Open Heart Surgery Recovery Timeline

What Is The Survival Rate Of Heart Surgery

Heart surgery survival rates vary based on the type of surgery and how many problems are repaired during the operation. Survival rates are:

• Mitral valve repair for mitral valve prolapse: 100%.
• Aortic valve replacement: 98.1%.
• Coronary artery bypass surgery : 97.8%.

Heart surgery is generally riskier for people who are very ill or have other medical conditions.

What To Expect While You Recover In The Hospital

There are a full range of cardiac surgery procedures that repair and restore heart function. How long you stay in the hospital depends on the type of surgery you have.

Immediately after surgery, youll receive care in the hospitals intensive care unit . A care team of cardiac ICU specialists, respiratory therapists and nurses monitors you closely.

After two to three days, youll transition to intermediate care. Here youll begin physical and occupational therapy to help you transition to home. Youll learn how to move through daily tasks while protecting your incision and minimizing discomfort as you heal.

For standard open-heart surgery, youll stay in the hospital for five to seven days. You may need more time to recover after more complex surgery. After minimally invasive procedures, youll stay for one to three days.

Many patients continue their recovery at home. If you need additional therapy, your doctor may recommend care at a rehabilitation facility before returning home.

You may experience a variety of symptoms after heart surgery, including chest pain, constipation, muscle pain, loss of appetite, swelling and trouble sleeping. Medications can provide relief, which should improve over time.

How Long Does It Take To Feel Normal After Heart Surgery

If your doctor has recommended surgery to treat a condition affecting your heart, its natural to have questions about your recovery: How long will I be in the hospital? Are there any restrictions on my activity once I go home? How long until I feel normal again?

The answers will depend on the type of heart surgery you have and your overall health. The good news is that your care team will guide you through the recovery process.

The key is to take the time necessary to recover so you heal properly and reduce your risk for future heart problems, says Daizo Tanaka, M.D., a cardiothoracic surgeon at Henry Ford Health. With healthy habits and regular follow-up visits to your doctor, you can extend the benefits of heart surgery for years to come.

Here Dr. Tanaka explains what to expect during your hospital stay and the dos and donts for recovery.

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Preparing For The Surgery

Preparation for open heart surgery starts the night before. A person should eat an evening meal as usual but must not consume any food or drink after midnight.

It is a good idea to wear loose, comfortable clothing to assist with restricted movement following surgery, but wear whatever is comfortable.

Be sure to have all personal medical information on hand. This might include a list of medications, recent illness, and insurance information.

It is normal to feel anxious before an anesthetic, and people should not hesitate to seek reassurance from the healthcare team.

The doctor may request that the person washes their upper body with antibacterial soap. A member of the healthcare team may need to shave the persons chest area before they can have the anesthetic.

The doctors may also need to run tests before surgery, such as monitoring the heart or taking blood samples. A doctor or nurse might place a line into a vein to enable the delivery of fluids.

After the medical team has completed the preliminary tasks, the anesthesiologist will administer general anesthesia.

What Are The Types Of Open

There are two ways to perform open-heart surgery:

• On-pump: A heart-lung bypass machine connects to the heart and temporarily takes over for the heart and lungs. It circulates blood through the body while moving blood away from the heart. The surgeon then operates on a heart that isnt beating and doesnt have blood flow. After surgery, the surgeon disconnects the device and the heart starts to work again.
• Off-pump:Off-pump bypass surgery takes place on a heart that continues to beat on its own. This approach only works for coronary artery bypass grafting surgery . Your surgeon may call this beating-heart surgery.

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What Are The Most Common Complications During Cabg Recovery

When you are ready to go home, you will be given a list of medications and instructions to help you recover from your operation. You will likely have some new prescriptions, and you may be told not to take some of your old medications. This may seem a little overwhelming at first, but your nurse will sit down with you and go over the instructions in detail. If you have any questions, your nurse will be able to help make things clear before you leave.

Youll Play A Key Role In Managing Your Pain

Post-surgical pain is unavoidable but can be managed in a variety of ways. Because of recent national legislation changes, physicians can prescribe no more than a seven-day supply of opioids to patients at the time of their hospital discharge.

Weaning yourself off opioids as soon as possible is important. You may need less than a seven-day supply, depending on your condition. Some patients do not require any opioids for pain management.

Other options for pain management include:

• Oral and topical analgesics such as acetaminophen and Salonpas patches

• Applying a warm cloth to the area, using caution near the incision because nerve sensitivity may be decreased, causing the skin to burn

• Relaxation techniques such as meditation and guided imagery

If you are on long-term opioids, you should meet with your prescribing physician to begin to wean down to the lowest dose possible before surgery.

