Monday
Dec212009

Preparing for Heart Surgery

All patients will meet with a surgeon before any scheduled operation.  The surgeon will review the patient’s records and discuss the planned surgery, as well as answer any questions that the patient may have.  “Informed consent” is completed before each surgery.  “Informed” means that the surgeon explains all the risks associated with surgery, potential benefits from surgery, and the option of having no surgery at all.  “Consent” means that the patient understands the risks and benefits of the surgery, and gives consent to proceed with the planned surgery.

 

Prior to your surgery, you will have a full evaluation to minimize potential problems during surgery.  A series of lab tests are performed to ensure that there are no abnormalities in your blood that may affect your outcome during surgery.  The tests include hemoglobin and hematocrit levels, which determine the number of circulating blood cells.  Patients with low hemoglobin levels may require a blood transfusion prior to surgery, and other patients may require a blood transfusion due to blood lost during the surgery.  There is a small risk of infection and immune reaction from blood transfusion, and some patients prefer to donate their own blood prior to surgery. 

 

The patient will have a series of tests performed to evaluate the heart itself before surgery.  An EKG evaluates the rhythm of the heart and looks for any signs of prior damage to the heart.  An echocardiogram is a non-invasive test that is performed to look at the function of the heart.  The echocardiogram uses ultrasound waves (which are not harmful to the body) to create images.  This provides valuable information on how well the heart is contracting and evaluates for damage to heart valves.  The echocardiogram is the exam used by cardiologists to determine if the aortic stenosis or regurgitation is present.  A cardiologist may also perform cardiac catheterization, which is a test that is used to look at the coronary arteries of the heart.  This test may be used before valve surgery to ensure that there is no significant narrowing in the coronary arteries that may lead to a heart attack during surgery.  In bypass surgery, the catheterization will help guide the surgeon in bypassing the diseased artery.

 

It is important to discuss all your medications with the surgeon prior to surgery.  Please bring a list of all medications to your appointment.  If you take aspirin, ibuprofen, or Coumadin (Warfarin), you should speak with your surgeon prior to surgery.  These medications may cause thinning of the blood, and usually need to be stopped prior to surgery.  Your surgeon will evaluate all your medications and give you specific instructions on which medications to stop prior to your surgery.

 

You will be given specific instructions regarding eating and drinking the night before surgery.  Patients typically do not have anything to eat or drink after midnight on the night before surgery.  This is important in decreasing the risk of complications when placed on heart and lung support during surgery.

 

On the day of surgery, you should not wear contact lenses (you can bring your glasses).  You should leave any valuables at home or with a friend or family member. You will be taken to a pre-operative room where you change into a hospital gown.  The anesthesiologist will talk with you before the surgery.  The anesthesiologist is a physician responsible for “putting the patient to sleep” and close monitoring during surgery.  The anesthesiologist will start an IV line prior to surgery which is used to give fluids and medications during the surgery. 



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