Undergoing heart or lung surgery can be very overwhelming. Dr Bassin and his team will explain everything to you step by step and provide as much support as is needed. Your surgical path may vary from the traditional one if you are a candidate for minimally invasive or robotic surgery. Your hospital stay and recovery period will be quicker with less pain and down-time allowing you to get back to your life faster.
Onset of Symptoms
You are experiencing concerning symptoms such as shortness of breath or chest tightness on exertion.
Go to see your GP
Make an appointment to see your GP, who will refer you onto a cardiologist for further tests if necessary.
If your symptoms are acute you should go to the emergency room. If you have any doubts it is always better to be on the safe side.
Go to see your Cardiologist
Your cardiologist takes a full medical history, then performs an examination and a detailed ultrasound of the heart (echocardiogram). If required, an angiogram will be performed. If you have severe valve disease, multiple blocked coronary arteries, or an aortic aneurysm you will then be referred to a cardiothoracic surgeon.
Consultation with Dr Bassin
Dr Bassin will review your notes and imaging prior to the appointment. He will then take a detailed history and perform an examination with a focus on whether surgery is required. Dr Bassin will have a detailed discussion with you regarding the treatment options which may include open heart surgery, minimally invasive or robotic surgery, or conservative management with the aim to review in a few months.
(Please bring your medication list and any chest x-rays/CT scans to the appointment.)
Prior to heart surgery an angiogram is required (if not performed recently) to determine the anatomy of the coronary arteries. This is performed by an interventional cardiologist under local anaesthesia. The artery in the leg or wrist is punctured and a thin tube (catheter) is guided into the heart under x-ray guidance. Contrast dye is injected into the coronary arteries to provide an outline of the flow of blood.
Dr Bassin may also request some other tests prior to surgery such as CT scans, lung function tests or blood tests.
At the pre-admission clinic, you will meet your anaesthetist and other clinical staff who will review your history and medications and prepare you for surgery. Although the details will vary for every patient, in general blood thinners are stopped 5 days prior to surgery including aspirin, clopidogrel, ticagrelor and warfarin (this also includes fish oils). Newer blood thinners such as apixaban and rivaroxaban can be ceased 3 days prior.
Admission to Hospital
Usually you will be admitted to hospital the night prior to surgery, though in some cases it is on the morning of the surgery. The hospital bed manager will call you in the days leading up to surgery to confirm this with you. Please bring your medications, imaging, toiletries and clothing to the hospital.
Dr Bassin will see you once you are admitted to hospital before your surgery.
You will have to fast from midnight on the night prior to surgery and this includes all food and liquids. You will be advised which of your medications can be taken on the morning of surgery.
Day of Surgery
You will be taken down to the operating theatres approximately one hour prior to the start of the operation. The anaesthetist will give you some medication to relax and then put you to sleep for the duration of the surgery.
Your family will want to be nearby but Dr Bassin will encourage them to leave the hospital and will call them once the surgery is complete to update them. They can visit you in intensive care approximately one hour after the completion of the surgery.
Following the surgery, you will be taken to intensive care while still asleep with a breathing tube in your mouth. There will be lines in your neck for infusion of medications and for taking blood, and drains coming out of your chest to drain blood and fluid. There will also be a catheter in your bladder to drain urine. The breathing tube will come out within six to twelve hours of surgery depending on your progress.
The drains usually are removed on the first or second day. The team of nurses and physiotherapists will get you out of the bed and standing up on the first day post surgery. It is paramount to keep you moving and walking, which will prevent lung collapse, pneumonia, and infection.
You are taken from ICU to the ward on the second day following surgery and stay there until you are ready to be discharged, with your total hospital stay around a week long. We make sure you have good analgesia and spend a long time with the physiotherapists getting your mobility back and doing breathing exercises since there is always some degree of lung collapse after major cardiac surgery. You will be assessed before you go home to make sure you can climb the stairs and can function independently. Some patients, especially the elderly, go to rehabilitation for a few weeks before going home, particularly if they live on their own.
Discharge from Hospital
After discharge from hospital you should arrange to see your GP within the first week and then regularly every week to check your blood tests, medications and blood pressure. Your GP can write a referral to Dr Bassin for your follo-up appointment which should be booked 4-6 weeks post-surgery or 2-4 weeks post pacemaker insertion.
REMEMBER TO CALL DR BASSIN’S ROOMS AND BOOK YOUR FOLLOW UP APPOINTMENT.
Early Recovery, 4 Weeks
Patients who have undergone minimally invasive surgery will be feeling fully recovered and back to their usual activities by 4 weeks and do not have any lifting restrictions.
You may not drive until 4 weeks after heart surgery, as per the national guidelines.
All patients should make an appointment to see their cardiologist after they follow up with Dr Bassin, approximately 6-8 weeks following surgery.
Follow up with Dr Bassin
Your follow up appointment with Dr Bassin will take place 4-6 weeks post surgery or 2-4 weeks post pacemaker insertion. Dr Bassin will check your wounds, review your post operative chest x-ray and any other test results. If required your pacemaker or defibrillator will also be checked by a device technician.
If everything is fine. Dr Bassin will advise you to follow up with your cardiologist for regular check-ups. You do not need ongoing follow-ups with your surgeon unless there is a specific concern.
Full Recovery, 3 Months
Your cardiac rehabilitation program will begin 6 weeks after surgery. This is a program run at the local hospital that will help you with overall recovery, exercise, diet and lifestyle.
After a sternotomy, you cannot lift more than 3kg until six weeks since the bone is not fully healed yet. You also should refrain from intense physical exertion until you are fully recovered.
Most patients will reach a complete recovery at 3 months post surgery, where they can resume all their normal activities and there are no more restrictions on lifting.
The Rest of Your Life
After undergoing heart surgery of any kind and finally regaining your health, it is important to remain active, maintain a good exercise regimen, eat healthily (which includes greens, low sugar diet, fibre, reduced carbohydrate), have regular checks with your GP and cardiologist, and pay close attention to your blood pressure to make sure your systolic blood pressure is less than 140.