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Who Needs To Have Heart Surgery

People with many different heart problems need heart surgery. These include blockages in the arteries that carry blood to your heart, valves that arent working right, and abnormal heart rhythms.

Usually, heart surgery is planned in advance as part of your treatment plan. This happens when your provider diagnoses a problem with your heart, and surgery is the best or only way to fix it.

Other times, heart surgery is an emergency treatment that comes up when you dont expect it. This can happen if you have a heart attack, or if youre diagnosed with severe blockages that put you in urgent danger.

Depending on the problem, you may not need surgery. Technology is providing us with innovative ways to manage heart disease. For example, percutaneous coronary intervention repairs blocked coronary arteries. Endovascular aneurysm repair repairs an abdominal aortic aneurysm through an artery in your leg.

These methods reduce your time in the hospital and make recovery easier. Theyre especially helpful for people who would face higher risks if they had surgery.

Care Of Your Incisions

As you heal, your incision will look better and the soreness will go away. Changes in the weather, too much or too little activity and sleeping in one position too long may cause increased soreness. You may also feel numbness or itching or see redness or swelling, which will also stop with time. To care for your incisions, we suggest:

• Wash gently with mild soap during your daily shower. Dry carefully with a towel. Pat it dry Do not rub the incision.
• If you have small pieces of white tape over your incision, you must remove them after you have been home for seven days. If the strips come off on their own, you may leave them off.
• If your incisions are puffy, have areas of redness, are oozing, or begin to open slightly, call your surgeon.
• Women should wear a bra. A good support bra will reduce the tension placed on the incision. If the bra bothers you, you may put a small piece of gauze under the bra for added comfort.
• For discomfort or soreness, you may use a heating pad. Apply it four or five times per day on the low setting for about 20 minutes each time. If needed, take pain medication prescribed by your doctor.

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Are There Alternatives To Standard Open

Thanks to medical advancements, many procedures that once required opening the chest can now take place using minimally invasive heart surgery or with small incisions. The surgeon sometimes still needs to cut through part of the breastbone .

Depending on your situation, your surgeon may be able to use these methods:

• Catheter-based: Your surgeon threads a catheter to the heart. The surgeon then inserts surgical instruments, balloons, or stents through the catheter to perform a procedure. Catheter-based procedures include transcatheter aortic valve replacement and coronary angioplasty and stenting.
• Video-assisted thoracic surgery : Your surgeon performs VATS by inserting a tiny video camera and surgical instruments into several small chest incisions. Your surgeon may use VATS to place a pacemaker, repair heart valves or treat an arrhythmia.
• Robotically-assisted: Certain patients with valvular heart disease, cardiac tumors, atrial fibrillation and septal defects may be candidates for this minimally invasive approach.

After Heart Surgery Dos And Donts For Your Recovery

So, when will you be able to return to your normal routine? Again, the answer depends on the type of procedure you have. Your doctor will give you guidelines about any restrictions in your activity.

In general, you can resume your normal activities within one to two weeks after a minimally invasive heart procedure. For open-heart surgery, you can return to many activities within a month after surgery. Allow up to three months for proper recovery and healing.

Many patients can resume working in an office or home office setting a month after open-heart surgery. You may be able to return in one to two weeks after a minimally invasive procedure, says Dr. Tanaka. If your work requires more physical exertion, discuss restrictions with your care team.

To ensure the best long-term recovery after surgery, Dr. Tanaka recommends following these dos and donts.

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Showering And Incision Care

You may shower if your surgeon has approved this prior to discharge. Your incisions may itch or feel sore, tight or numb for a few weeks. Some bruising around the incisions is also normal.

• Use warm water.
• You may wash your incisions gently with soap and water, but do not scrub them.
• Pat your incisions dry.
• Do not take baths or use powders or lotions near the incisions.

You may have white pieces of tape on your chest. These are called “steri strips”. They will gradually fall off. If they have not fallen off in 7 days, gently wash your chest with soap and water and gently peel them off. You may have some bleeding if the strips pulled off any scabs.

If you find it more comfortable, a thin layer of gauze may be placed over the incision. Women may wish to place cotton or soft material between the bra and chest wall.

Incision Care

• Your skin is sealed within 24-48 hours after surgery.
• You may itch or feel sore, tight or numb for a few weeks. Some bruising around the incision is also normal.
• Avoid sun exposure for the first year
• Chest tube drainage Within the first week after surgery, fluid may leak out from your chest tube sites. You may cover the sites with sterile bandages. Call your surgeon’s office if have to change the bandages more than once/day.

