Prior to your first appointment at Yavapai Cardiac Surgery, your surgeon will have already discussed your case with your referring physician. When you meet your surgeon at your first appointment, you’ll have the opportunity to ask any questions and review any concerns you have.
At this appointment, you’ll work with our scheduling coordinator to schedule your surgery. We’ll also make sure we have all the necessary information to work with your insurance company to obtain any necessary pre-authorization.
If pre-operative testing is needed, that will also be scheduled at this time. More information about the tests your surgeon may order can be found here.
While heart and lung surgery is a common occurrence for us, we know it can seem like a huge undertaking for you, both emotionally and physically.
This guide is intended to help prepare you for your surgery so you can relax as much as possible, confident that you’re in good hands. Here’s what you can do to maximize your potential for a successful operation and speedy recovery:
Smoking. If you currently smoke, we recommend you stop completely as soon as possible. The American Heart Association offers resources to help you quit smoking.
Medication’s that need to stop before surgery:
If you’re taking any other blood thinning medications, herbal medications, or supplements, let your surgeon know.
Ask your surgeon what medications, if any, should be taken on the day of surgery.
IF YOU HAVE ANY QUESTIONS ABOUT YOUR MEDICATIONS, PLEASE CALL US!
Food and Drink. Do not eat anything after midnight, the night before surgery, including chewing gum. Refrain from drinking alcoholic beverages for at least 48 hours before your operation.
Dental Care. If you haven’t seen a dentist recently or you’re experiencing dental issues, we may ask you to schedule a visit before your surgery. This is important to prevent any infection after your operation.
Breathing Exercises and Your Incentive Spirometer. In order to help you maintain your activity level during recovery, practice your breathing exercises as instructed by your surgeon. Remember: No one can breathe or cough for you! Doing the exercises will help you recover as quickly as possible, and will also help prevent pneumonia, as they keep your lungs open and clear of mucus.Practice the exercises several times each day.
General Health. Report any symptoms of flu, cold, or infections to your surgeon. It’s important that you’re in optimal health prior to your operation.
Contact info. Please confirm that we have your most recent and correct telephone/cell number at all times, particularly the day prior to surgery. In the rare situation when your operation may need to be rescheduled, we need to know how to get in touch with you.
Your surgeon may order any or all of the following tests:
❏ Blood work (“Labs”) – We will need to obtain many different lab tests for your surgery. One will be a “type and screen” for blood that may be used during your surgery. This lab test MUST be done at the hospital where the surgery will be performed. In addition, it will need to be drawn within 3 days of your scheduled procedure.
You will be given a blue sheet at the time of the blood draw; please be sure to bring this sheet the day of your surgery. You may also be given a wristband (also known as a hospital bracelet or blood band). It is critical to keep this wristband on until after your surgery. If you remove the wristband, your blood work will need to be re-done before surgery.
❏ Chest X-Ray – This x-ray will look at the chest, lungs, heart, large arteries, ribs and diaphragm. Two views are usually taken: one in which the x-rays pass through the chest from the back (posterior-anterior view), and one in which the x-rays pass through the chest from one side to the other (lateral view). You stand in front of the machine and must hold your breath when the x-ray is taken. There is no preparation for this test. This test usually is complete in under an hour.
❏ Electrocardiogram – “EKG” – measures the electrical activity of the heart. Electrodes (stickers) will be placed at specific locations on your body (chest, arms and legs). A graphic representation (tracing) will be generated which can indicate one or more heart-related conditions (conduction disorders, arrhythmias, valve disease, etc). There is no preparation for this test. This test usually is complete in under an hour.
❏ Pulmonary Function Test – “PFTs” – measures how well the lungs take in and release air and how well they move gases such as oxygen. For the test, you will breathe into a mouthpiece that is connected to an instrument called a spirometer. The spirometer records the amount and the rate of air that you breathe in and out over a period of time. This will give the surgeon an idea of how well your lungs work and your risk for being on the ventilator long term. There is no preparation for this test. This test usually takes one hour.
❏ Carotid Doppler/Ultrasound Study – “Carotids” – The major goal of carotid ultrasound is to screen patients for blockage or narrowing of their carotid arteries, which if present may increase their risk of having a stroke. For this test, warm water-based gel will be applied on your neck and then a transducer (ultrasound probe) will be firmly pressed against your skin, moving it back and forth over the area of interest until the desired images are captured. There is usually no discomfort from pressure. There is no preparation for this test. This test usually takes 30 minutes.
❏ Surface Echocardiogram – “echo” – This is a non-invasive test that looks at your heart valves, chambers and how well your heart is functioning. For this procedure, a warm water-based gel will be applied to your chest and then a transducer (ultrasound probe) will be firmly pressed against your skin, moving it back and forth over the heart until the desired images are captured. There is usually no discomfort from pressure. There is no preparation for this test. This test usually takes 30 minutes.
❏ Vein Mapping – This is a non-invasive test that looks at the veins in your legs. It will create a “map” of your leg veins for the surgeon in preparation of bypass graft surgery. For this procedure, a warm water-based gel will be applied to your legs and then a transducer (ultrasound probe) will be firmly pressed against your skin, moving it back and forth until the desired images are captured. There is usually no discomfort. There is no preparation for this test. This test usually takes 30 minutes.
