Heart & Aorta
Preoperative & Postoperative Informational Video
Heart Surgery – Preparation
You will meet with your surgeon and other members of the surgical team either in the office or the hospital about your condition and why surgery is being considered as a treatment option. You should understand the nature of your problem and why surgery is felt to be a good treatment for you. You should also understand the basic nature of the procedure recommended and the risks involved with the operation. If having valve surgery, you should discuss the different types of prosthetic heart valves available and selected which type you would prefer.
For outpatients, a pre-operative appointment will be made where you will receive pre-operative teaching about what to expect with surgery and the recovery process. This will be done by the nursing staff and by our nurse practitioner if you are admitted to the hospital. You will have standard blood work, a chest x-ray, and other tests done before surgery. For almost all patients, a coronary angiogram (“heart cath”) will be done prior to surgery. The coronary angiogram is performed in the hospital by your cardiologist. This typically takes half of a day at the hospital and is scheduled by your cardiologist two or more days before your surgery. You may also need some additional test for your particular condition. We encourage you to ask questions throughout the process. It is best to have a family member/friend accompany you to take notes and write down questions.
Your surgeon or a surgical team member will go over your medications and discuss with you any medications that may need to be stopped or changed prior to surgery. The day before surgery, you should take your medications as directed unless instructed otherwise by your surgeon. Medications that typically need to be stopped prior to surgery include Warfarin/Coumadin, Plavix, Pradaxa, Effient, and other blood thinners, diabetic medications such as Metformin, and blood pressure medications of the class call ACE inhibitors (lisinopril, Zestril, and others). Aspirin should not be stopped prior to surgery unless specifically directed to do so. You should not take any medications on the morning of surgery unless specifically told to do so. You will be given special soap to shower with the night before surgery; you will also be given antibiotic ointment to place in your nostrils the night before surgery. You should not eat or drink after midnight the night before surgery. It is okay to brush your teeth with a small sip of water the morning of surgery.
You should avoid people who are ill prior to surgery. Avoidance of large crowds and air travel during the week prior to surgery is also recommended. Vaccine such as flu and pneumonia are not recommended less than two weeks before surgery. You should continue to be as active as your condition allows unless directed otherwise. Regular walking is good preparation for your surgical recovery.
If you would like to tour the Intensive Care Unit or the Cardiovascular Unit where your post-operative recovery will occur this can be arranged through our office.
If you smoke, it is recommended that you stop smoking for at least a week prior to surgery. Stopping smoking causes your body to produce a great deal of mucus in the lungs several days after stopping smoking. If you wait until the day before surgery to stop smoking, you will experience heavy phlegm in the first several days after the operation. Coughing during this time is already difficult due to pain from the incision. Excessive phlegm plus poor coughing after surgery can rapidly lead to pneumonia, a potentially fatal complication.
Heart Surgery – Day of Surgery
You will arrive in the pre-operative (pre-op) preparation area approximately two hours before the scheduled time of your operation. For patients coming from home, you will be given an arrival time when your surgery is scheduled in the office. For patients already in the hospital, you will be taken to the pre-op area by the hospital staff. Two family members can accompany you in the pre-op area. The pre-op area has limited space and cannot accommodate larger groups. In the pre-op area, a nurse will review with you the operation planned, your medications, and when you last ate or drank. An IV will be started in a vein in your arm and your chest, abdomen, groins, and legs will be shaved.
You will have the opportunity to meet with the anesthesiologist and ask any questions you may have about the anesthetic plan. Almost always, the anesthesia will be general anesthesia that involves going to sleep completely with a breathing tube placed into the windpipe for control of the airway during the operation. If you or family members have had previous problems with anesthesia be sure to tell the anesthesiologist about these issues.
Please be patient while waiting in the pre-op area. We realize that this is a time of great anxiety for you and your family. Please also recognize that only the first operation of the day starts exactly on time; all other “scheduled” times are estimates of when the next operation will begin. Scheduled surgery times are affected by many things such as the emergency operations, unexpected difficulties during surgery, and surgical, anesthesia, and patient delays. Any of these factors can cause your “scheduled” time to be moved up sooner, delayed, or cancelled completely. If this happens, we apologize for the stress caused to you and your family. If changes occur to the scheduled time please understand that the change is necessary because we believe that it is in your best interest, or for another patient with an urgent need for surgery.
Lungs & Chest