Cardiac Surgery

What to expect

Your Journey

1. Before surgery

   Use the weeks before surgery to get as fit as you can (see the Prehabilitation section below). The fitter you go in, the smoother your recovery tends to be.

   Your teeth may be checked before surgery, as dental infections can be serious after heart surgery.

   Getting Ready for Hospital (PDF)

2. The day of surgery

   You'll usually be admitted the day before your operation. Your surgeon will confirm consent and the surgical plan, your anaesthetist will discuss your anaesthetic and pain relief, and your nurse will run through a checklist, do an ECG, and prepare your skin (this may include shaving your chest and parts of your arms or legs).

   Heart surgery is done under general anaesthesia and usually takes 4 to 6 hours. Once you are under anaesthesia, your anaesthetist places extra monitoring: a fine line in your wrist (an arterial line) for continuous blood pressure monitoring and blood samples, and a line in your neck (a central line) for fluids and medicines. These let the team watch you as closely as possible throughout the operation. Some patients need a blood transfusion during or after heart surgery; this is monitored closely and only given if you need it.

   We'll keep your whānau updated if the operation runs significantly longer than expected.

   You'll go straight to the Intensive Care Unit (ICU) afterwards, still under anaesthetic. The ICU team will make sure your condition is stable, then stop the medications that are keeping you under anaesthesia, allowing you to wake up in your own time. It's bright and busy, with lights on day and night, so it's common to feel unsure about time at first. You'll wake with several tubes and lines in place, all there to help us look after you, and all removed as soon as you no longer need them:

   • a breathing tube, removed once you're awake and breathing on your own
   • the arterial and central lines placed during your operation
   • ECG leads monitoring your heart rhythm
   • a urinary catheter
   • one or more chest drains
   • fine pacing wires (a backup for your heart rhythm; you won't feel them)

   Seeing you in ICU can be confronting for family and whānau, as you'll look different at first surrounded by this equipment.

3. In hospital

   Most people spend one to two days in ICU before moving to a closely monitored step-down area, then to the ward. Your total stay is usually 5 to 7 days. The team updates you each day on the ward round, and lines and tubes come out gradually as you need them less.

   Pain relief. Good pain control matters. It lets you breathe deeply, cough, and move, which helps prevent chest infections. You'll have regular paracetamol plus stronger relief (a patient-controlled button in ICU at first, moving to tablets once your chest drains are out). Ask for more if you need it.

   Breathing and moving. The bypass machine and a sore chest can make deep breathing harder, raising your risk of a chest infection. Do your breathing exercises (see the Prehabilitation section below), sit up, and get out of bed as soon as you can. A physiotherapist will guide you and check you before you go home.

   Cultural and pastoral support is available throughout your stay, including Whānau Care Services for Māori patients, Pacific health support, and chaplaincy for all faiths and none. Ask staff for a referral.

4. Going home

   You'll leave with a discharge summary (also sent to your GP), a medication plan, and a booklet covering early recovery, what to watch for, follow-up, and cardiac rehabilitation. Don't restart old medications without checking with your pharmacist or doctor first.

   Sternal precautions. While your breastbone heals (about 6 to 8 weeks), avoid lifting, pushing, or pulling anything heavy, and support your chest with a folded towel or pillow when you cough.

   Driving. No driving for 4 weeks after surgery (an NZTA requirement). Your team will tell you if you need a specialist assessment before returning to the wheel.

   Work. Most people need 6 to 8 weeks off, longer if your job is physically demanding.

   What to expect. Most patients are surprised to find they're less sore than they expected, but far more tired. That's normal; it can take up to 12 weeks to feel back to full strength. You may also notice you have to think harder about things that used to feel automatic. For most people this clears within a few weeks; for a smaller number it can take several months. None of this means something has gone wrong. Talk to your surgeon or anaesthetist about what to expect for you specifically, and ask as many questions as you need to.

   Check your wound daily for redness, swelling, discharge, increasing pain, or fever.

   Cardiac rehabilitation. An outpatient programme is an important part of your recovery, and most people find it genuinely useful.

   Get urgent help (your nearest emergency department, or call 111) for chest pain, a fast or irregular heartbeat, severe or worsening breathlessness, or fainting. Contact your GP or surgical team for a fever, wound redness or oozing, or pain your medication isn't controlling.

   Looking after your heart, long term.

   • Maintain a healthy weight and eat well: more vegetables, fruit, whole grains, and lean protein; less processed food, salt, and saturated fat.
   • Keep cholesterol and blood pressure checked and treated. Both quietly damage arteries over time, often with no symptoms.
   • If you have diabetes or pre-diabetes, keep your blood sugar in range with your GP.

   See the Heart Foundation for more information, or self-refer for a Green Prescription (subsidised exercise support).