Open Heart Surgery: What to Expect?

Having open heart surgery can be terrifying, but often there is not an alternative.  People have open heart surgery to correct various heart conditions that would otherwise kill them. There are procedures to correct defective heart valves, repair aneurysms, unclog or bypass arteries, implant stents, and in the most critical cases replace a failing heart with an entirely new one. Some people are diagnosed with a heart condition and plan their open heart surgery accordingly while others are subjected to emergency surgery to save their lives.  It’s debated which circumstances are worse psychologically; to have the foresight of surgery in advance or to be thrust into the situation with no time to contemplate it. Often patients who know about the surgery in advance spend the days leading up to it fearful, anxious, bitter, angry, or depressed. Healthy individuals who are diagnosed out of the blue with a heart condition seem to have the hardest time coming to terms with having to have open heart surgery than for example a smoker who has not taken care of themselves. Age can also be a factor in how a patient deals with a diagnosis. Younger people seem to have a harder time coping with it psychologically than elders. Survivors of emergency open heart surgery can often have a harder time psychologically in recovery than those who had a planned operation.

Individual experiences may vary, but below is a general idea of what to expect with open heart surgery. In the days leading up to your open heart surgery you’ll want to get your affairs in order and plan in advance to have a stress free recovery. If you’re like many heart patients you’ll have a period of introspection as the date of your operation gets closer, and you’ll probably want to spend quality time with your family. The night before your surgery is a good chance to have some intimate quiet time with those you’re closest with. 

On the morning of your open heart surgery you won’t eat anything, and you’ll take a shower with a special “sanitizing” soap provided by your surgeon.  When you arrive at the hospital you’ll have an administrative check-in where you fill out some paperwork. Then you’ll have your vitals taken, and soon after you’ll be sent to the cardio-thoracic surgery floor. In a good hospital your family is allowed to accompany you to the cardio-thoracic floor. When you arrive there will be a number of doctors and nurses present, as well as your anesthesiologist. They will take your vitals again, and when your surgeon arrives they will brief you and your family on what the open heart surgery will entail. The anesthesiologist will tell you how things will progress putting you to sleep, as well as what to expect when you wake up afterward. Your surgeon will give you a rundown of everything and give you a chance to ask any outstanding questions. When they’re done talking to you and your family, your anesthesiologist will most likely put an IV in each arm while you are still awake. They use these to administer anesthesia and other medicine once you’re on the operating table. 

Next you will say your goodbyes and a nurse will lead you to the operating room. The operating room will be ultra-bright with brilliant lights shining down. The operating table is a slightly padded table on a pedestal that looks just the right size to hold your body and nothing more. There are no railings, obstructions, or legs on the corners. Bright lights beam on it, highlighting it as the center of attention. It looks kind of like an ironing board. Alongside it are surgical tools laid out in an obsessively organized manner.  Often there are a bunch of other doctors and nurses in the room that will have various responsibilities during the surgery. You will be asked to climb onto the table and lay down. Nurses will start connecting you with various wires, and you may be asked to sign a waiver so that representatives from medical equipment companies can observe the surgery. Soon the anesthesiologist will begin to administer your initial anesthesia. Your surgeon may give you a final acknowledgement as you begin to feel drowsy, and before you know it you’ll be in a deep sleep. At that time the crew will continue connecting wires, inserting tubes (your urinary catheter, swans catheter, and later your breathing tube and more).  You will be unconscious for the rest of the surgery, but in a good hospital the staff will give your family regular updates on how things are going. When the surgery is finished your surgeon will come out and brief your family, and soon after they will be allowed to see you in the recovery room. 

In all likelihood you will still be unconscious when your family first sees you in the recovery room. You will probably still have a breathing tube in, and it may be a little scary for them to see you this way. Most patients claim their first memory after surgery is when the breathing tube is pulled out. You’ll be heavily sedated but you’ll probably hear a nurse inform you that they’re going to pull out your breathing tube. You’ll cough for a few moments and your mouth will feel hot and dry. You’ll be very thirsty but the nurse will only be able to offer you a wet swab on your lips and tongue until you are a little more alert at which time they may offer you ice chips. The amount of pain felt varies from patient to patient, but generally most heart surgery patients do not feel much pain due to the significant levels of pain killers that they are on.  Generally speaking, patients say that the pain was much less than they thought it would be.