Signs of Possible Infection

• Increased swelling/tenderness along incision line
• Persistent high fever

Activities During Bypass Surgery Recovery Period

The patient has to be careful while choosing the activities during bypass surgery recovery period, he or she cannot do whatever they want and have to be very careful in performing certain activities. There are a few things recommended by the team of doctor and nurses taking care of you in the hospital and they will ask you to avoid during the first few weeks after the bypass surgery. In the beginning days after you have undergone the bypass surgery you will be allowed to do some light and easy things like cooking, walking short distances, playing board games & carrying light objects. After a longer period of the bypass surgery you might be able to do a bit tougher jobs like driving, vacuuming, carrying medium weight objects, carrying babies and shearing the lawn.

If your job is not physically challenging then you might get back to your job in 6 to 8 weeks. Getting back to your job also depends on the complications that you may or may not have faced. Also if your job involves a lot of time involved in lifting and standing it is recommended to take off for a longer period of time or till the time you are perfectly fit for it. Taking rest is the most important key to bypass surgery recovery period. Also it is recommended that you take up all the activities slowly to get time for relaxing.

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Side Effects Of Surgery

After you have been discharged from hospital, you may experience some side effects as a result of the operation.

These can include:

Follow any advice that you have been given on discharge from hospital.

See a GP if you have:

• worsening pain in or around the wound
• redness and swelling around the wound
• pus or blood coming from the wound
• a very high temperature or you feel hot and shivery

Call NHS 111 or contact your local out-of-hours service if you’re unable to contact your GP.

How Many Heart Surgeries Take Place Each Year

The number of heart surgeries can vary by year. In 2018, nearly half a million people in the U.S. had heart surgery.

But the COVID-19 pandemic affected how many people are having heart surgery. The monthly average dropped by 50% in April 2020. The number continued to be lower than normal through the rest of 2020. Partly, this is because hospitals needed to postpone non-elective care. But it seems many people also chose to delay care even if they had symptoms.

If youve been putting off your appointments because youre concerned about COVID-19 exposure, youre not alone. But its important that you call your healthcare provider and make an appointment. Ask your provider what their office is doing to help keep you safe. And keep in mind that untreated heart problems can get worse and lead to more serious issues down the road.

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The First Few Weeks At Home

During the first few weeks after hospital discharge, many people who have undergone heart bypass surgery:

• Experience low energy levels and feel fatigued frequently
• Have intermittent post-operative pain
• Need to continue taking pain medication, as ordered by the healthcare provider
• Are not yet able to return to work
• Have strict activity limitations such as a lifting and driving restrictions
• May experience sadness and mood swings
• Commonly have symptoms of major depression

Coping During the First Few Weeks at Home

You should rest often and sleep when you feel tired. Sleep will help your body recover and help to replenish your energy level. If you have trouble getting enough sleep at night, there are some things you can do to help, including:

• Be sure to establish a regular pattern of going to bed and getting up at the same time every day.
• If you have frequent insomnia, you may want to eliminate naps to ensure you are tired at night.
• Take your pain pills before you go to bed
• Be sure to sleep on your back for the first four to six weeks while your breastbone heals.

Coping with Pain

Pain after bypass surgery is common, some things you can do to relieve pain include:

Important Activity Warning

• Lifting objects that weigh over 10 lbs: This includes children, laundry baskets, trash receptacles and other objects.
• Driving: Even a minor car crash could cause the chest area to slam into the steering wheel.

What Are Some Types Of Heart Surgery

There are many types of heart surgery. The National Heart, Lung, and Blood Institute, which is part of the National Institutes of Health, lists the following as among the most common coronary surgical procedures.

In addition to these surgeries, a minimally invasive alternative to open-heart surgery that is becoming more common is transcatheter structural heart surgery. This involves guiding a long, thin, flexible tube called a catheter to your heart through blood vessels that can be accessed from the groin, thigh, abdomen, chest, neck, or collarbone. A small incision is necessary. This type of surgery includes transcatheter aortic valve implantation to replace a faulty aortic valve with a valve made from animal tissue, MitraClip® placement for mitral valve abnormalities, and WATCHMAN® placement for nonvalvular atrial fibrillation patients.

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You May Feel Like Youre On An Emotional Roller Coaster

Recovering from open-heart surgery involves physical and emotional healing. The recovery process uses emotional and physical energy.

If you feel upset or emotional in the weeks after your operation, dont worry this is a normal reaction. Many patients report these feelings up to three months after the operation:

• Mood swings that may include depression, fear, anxiety, loneliness, helplessness and anger

• Crying easily for no apparent reason

• Lack of energy or motivation

• Getting easily frustrated

• Having good days and bad days

• Feeling more emotional or sentimental than normal

Even though you may feel drained physically and emotionally, its important to follow guidelines for good self-care:

• Get dressed every day

• Walk daily within your limits

• Get plenty of rest