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What can I expect during surgery?
You will be asleep during the surgery. Your anesthesiologist will meet with you prior to surgery to discuss any allergies, concerns about medication and pain management following surgery. Bring a list of all your current medications, as this will help the anesthesiologist in planning your care.
The length of the operation varies. It can take anywhere from two to six hours. Dr. Ramchandani will provide you with a better estimate based on your selected treatment.
What do I need to do before surgery?
Please contact your insurance company to verify coverage and determine whether a referral is required. You will be asked to pre-register with the appropriate hospital and provide demographic and insurance information. This must be completed at least five to 10 days before the date of surgery. Dr. Ramchandani will give you specific instructions on how to prepare for your surgery.
What happens on the day of surgery?
You will report to a pre-operative nursing unit and will be asked to change into a hospital gown. A nurse will review your chart and confirm that all paperwork is in order. You will be taken to a pre-operative nursing unit and an anesthesiologist will start an IV. Before any medications are administered, Dr. Ramchandani will verify your name and the type of procedure you are having. You will then be taken to the operating room. After the appropriate form of anesthesia is administered, surgery will be performed.
What type of anesthesia will be used?
You will have a pre-operative interview with an anesthesiologist who will ask you questions regarding your medical history. The valve replacement will be performed under general anesthesia. With general anesthesia, you will be asleep during your surgery.
What happens during the surgery, and how is the surgery performed?
Dr. Ramchandani will begin by exposing the heart. An incision is made to divide the breastbone. After the heart is exposed, blood must be rerouted to a heart-lung machine. This allows the blood to be pumped and oxygenated while the surgeon operates on the heart.
Dr. Ramchandani can now replace the damaged valve. An incision is made in the aorta to access the aortic valve. The diseased valve leaflets are then removed. After the appropriate valve is selected, sutures are used to secure the prosthetic valve. The aorta is then closed.
Blood is allowed to flow into the coronary arteries. If needed, an electric shock is used to start the heart. Before the chest is closed, pacing wires may be left to control irregular rhythm. |
Heart Pump Machine
Seated Replacement Valve
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After beating heart bypass surgery
You may go into a cardiac surgery recovery room, or Intensive Care Unit (ICU), where you will be closely monitored. Your family can visit you for short periods of time.
A breathing tube is used during surgery. It will be removed as soon as you are able to breathe on your own. In some cases, the tube may be removed in the operating room. After the breathing tube is removed, you will be asked to cough and do deep breathing exercises.
You will be connected to monitoring devices that will assist the medical team in evaluating your progress. Tests will be performed during your stay, such as an ECG, blood pressure monitoring and blood sampling.
Once you are able to swallow liquids, you will progress to solid foods as tolerated by your digestive system.
You may experience some discomfort from the incisions. If you are uncomfortable, remember to ask for pain medication before the pain becomes extreme. You may feel very tired. Fatigue is to be expected after a surgical procedure.
If your saphenous vein was harvested, swelling may occur in the leg. You may notice some bruising and fluid collection in the lower portion of your leg. Your healthcare professional may recommend you wear the elastic support stockings provided by the hospital for a period of time.
You will be instructed about activity and exercise. Assistance will be provided to help you increase your activities.
Typically, your complete hospital stay after beating heart bypass surgery may range from three to seven days, depending on the procedure performed and the necessary treatments required following your surgery.
Returning Home
Dr. Ramchandani will discuss with you the importance of a cardiovascular rehabilitation program. Cardiac rehabilitation can help your recovery and reduce your chances of having more heart problems.
Post-operative instructions may include:
- Contact your physician if you experience any
chest pain.
- Observe your incisions daily. Notify your doctor of any redness, swelling or drainage with your incisions.
- Take a rest period at least once a day. Resting helps your body to heal.
You also will recieve specific instructions regarding lifting heavy objects, when to resume driving and when to begin your exercise program.
You have had coronary artery bypass surgery and begun your cardiac rehabilitation program. What's next? You can control and improve your chances of living a longer, healthier life by changing your lifestyle and reducing the risk factors associated with coronary artery disease.
Certain risk factors increase your chance of atherosclerosis
(hardening of the arteries):
- Smoking
- gh blood pressure
- High cholesterol
- Sedentary lifestyle (lack of exercise)
- Obesity (being overweight)
- Diabetes
- Stress
- Family history of coronary artery disease
What should I watch out for?
Be sure to call Dr. Ramchandani's office if any of the following symptoms appear:
- Fever
- Warmth, redness, or swelling around the incision
- Drainage from the incision
Will there be scar(s)?
A scar will remain along the chest bone.
When can I expect to return to work and/or normal activities?
Dr. Ramchandani will advise you to walk or to do other physical activities, increasing gradually in order to regain your strength and return to a normal, active lifestyle. Most individuals who have sedentary jobs can return to work in four to six weeks. Those who have physically demanding jobs will have to wait longer. Additionally, you should not drive for six weeks.
Information contained in this booklet is intended to provide you and your family with a better understanding of coronary artery disease, beating heart bypass surgery and endoscopic vessel harvesting. This booklet is designed to use in conjunction with a consultation with your physician. This is not intended as a substitute for medical advice. If you still have questions after reading this booklet, please write them down so that your doctor or other health care professional can answer them for you.
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