Hospital stays vary widely after open heart surgery depending on which procedure you have. You will be on a lot of pain meds in your first days in recovery. You’ll probably have a morphine drip that you can administer yourself by pressing a button when you’re in pain. There are limits to how much you can pump into yourself so you don’t have to worry about pressing the button too often. You will sleep a lot and be loopy for the next few days. Around this time you’ll probably notice your scar as well as some bumps underneath it. The bumps are from the titanium wire they used to connect your ribs back together after surgery. They don’t really cause any harm and aren’t easy to notice unless you run your finger over them. Most heart surgery scars fade away pretty nicely over the years. Your head will feel hazy due to the pain meds, and from the general effects of surgery and being on the heart-lung(bypass) machine. After a few days you’ll probably be encouraged to get out of bed and begin walking. Initially a short walk to the lavatory will seem like climbing Mount Everest, but soon after you’ll be able to do it with ease and be able to walk the halls on the floor with your physical therapist. You’ll be afraid of coughing, laughing, or sneezing, but you’ll probably be given a stuffed animal or something to hold against your chest when you do, to counteract the pressure generated and make it more comfortable. You’ll dread having your first bowel movement, but they won’t let you go home until you do. When you finally do have that prized moment you will be pretty close to going home if all else is up to par. There are many things that can happen after heart surgery, arrhythmias, atrial flutter, low hemoglobin levels or blood issues, and many more that could warrant a longer stay, but your attitude during any setbacks can make a huge difference in everything. Stay positive because once you get home your real recovery work begins.


19 comments:

Jeff Rumrill said...

Thank you so much for posting this. I find it to be helpful as I am getting closer to needing Open Heart Surgery to repair an aortic annuerism and valve replacement to remove a leaking bicuspid aortic valve. Thank you again.

Benjamin J. Carey said...

You're welcome Jeff. You'll be cool. I thought it was going to be a catastrophe and put off surgery too long. It wasn't nearly as bad as I thought. My surgeon "spared" my valve, but since you have a bicuspid one I suppose that's not in the plans. My friend had a bicuspid valve and aneurysm and faced the same surgery. He's doing well. He has a metal valve. I would have opted for a different valve, but it comes down to a personal choice. Good luck brother!

Jeff Rumrill said...

Thank you for your words of encouragement. I too will be choosing the other option with the valve replacement. The metal option just scares me with the blood thinners and all.
Just wanted to let you know how much I enjoyed your book. My wife is now reading it. Thank you again.

Benjamin J. Carey said...

Ditto Jeff, thanks for the kind words. Keep in touch!

ann tully said...

Just finished reading barefoot in november, it was gr8. Ihad angiogram in march, everything turned out to be ok, i was having typical angina symtoms, also have f h of heart disease, the worst part was waiting for procedure, and not knowwing, limbo, im 50 yrs old , and u have inspired me to start running :-)
ann tully, :-)
birmingham, uk

Benjamin J. Carey said...

Hi Ann. Stay strong. I agree...the waiting...the not knowing...I felt the same way. In the end it seemed much easier than I expected. Ann, shoot me your email address.
bjc

Anonymous said...

My experiences: I had surgery on Wednesday, they had me walking on Thursday (at least a little bit)and doing stairs on Friday :) and I was out of the hospital Sunday morning. I am 46 years old with a congenital aortic valve defect and an enlarged aorta. I had a week between diagnosis and surgery. It is now 8 weeks later and I just got back from a business trip. The only issues were the weight restrictions on luggage and also the high altitude relative to where I live caused me to be short of breath. I went with the bio-mechanical valve because I didn't want to be on blood thinners the rest of my life. Plus, if it needs to be replaced again the technology will be far advanced from where it is today. In terms of out of the hospital I was off narcotic pain meds in a week and now take an aspirin as a blood thinner and sometimes ibuprofen if I feel particularly sore.

Hope this helps someone. I wish I had read this material before surgery

Maisie said...

I wish i had seen this before my surgery! I had open heart 2 weeks ago after 2 failed keyhole operations, i only gave an asd but unfortionatly it grew too quickly so my atrial rim was deficient. My feminal artery also burst in surgery so had a few complications. I also spent my 18 birthday in hospital which wasnt fun, but i had it done at papworth and everyone was really nice all week and sang happy birthdat. Wish i found this website earlier so i didnt feel so alone, now im on the road to recovery so all is good (:

Kevin said...

Thanks so much for this. I was just recently diagnosed with Papvr/asd, and the right side is already nearly 2.5x too large. I'm nearly 40, and have been running for over 20years. To say I was shocked to learn i need is an understatement! I'm glad I've found this site, knowing there are so many folks in the same boat (unfortunaely) helps! I'm more nervous right now about trying to explain this to our 3 young kids. Dads are supposed to be invincible! Anyway, thanks for the words of encouragement.

Anonymous said...

