Center for Cardiothoracic Surgical Services

Thank you for choosing Abbott Northwestern Allina Health Minneapolis Heart Institute.

We are here to take good care of you.

Now that you and your doctor have chosen Open Heart Surgery, we want to help you and your support system prepare for this procedure.

This video program will guide you through each stage of your care … from Pre-Planning, to Procedure Day, and Days After Procedure.

By understanding the major aspects of Open Heart Surgery before your hospital stay, you can focus on getting better once treatment begins.

It is equally important for your support team also to understand Open Heart Surgery before your hospital stay.

By understanding the details ahead of time, loved ones will feel better prepared to help you during treatment.

We recommend you designate one lead person as family liaison during your hospital stay.  This person would then keep your support system updated on your progress as needed.

You and your family, friends, and loved ones are critical partners of our health care team.  By working together, we will achieve the best patient experience possible.

Pre-planning

• Understanding Your Procedure
• Surgery Instructions
• How to Wash Your Skin 
• Tips for Getting Up & Down
• Breathing Exercises
• Mind Body Coaching
• Care Map

Open heart surgery requires an incision in your chest through your breastbone. This allows your surgeon to directly view and access the surgical area.

Heart surgery can be divided into two groups: "On Pump" and "Off Pump".

"On-Pump" surgery makes it possible to operate when your heart is not beating, which has many advantages.

With on pump surgery, a heart-lung bypass machine performs the role of heart and lungs by circulating blood and oxygen throughout the body.

“Off Pump" surgery is performed while your heart is beating.

Your health care team will work hard to keep your blood loss as low as possible.  

However, many patients do need more blood during or following surgery.

Several blood transfusion options are available.  You may receive blood from a certified blood bank. 

A cell saver machine may also be used to collect, cleaned, and return your blood to your body during surgery.

You and your doctor will decide on which blood management plan is best for you.

Open heart surgery typically lasts from three to five hours, depending on the type of procedure. Most patients leave the hospital 4 to 7 days after surgery. 

Good preparation prior to Heart Surgery is critical to achieve the best outcome possible.  

An appointment with our Pre-Operative Clinic will help you and your support team understand the major aspects of Open Heart Surgery. 

This visit also allows time to assess any other health conditions so we may be better prepared to ensure these conditions are monitored closely during your hospital stay.

This consultation will not only help clarify the details, it will also help you and your support team to focus on getting better once treatment begins.

Surgery Instructions will be provided and outline:

1. What medical appointments are needed to be done before surgery …
2. How to handle your current medications …
3. What to bring for your Hospital Stay …
4. What preparations are needed to be done before your arrival.

Washing Your Skin Prior to Surgery

Before you come to the hospital, you will need to wash your skin to remove most of the bacteria that normally is found there.

Two containers of anti-bacterial soap are provided for you to shower twice with before surgery: 

Once the evening before surgery and again on the morning of surgery.  Follow the instructions provided.

Tips for Getting Up & Down

Moving your body up and down after surgery takes a little getting used to. 

It is best to practice the following techniques at home to increase your comfort and mobility during treatment.  During all of these exercises, focus on breathing naturally.

To get into bed

• Sit on the edge of your bed, about halfway down but a little more towards the head of the bed.
• Hug your pillow and take a few breaths. Focus on breathing naturally.  It is important to not hold your breath as you move your body.
• Lie down on your side and bring your legs up and roll onto the bed.

To get out of bed

• Hug your pillow,
• Roll onto your side and dangle your feet over the edge of your bed.
• Again, Focus on breathing naturally
• Try to use your legs to pull yourself into a sitting position.

To get out of a chair

• Slide or wiggle your body toward the edge of a chair.
• Place your feet apart for a wide base of support.
• Breath naturally
• Put your head forward so your nose is over your toes.
• Put your hands on your thighs above your knees. 
• Look up as you Stand up using your leg muscles to rise out of the chair.  Do not use your hands to push of the chair.

To get into a chair

• Back up to the chair until your legs touch the chair.
• Lean your upper body forward.
• Breath naturally
• Place your hands on your thighs for stability.
• Keep your feet apart for a wide base of support.
• Bend your knees and squat down slowly until you are sitting in the chair.

Breathing Exercises - Using an Incentive Spirometer

An incentive spirometer is a handheld device that exercises your lungs and measures breathing capacity.

Doing breathing exercises will strengthen your lungs and keep them clear for oxygen.

To exercise your lungs, hold the incentive spirometer in an upright position.

Place the mouthpiece in your mouth, sealing your lips tightly around it.

Breathe in slowly and as deeply as possible. 

A small column measures your efforts as "good," "better," or "best."

Hold your breath as long as possible. Then exhale slowly and allow the piston to fall to the bottom of the column. 

