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Heart Surgery Guide

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Heart Surgery Guide What should I expect during and after heart surgery? 2 Heart Surgery Thank you for entrusting your cardiac care to Piedmont Healthcare. Our physicians and staff are dedicated to providing the best care possible. An important aspect of your care involves the education of you and your loved ones. This booklet has been created to help you care for yourself before surgery as well as what to expect while you are in the hospital and how to care for yourself after leaving the hospital. Please note: If you are having heart surgery for a VAD implant or heart transplant, your care will differ from the information in this book. You will receive additional education materials regarding your recovery. In addition to this book, you may find the following resources helpful: • TIGR video system: Piedmont Atlanta Hospital has an educational video system called TIGR you may use free of charge while you are in the hospital. Ask your nurse for more details. • www.piedmontheart.org • www.americanheart.org • www.choosemyplate.gov • Piedmont’s You Tube Channel (can be accessed from www.piedmontheart.org) • Georgia Tobacco Quit Line: 1.877.270.STOP (7867) The information in this book provides general education material for informational purposes only. It is not intended to substitute for the advice of your physician. Please always follow your physician’s specific advice. Table of Contents All About the Heart ....................................... 6 Home Exercise Plan .....................................24 How the Heart Works .................................. 6 Coronary Artery Disease ............................. 6 Checklist for First 4 Weeks Heart Valve Disease ......................................7 Out of the Hospital ..................................... 25 Surgical Treatments ..................................... 8 When to Call the Doctor .............................26 Coronary Artery Bypass Graft Surgery ....... 8 When to Call 911 ........................................ 26 Valve Surgery ............................................... 8 Atrial Septal Defect ..................................... 9 Frequently Asked Questions .....................28 Aortic Aneurysms ........................................ 9 Managing Risk Factors ...............................30 Myxoma........................................................ 9 Risk Factors for Heart Disease ..................30 Before Your Surgery ................................... 10 Tobacco .....................................................30 The Night Before .........................................10 Exercise .......................................................31 The Morning Of ...........................................11 Healthy Diet ................................................31 Diabetes and Heart Disease ...................... 35 Incentive Breathing Device Blood Pressure ........................................... 35 (deep breathing and coughing) .................12 Healthy Body Weight ................................. 36 Control Cholesterol ................................... 36 After Your Surgery ...................................... 16 Manage Stress ............................................37 CV-ICU (12-24 hrs after surgery) ................16 Step-Down Unit (1-5 days after surgery) .... 17 Glossary .......................................................38 Recovery After Leaving the Hospital ........ 14 Recovery Time ............................................14 Pain .............................................................14 Activity Restrictions....................................14 Mobility .......................................................15 Sleeping ......................................................16 Riding in a Car ............................................16 Climbing Stairs ........................................... 17 Support Stockings ...................................... 17 Swelling/Blood Clot Prevention ................ 17 Appetite ...................................................... 17 Emotions ..................................................... 17 Sex ..............................................................18 Incision Care/Showers ..............................19 Dress .......................................................... 20 Medicines................................................... 20 Follow-up Appointment ............................. 21 My Questions to Ask ................................... 21 All About the Heart HOW THE HEART WORKS Your heart is a muscular organ that pumps blood to all PATHWAY OF BLOOD FLOW THROUGH THE HEART parts of your body. All parts of your body need oxygen and Superior vena cava Aorta nutrients that are delivered by the blood. The inside of the (from upper body) Left pulmonary artery (to left lung) heart is divided into four chambers. The upper chambers Aortic Right pulmonary valve artery (to right lung) of the heart are called the atria; the lower chambers of the Left pulmonary heart are called the ventricles. In between the atria and the veins (from ventricles are valves. The valves help direct blood flow in left lung) the proper direction. Right pulmonary Left atrium veins (from right lung) Normal blood flow starts on the right side of your heart in Left AV valve the right atrium. Blood then passes through the tricuspid Left valve into the right ventricle. From the right ventricle ventricle blood is pumped through the pulmonic valve where it then enters the lungs. In the lungs, the blood receives Right atrium Right AV valve oxygen and carbon dioxide is removed. Oxygenated blood leaves the lungs through pulmonary veins and travels back to the heart where it enters the left atrium. From the Pulmonary valve Right ventricle left atrium it passes through the mitral valve and enters Inferior vena cava the left ventricle. From the left ventricle blood is pumped (from lower body) through the aortic valve into the aorta. The aorta delivers oxygenated blood to your entire body. Then the blood returns to the heart through the peripheral veins to the right atrium, and the cycle begins once again. ARTERIAL SUPPLY OF THE HEART CORONARY ARTERY DISEASE The heart requires a supply of oxygen just like all other Left coronary artery organs and muscles. The heart has its own set of arteries Right coronary artery Circumflex to deliver blood, called the coronary arteries. The coronary artery arteries branch off the aorta. There are three main coronary arteries with many branches. These arteries lay on the Anterior interventricular outer surface of the heart and carry oxygen to the heart artery muscle. If the coronary arteries are blocked or narrowed, the heart muscle may not receive enough oxygen. When the coronary arteries are blocked or narrowed this is called Coronary Artery Disease (CAD) or Coronary Heart Disease Posterior interventricular (CHD). This can cause angina (chest discomfort), damage artery to the cells of the heart muscle, a heart attack, or even sudden cardiac death. Marginal artery 6 ALL ABOUT THE HEART Atherosclerosis is a buildup of plaque (fatty substances STAGES OF ATHEROSCLEROSIS that are made up of cholesterol and other particles) in blood vessels. When this buildup occurs in the coronary arteries, it is called coronary artery disease (CAD). This Healthy buildup of plaque damages the lining of the artery walls artery and causes the arteries to be stiff (less able to expand). As the plaque buildup gets worse, it can narrow the artery. Buid-up This reduces the blood flow to the heart muscle. Plaque begins can also rupture (crack open), tearing the lining of the artery. Blood clots form around the rupture site. This can Plaque completely block the artery, and the heart muscle below forms the blockage does not get any oxygen. When this happens, Plaque it is called a heart attack (myocardial infarction, MI). Lack of ruptures; blood clot oxygen to the heart muscle causes damage to the muscle forms and can decrease the heart’s ability to pump blood. HEART VALVE DISEASE Normally, your four heart valves are thin and smooth with one directional blood flow through the heart chambers. Scarring or thickening of the valves can occur from birth defects, infection, rheumatic and scarlet fever. These changes can make the valves harder to open (stenosis) or not close all the way (insufficiency). The mitral and aortic valves are most affected by these changes. Symptoms may INTERNAL ANATOMY OF THE HEART include palpitations with an irregular heartbeat, shortness of breath, swelling, coughing, and fatigue Aorta (extreme tiredness). Left pulmonary artery Aortic valve Superior vena cava Bacterial Endocarditis Left Right pulmonary This is a very serious infection of the heart valves and/ pulmonary veins or inner lining of the heart (endocardium). It can damage artery or destroy the heart valves. Endocarditis may happen Right Left atrium pulmonary veins when bacteria enter the bloodstream during infection, Left AV valve dental work, surgery, or IV drug abuse. You are at risk for Left endocarditis if you have a heart defect, heart valve disease Right atrium ventricle or have had heart valve surgery. Check with your doctor prior to dental work and any major or minor surgeries/ Right AV valve procedures. They may prescribe antibiotics pre-procedure. Inferior Symptoms of endocarditis may include fever, chills, vena cava sweating, tiredness or loss of appetite. Call your doctor if the symptoms don’t go away within 2 or 3 days. Pulmonary valve Right ventricle 7 Surgical Treatments It is important to understand
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