Thank you so much for sharing this! I have Marfan's Syndrome, so have had echos every year to check for aortic enlargement. They have always been fine, but after a recent CT scan, found out 3 weeks ago that I have an aortic aneurysm that wasn't visible on the echos. I will be having open heart surgery in the next couple of months. I can't tell you how much this has helped/encouraged me ... Thank you! Looking forward to getting your book. I plan to take it to the hospital with me, to remind me to stay positive - no matter what.

Benjamin J. Carey said...

Great comments and feedback. I hope all of you will stay in touch by following us on Facebook and Twitter and share the pages with your friends and family. There are links to both on the top of the Heartosaurus home page. It's been nice meeting so many of you who've found me through the blog or read my book. I've spoken to many of you on the phone, via email, and even done some runs with you. Two particular instances that stand out is when a woman called me whose husband was having to undergo heart surgery. They were both anxious about everything and had a ton of questions but the husband was a little too shy to reach out himself. They had both read my book, and I'm glad I could help them out by answering questions and letting them know what to expect. He's doing well now and I keep in touch. The other was a patient who read my book before surgery and then passed it on to everyone in his family to put them at ease, and his spouse brought the book to the hospital to refer to during the whole ordeal. These interactions keep my own mortality fresh in my mind. I hope my blog does the same for you. Thanks for the kind words, I enjoy talking to all of you.

jessica said...

Wow this was great to see im going to the dr the first week of February to find the day my surgery will be on i have marfans syndrome and will be having aorta and mitral valve done and i think im leaning towards the mechanical valve but not sure i still need to do researchon it

Mary said...

I'm so happy to find your site, it's a great relief. I've been looking through Swedish websites for something similar without luck. My husband finally must have the surgery done. Im not sure what its called in english but he's chamber is enlarged and he needs to change the pulmonary valve. Johan just turned 40 and is really freaking out. We are still waiting for the date, its been a couple om moths now, and its just so frustrating. We have a 3 year old girl and a 7 year old son. I would so much like to get in contact with other people going through the same thing. Its just the toughest thing ever. We only know that it will be done in march...

Anonymous said...

Hi!

Thank you for writing this!!!!!! Great article!

-Chris

Unbroken said...

Thank you for this article, I am 39 yrs old and I face open heart surgery on June 7th, I am terrified! I have to have my bicuspid aortic valve replaced, I was born with aortic stenosis, it has a leaky valve and aneurysm, I might have to have root replacement too. My husband (40) just had open heart surgery had 4 blockages, only 3 were bypassed and those blockages were 90%, 90% and 100%. My aneurysm has grown to 4.5cm but because I am small they said I have to have it done now. There is no articles that covers people with mental illness and the anxiety for them and how surgery care is for us. My husbands was emergency because he was having heart failure, but mine is scheduled, and each day that gets closer I'm not wanting to go through with it..it was very traumatic to be on the sidelines seeing my husbands, trust me when I say..I have phobias so bad that there was things that I was not letting them do to him..and now him and our two kids will now have to see me go through mine. I have already signed consent forms for everything and I still am afraid I will back out at the last minute. I'm totally terrified at the thought if the cardiac catheterization before my surgery, this is going to be so hard to get through..and I'm thankful you have an article like this because honestly this is the first I have found that helps people with anxieties about open heart surgery.
Thank you for sharing this.
Heidi

faye said...

Thanks for writing this info. Iwill see dr july8, and make decision what to do about my valve. I am afraid but there is no other option to see my children around.

631b5256-5183-11e4-b49d-7b73b18c6811 said...

I have to go through open heart next month, Nov., 2014 and have to have a valve, bypass and a couple of stents. Am 64 years old...and this episode reminds me of gearing up for a couple of patrols I did in Vietnam. Man, the dread is almost so thick, you can cut it with a knife. But..I have to go on, no turning back now. But reading this article and the brochures given to me.....it would appear, although dangerous, one can survive it, as those who have posted. So, thanks for sharing and knowing there are others out there. Take care, peace.

Karli Fawcett said...

I'm 16 years old and have to get open heart in a couple days and was looking for something that could prepare me for it. And this helped, thank you.

Corey said...

I had a aneurysm repair and repair of bicuspid valve 3 weeks ago. Dr had been watching the size of my aneurysm for 5 years so I have known for a while that I would be needing surgery. I am 40 years old. I will say I put off having surgery as long as I could because I was pretty freaked out about it. I will just say that the fear I had before surgery was so unwarranted. While any surgery isn't fun, I honestly think that my wife had more pain and a harder recovery after each of her 3 c-sections than I did. The pain is so much less than I ever thought. After 3 weeks, most of the day I don't feel anything from the surgery except if I cough or sneeze (avoid sneezing at all costs lol) that does not feel great. I just wanted to share so if there was anyone out there feeling like I felt that this might be helpful in putting their mind at ease. Good luck!

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