Rest for a few seconds, breathing naturally, and repeat the process.

Position the indicator to mark your best measurement in milliliters.  

After each set of 10 deep breaths, cough to help your lungs stay clear.

You will be supporting your incision when coughing by hugging a pillow firmly against it.

Mind-Body Coaching

Did you know that the Penny George Institute for Health and Healing offers services to surgery patients free of charge?

The Mind-Body Coaching program provides patients with a set of self-care tools to aid recovery following heart surgery.

These tools include meditation, breath work, guided imagery, biofeedback, and other relaxation techniques.

Let us know if you are interested in meeting with a mind body coach prior to your surgery.

Care Map

You will be provided with a care map that outlines the path that your recovery will typically take.  Everybody’s experience is slightly different, but this will help you and your support team to better understand the critical milestones.

Procedure day

Once you arrive on campus, enter the main public parking ramp located next to the Heart Hospital.

Take the parking ramp elevator to level D/E, which opens to the second floor skyway area.

A parking fee pay station is located nearby for your convenience when visitors leave the hospital.

Walk down the 2nd floor hallway towards the Heart Hospital registration area, labeled H2000.

The receptionist will get you checked in and take care of needed paperwork.

After registration, take the elevator to the 3rd floor.  Walk across the lobby towards the Cardio Vascular Services reception area, labeled H3000.

A Reception Liaison will greet you and help with any other needed details.

You are now ready to wait in the patient family waiting area.

When it is time for your procedure to begin, you will be escorted to a preoperative care suite, also called the PACU.

Once you are settled into your hospital bed, the person with you on the day of surgery will be invited back to join you.

An IV line will be placed into your arm for fluids and medications.

Your nurse will work with you to complete your care plan.

Your Anesthesiologist will stop by and review their process with you.

When your surgeon arrives, he or she will mark the surgery site on your body.

You are now ready to head to surgery.

We request at least one family member remains in the waiting area during your surgery.  

In the operation room, general anesthesia will keep you asleep during surgery.

A chest tube is inserted to drain any blood, fluid, or air from around your lungs.

An endotracheal or breathing tube, is placed into your airway? through the throat to keep your airway full and clear for breathing.  

After surgery, you will be transferred to the intensive care unit, or ICU. 

Your Family will be notified and have a consultation with your doctor.

In the ICU, you will be under close monitoring by nursing staff. 

When you first wake up you will be unable to speak, due to your breathing tube.

Breathing tubes are typically removed within 4 to 8 hours after surgery.

After the breathing tube is removed, any potential throat soreness may be alleviated by sucking on ice chips.

Your heart monitor will stay in place for several days for continuous observation by your health care team.

Do not be alarmed by any machine beeping sounds.  These sounds are typical during the monitoring process.

Your nurse will ask you often about your pain.  

Since you are the only one who knows where and how severe your pain is, you have an important part in managing your pain.

Tell the nurse if your pain is not under control.  Your care team will work with you on pain control to promote recovery.

It may take 1 to 2 hours for you to get settled into your ICU room. When you are ready, we will reunite you with your family.

You will be quite tired on the first day of surgery. You may shiver as the anesthesia wears off.

Remember you should be able to sit up in bed or in a chair, with help, by end of day.

You may not be hungry after surgery. Nutritional supplements are available, if necessary.

Your comfort level will depend on several factors. Refer to the Care Map for a complete list of what to expect on your first day of surgery.

Days after surgery

When your doctor determines that you are ready, you will be moved from the ICU to a telemetry patient room. Most people transfer out of the ICU the day after surgery.

A nurse will monitor you on the telemetry unit.

Breathing exercises using an incentive spirometer will be very helpful to your recovery.

Your lead family liaison will continue to keep people updated on your status.

Recovery will continue with an increased focus on cardiac rehabilitation exercises.

Try your best to keep up with this regimen in order to become acclimated back to your daily life.

Little by little, you will have more energy. Together, you and your family will learn more about various self-cares needed throughout recovery.

Your comfort level will depend on several factors.  Refer to the Care Map for a complete list of what to expect on the days following surgery.   

If you have pain, tell your healthcare provider.  Your input will help your provider prescribe the right medicine and therapy to manage pain and avoid serious side effects.

There are other treatment options for pain in addition to prescription medicines.

Your healthcare team will work with you and your family when it is time for discharge planning.

Many details must get into place before you leave the hospital, such as diet plan, medications, rehabilitation schedule, and follow up appointments.

Make sure to ask any and all questions you may have.

Recovery from Heart Surgery doesn’t happen overnight, but with some good planning we can make it as smooth as possible.

We are thankful you learned about your condition and have taken action to improve your health.  We wish you a good recovery back to your normal life.