❏ Trans-esophageal echocardiogram – “TEE” – This is an invasive test that looks at your heart valves, chambers and how well your heart is functioning. It also looks at the diameter/size of certain areas of the aorta. For this procedure, you will be given sedation and a small probe will be placed in your mouth and passed down your throat (in the esophagus) while a camera captures pictures of your heart. You cannot eat or drink 6 hours prior to this procedure. You will need someone to drive you home. You will have an IV placed prior to the procedure. This test will take approximately 1 hour to complete and 2-3 hours for recovery from sedation.
❏ ECG-gated SPECT myocardial perfusion imaging – “Stress Test” – This is a cardiac perfusion scan which measures the amount of blood in your heart muscle at rest and during exercise. It can identify areas in the coronary artery blood vessels that may not be getting adequate blood flow or areas of the heart muscle that have been damaged. During the scan, a camera takes pictures of the heart after a special test medicine (radioactive tracer) is injected into a vein in the arm. The tracer travels through the blood and into the heart muscle, allowing images to be taken. You will have an IV placed for this scan. You may not eat or drink 4 hours prior to the test. You cannot have caffeine or tobacco 24 hours prior to this test. There are certain medications that cannot be taken the day prior to this test (such as beta blockers, calcium channel blockers and long-acting nitrates). The scheduler will discuss specific medications with you. This test may take up to 3-6 hours to complete.
❏ Heart Catheterization – “Cath” – This is an invasive test that looks at the coronary blood vessels for any blockages (coronary artery disease). If blockages are identified, you may need an intervention prior to your surgery or bypass at the time of your surgery. For this procedure, you will need to lay flat while a catheter is placed in your groin blood vessel (or sometimes your arm blood vessel) while a camera captures images of your heart blood vessels. You cannot eat or drink 6 hours prior to this procedure. You will have an IV placed prior to the procedure as IV contrast dye is administered for this test. You will need someone to drive you home. This test will take approximately 1 hour to complete and 4-6 hours to recover (looking for no signs of bleeding from the groin site).
❏ Computed Tomography Scan – “CT” – This test that looks at the aorta (largest blood vessel in the body), lungs and other organs. It will identify if an aneurysm is present or other issues that may need to be addressed before or at the time of surgery. If your surgery is a re-operation, it will allow the surgeon to see how safely they can enter the chest cavity. You will have an IV placed prior to the procedure as IV contrast dye is administered for this test. You cannot eat 6 hours prior or drink 2 hours prior to this procedure. This test will take one hour to complete.
❏ Cardiac Magnetic Resonance Imaging – “MRI” – This test provides detailed pictures of the heart. It also reveals how well the heart is functioning and the overall size and shape of the left ventricle (pumping chamber of the heart). In addition, it allows the visualization of abnormal tissue in the heart muscle. Because they interfere with the magnetic field of the MRI unit, metal and electronic objects are not allowed in the exam room. You will need to complete a questionnaire prior to your appointment – be certain to tell your surgeon if you have a history of metal implants, shrapnel and/or claustrophobia.
*** PLEASE NOTE: Every effort will be made to keep your surgery date and testing on the original dates provided. However, due to unexpected emergencies, your surgical date and/or testing may have to be rescheduled. If this occurs, everything possible will be done to reschedule you to the earliest available surgical date.
Even before your surgery, start thinking about what you’ll need for a smooth recovery after your operation. The last thing you want is the added stress of trying to arrange your life while you should be focusing on recovering.
Prior to your surgery, your surgeon will give you an estimated hospital discharge day. Using that day, be sure to arrange your ride home as well as any other support you’ll need for the first few days. You cannot be discharged without the assurance that you have adequate support at home!
- If you have pets, consider boarding them or asking for help in caring for them for at least the first few days after you return home.
- If you live alone, consider making and freezing meals ahead of time so you don’t have to worry about eating properly during recovery.
- If you live with family, make sure someone will be around to help you after you are discharged. If you live alone, you may want to ask a friend or relative to stay with you for a few days as you regain mobility and stamina.
- If possible, move to a ground floor bedroom, and rearrange furniture if necessary so you can move around easily.
- If you are working, let your employer know that you may be out of work for up to six weeks. You’ll want to make these arrangements and file any paperwork necessary as soon as possible as you may be required to notify them at least 30 days in advance. We recommend talking to your company’s Human Resources department about how they handle leave and educating yourself on the Family and Medical Leave Act (FMLA).
Department of Labor Information on FMLA
Guide to the Family and Medical Leave Act from National Partnership for Women & Families (PDF)
American Heart Association Q & A on FMLA
FMLA Forms from the Department of Labor
- In the unlikely event it may be necessary, make sure your family or other designee has the legal right to make decisions regarding your care, should you be unable to do so. You’ll want to make sure they understand your wishes, as well as your medical history so they know any allergies or other conditions that might affect your surgery and care.
- If you anticipate that you may need additional care after surgery, such as a nursing facility or at-home care or therapy, discuss this with your surgeon before surgery so arrangements can be made and needed equipment can be ordered.
- Insurance may not cover all your expenses. Be sure to contact your insurance company directly to understand what your plan covers and so you can plan ahead for any financial needs.