Overview
Heart surgery and what to expect
This information will tell you what to expect if you are having heart surgery at one of our hospitals.
Admission
Your admission letter will give you clear instructions about when to stop eating and drinking (fasting). Unless told otherwise, you can eat up to 6 hours before your operation. You can drink water (non-fizzy) and take your usual medicine (as directed by our team) up to 2 hours before your operation. It is important that you follow these instructions as having food or liquid in your stomach can cause serious complications.
We may need to carry out some tests to make sure your surgery can go ahead. This will be on the day before your surgery and your admission letter will tell you what time to arrive, and where you need to go.
You will meet your surgical team, anaesthetist, and nursing staff who will explain and complete your admission assessment with you.
As space is limited you can only bring one person with you, usually your next of kin, or one close family or friend.
We will do everything we can to make sure your surgery goes ahead as planned. To avoid it being cancelled at short notice we need:
- the full surgical team in place
- a bed available in overnight intensive recovery (OIR)
- to make sure that you are fit enough for surgery
Your surgery could be cancelled if an emergency operation takes priority.
Asking for your permission (consent)
We want to involve you in decisions about your care and treatment. If you decide to have the procedure or treatment, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.
You can read more about this on our consent page.
The team looking after you
Many different healthcare professionals are part of the team to help your surgery and recovery go as well as possible.
Consultant surgeon and team of doctors
The surgeon is a doctor who specialises in treating your condition. You will have already met your surgeon (or a member of their team) at your clinic visit. It is the surgeon and the team who will perform your surgery and monitor your recovery.
Anaesthetists
Your anaesthetist is a specialist doctor who will manage your pain during and immediately after surgery. This means providing the most appropriate anaesthetic for you and prescribing pain relief after your surgery.
Ward nurses
Your nurse will help you to get fit again after your surgery, including your nutrition, pain management and encourage you to move around.
Advanced nurse practitioners (ANPs)
ANPs are highly skilled specialist nurses. They will be working closely with the doctors on the ward to monitor your progress after surgery.
Staff from perioperative medicine for older people having surgery (POPS)
The POPS team support older people and those with complex problems who need an operation. They work closely with surgeons, anaesthetists and ward teams to help prepare you for surgery.
Pain team nurses
Pain team nurses are specialists who manage patients’ pain after surgery. It is important that your pain is controlled so you can complete your deep breathing exercises, eat and drink, and walk around. You will be referred by your doctor or nurse if needed.
Physiotherapist
Getting up, moving about and completing deep breathing exercises will help reduce the risk of chest infection. You will be referred by your doctor or nurse if you need extra help with this. The physiotherapist will see you before you leave hospital to help with advice on returning to your usual activities.
Dietitian
Dietitians are regulated healthcare professionals whose job is to assess, diagnose and treat nutritional problems. You may be referred to a dietitian if we are concerned you are not eating enough. You can also ask to see a dietitian for advice, or if you have any concerns.
Occupational therapist
Occupational therapists can help you with the practical aspects of your return to daily life after surgery. Your nurse will refer you to the occupational therapist only if required.
Pharmacist
Pharmacists help to make sure any medicines the doctors choose are adapted to best fit how your body is coping at the time. They can give advice if you have any side effects, and tell you how to take your painkillers when you leave hospital, as well as how to gradually reduce them as you heal.
Research team
We are a teaching hospital where research trials and studies are carried out to develop and trial new treatments for patients. The research we do also helps us to understand medical conditions better, and hopefully improves our care of patients. You may be approached by one of the research teams to take part in a research study. Taking part is voluntary, and if you do not take part, it will have no effect on your care now or in the future.
You may meet other healthcare professionals who also contribute to your care and recovery.
Anaesthetic
General anaesthetic is used for all heart surgery. There are different types of anaesthetic to stop you feeling pain during an operation or treatment.
Read more about having an anaesthetic for heart surgery.
During surgery
Heart surgery usually takes 3 to 5 hours. During the operation we use a special pump called a heart-lung bypass machine to do the job of the heart and lungs. Throughout your operation, the theatre staff will look after you and treat you with care and dignity.
It is normal to lose some blood during heart surgery and where possible we use a special machine to collect your blood so it can be transferred back to you. You may also require transfusion of blood during or after your operation.
If you have any concerns about having a blood transfusion you must discuss this with your surgeon during your pre-assessment or inform the nurse practitioner team. You will not receive any more than is needed for a safe recovery.
You will have various drips, tubes and equipment attached to you.
Breathing tube (ventilator tube)
You will be kept asleep for a few hours to ease the work of your heart and lungs. The breathing tube is connected to the ventilator which lets the machine to breathe for you. When you are ready we will begin to reduce your sedation and you will start to wake up. While the tube is in, you will not be able to speak. We will ask you to communicate with us by asking you to nod your head and squeeze our hands to answer questions. Once you are sufficiently awake and breathing for yourself, the tube will be removed and an oxygen mask will be placed over your nose and mouth.
Cardiac monitor
This is a machine that is mounted on the wall behind your bed. You will have sticky tabs on your chest that are wired up to the monitor. This allows us to see your heart rate and rhythm. We also do a continuous reading of your blood pressure, and monitor the oxygen level in your blood by using a small electrical sensor attached to your finger.
Drips and tubes
You will still have the small tubes in your arms and neck. These allow us to monitor your blood pressure as well as taking blood samples. We can also use these tubes to help keep you hydrated and give you the medicines you will need.
Urinary catheter
This is a small tube that goes into your bladder and drains pee (urine) into a measuring bag. This enables us to monitor the amount of urine and saves you from worrying about going to the toilet while you are asleep. This is usually removed on day 2 after surgery.
Chest drains
You will have drains inserted below the wound to collect any fluid. The drains and stitches (sutures) will be removed before you go home. Occasionally stitches are to be removed once you leave hospital, and we will make an appointment for you with a practice nurse to remove them.
Pacing wires
You may have some wires inserted just below your chest wound which help to maintain your heart rate. These wires are usually be removed 3 to 4 days after surgery and you will need to stay in hospital for 1 night after they have been removed.
Wound
Your wound will be covered with a dressing which will be removed about 4 days after surgery. It will be checked regularly and a new dressing applied if needed. Do not remove the dressing unless you have been asked to do so.
You may feel a lump around your wound, and your wound may feel numb and itchy. This is part of the healing process and will gradually disappear.
Ask your nurse when it is OK to shower or have a bath.
Your wound will be closed with glue, clips or stitches. Glue and dissolvable stitches will gradually dissolve on their own. You may need to ask your GP or practice nurse to remove the clips or non-dissolvable stitches.
Monitoring your wound
So that we can monitor your wound after you have left hospital, we will ask you to take part in our online wound monitoring programme called ISLA.
This allows your cardiac surgery team to monitor your wound, without you having to come in to hospital, and they can give you advice if necessary.
If you agree, we will take pictures of your wound before you leave hospital.
A week or two after you have been discharged, we will send you an email or text to ask you to send us pictures of your wound.
Contact your cardiac advanced nurse practitioner if you have questions about this. Details are in the Contact us section.
Your breastbone
In most cases, the surgeon has to divide the breastbone to reach your heart. Small wires are inserted to hold the bone together to allow it to heal. These wires are permanent and rarely cause any problem. They do not rust, and they will not affect any airport security scanners.
Your breastbone will take 8 to 12 weeks to heal. It is very important that you do not lift anything for that time as you may need another operation to rewire and set the bone if it doesn’t heal.
Resource number: 5455/VER1
Published date: December 2023
Review date: December 2026
