Where Will I Go After the Surgery?
After surgery, you will be moved to the Medical Surgical Intensive Care Unit (MSICU). You will stay there for about two to four days.
When you wake up, it may seem noisy and busy. This is a normal part of your care. Try to stay calm and don’t pull on any tubes.
What Can I Expect to Have on My Body?
After your surgery, you will have:
Incisions
Incisions. Image used with permission from University Health Network Patient and Family Education Program. © University Health Network, Patient & Family Education.
You will have an incision called a sternotomy down the middle of your chest. It will be about 20 centimeters (seven to eight inches) long.
Your surgeon uses dissolvable stitches to close the incision. This means they go away on their own. Bandages will cover your incisions; they will be removed two days after your surgery.
Endotracheal Tube (ETT) Ventilator
Endotracheal Tube (ETT) Ventilator. Image used with permission from University Health Network Patient and Family Education Program. © University Health Network, Patient & Family Education.
An endotracheal tube is also called a breathing tube. The tube is attached to a ventilator. Together, they help you breathe until your body recovers. Your healthcare team will remove the tube when it’s safe for you to breathe on your own.
When you first wake up, the breathing tube may make you feel like you are choking. Try to stay calm. You won’t be able to talk while you have the tube, but we will give you a writing pad. You will still be able to let your healthcare team know your needs.
Chest Tubes
Chest tubes. Image used with permission from University Health Network Patient and Family Education Program. © University Health Network, Patient & Family Education.
You will have 3 chest tubes coming out of your sides. These tubes remove air and fluid from the inside of your chest area. The tubes are attached to a machine that helps suck the air and fluid out.
Stitches are used to keep the chest tubes in place. These are not dissolvable. Your healthcare team will remove your chest tubes once it is safe and will remove the stitches 24 hours after the tubes are taken out.
Pacer Wires Connected to a Pacemaker Box
Pacer Wires Connected to a Pacemaker Box. Image used with permission from University Health Network Patient and Family Education Program. © University Health Network, Patient & Family Education.
You will have pacer wires attached to your heart. These wires are connected to a pacemaker box.
After your surgery, your heart rate may slow down. The pacemaker will use electric current to help your heart beat faster. Once it is safe, your healthcare team will remove these wires at the same time as your chest tubes.
Intravenous (IV)
Intravenous (IV). Image used with permission from University Health Network Patient and Family Education Program. © University Health Network, Patient & Family Education.
You will have one IV line in your arm so your healthcare team can give you fluids and pain medicines. These medicines will help you relax and manage any pain you may feel.
Central Lines
Central Lines. Image used with permission from University Health Network Patient and Family Education Program. © University Health Network, Patient & Family Education.
You will have two central lines. One line (like a big IV catheter) will be in the right side of your neck and 1 will be in the upper left side of your chest. These lines are used to give you medicines and take blood samples. Your healthcare team will also use them to continuously check your blood pressure on the right side of your heart and pulmonary (lung) artery.
The central line from your neck will come out at the same time as your chest tubes and pacer wires. The central line in your upper chest will come out within one week after surgery.
Arterial Lines
Arterial Lines. Image used with permission from University Health Network Patient and Family Education Program. © University Health Network, Patient & Family Education.
You will have tow arterial lines. One will be in your wrist and one will be in your groin area. These tubes will look like your IV, and your health care team will use them to take blood samples without having to poke you with needles. They will also continuously check your blood pressure.
Urinary Catheter
Urinary Catheter. Image used with permission from University Health Network Patient and Family Education Program. © University Health Network, Patient & Family Education.
You will have a tube draining your bladder for up to seven days. While you are in the hospital, the nurse will measure how much you urinate (pee).
Heart Monitor
Heart Monitor. Image used with permission from University Health Network Patient and Family Education Program. © University Health Network, Patient & Family Education.
Your healthcare team will attach you to a heart monitor. This doesn’t mean there is a problem with your heart; this for all patients who have your type of surgery.
The heart monitor will help your healthcare team see your vital signs like your heart rate, your blood pressure, and how much oxygen is in your blood.
While you are in the MSICU, your body will be recovering. When it’s safe, your healthcare team will remove your breathing tube and some other tubes or drains, and move you from the MSICU.
What Happens After I Leave the MSICU?
You will be moved to the Thoracic Surgery Step-Down Unit (SDU), where you will stay in for about two to four days.
You will still be connected to a heart monitor and may still have some of the tubes you had in the MSICU. You may also need oxygen for a short time as you recover. But, as your health improves the rest of the tubes will be removed from your body.
When you are ready, you will be moved to a regular ward room, where you will stay until you go home.
During the rest of your hospital stay, you will work closely with a physiotherapist and respiratory therapist. They will help you exercise your body and lungs.
How Can I Manage My Pain?
Most patients don’t have a lot of pain. After your surgery, you will be given pain medicine through your IV to stay comfortable. Once you are able to eat and drink again, you will be given pain medicine pills. Your healthcare team will work with you to help find the best medicine to manage any pain you feel.
It's important to ask your nurse for pain medicine before your pain becomes very bad.
Controlling your pain is important. It will help you rest, move, walk, and do breathing exercises like deep breathing and coughing. These are all important to help you recover.
When Will I Start Taking My Medicine Again?
You start taking your warfarin or new oral anticoagulant (for example, rivaroxaban) after all your tubes and drains are removed.
If you are taking warfarin, the Thrombosis Clinic or your family doctor will check your bloodwork and adjust your dose after you leave the hospital. They will be responsible for making sure your INR stays between 2.0 to 3.0.
Before you leave the hospital, your healthcare team will give you a prescription for Warfarin or another type of blood thinner.
Always follow the instructions for taking this medicine. You will need to keep taking your blood thinner for the rest of your life to prevent new blood clots from forming.
To keep information about your blood thinning medicine with you at all times, get a MedicAlert bracelet. You can find an order form at the website: www.medicalert.ca or call 1-800-668-1507.