recovering. You will probably be in the ICU for a day or two. Because the nurses are constantly checking on you this period of time won’t be very restful. Also, you will have some discomfort and pain. If you need pain medicine, don’t wait too long to ask for it. It’s there so that you can get the rest you need to heal. The ICU nurses keep a constant watch on your condition and do whatever else is needed to make you comfortable.

  • Family visits

Your family can visit you in the ICU for brief periods of time even though you may drift in and out of consciousness at first They should know you will look pale and your face may be swollen. Because your blood was cooled down for surgery, you will feel very cool and may shiver right after surgery. When your family leaves the hospital, they should let the ICU staff know how they can be reached and when they will be back.

Tags: Cardiac surgery, General anaesthesia, Anesthesia, open heart surgery, Surgery, surgeon, Intensive-care medicine, Intensive-care unit
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