In the operating theatre
Cardiac procedures have an average duration of 4 hours. They are carried out with the help of a cardiopulmonary bypass, a machine which provides oxygenation and blood flow in place of lungs and heart. Operations on a patient who has already received a heart or chest operation usually last longer.
For hygiene reasons, nurses and doctors are wearing pants and a blue tunic. They have caps on their heads and masks to cover nose and mouth. When you arrive in the operating theatre, electrodes (self-adhesive pads) are applied to your chest, your shoulders and hips to monitor your electrocardiogram. A clamp is placed on your finger or your ear to monitor your oxygen level.
After local anesthesia, the anesthesiologist places some catheters (small tubes) in the vessels of the arm, to administer the products necessary for your anesthesia. Before injecting the anesthesia products, you will breathe oxygen through a mask.
To reach the heart, the chest has to be opened at the sternum (sternotomy) or laterally between the ribs (lateral thoracotomy). The kind of incision is discussed with the surgeon and chosen according to surgery indication. The sternum is usually opened from top to bottom so that you will keep a scar running from neck to stomach.
If the intervention consists of bypass surgery, you will sometimes have scars on the legs. Indeed, coronary artery bypass surgery is the replacement of some coronary narrowed (stenotic) or occluded (thrombosed) arteries which supply the heart muscle by other arteries or veins. To achieve the bypass, the surgeon can use the mammary artery (thorax), the gastroepiploic artery (stomach), the radial artery (arm) and saphenous veins (legs).
During anesthesia, you will be placed under artificial respiration through a tube placed in your mouth and into your trachea. This tube passes between the vocal cords. As a result, when you wake up, even if you want to talk, no sound is audible to those around you. You will find your voice back as soon as the endo-tranchéal tube will be removed within hours after surgery.
To protect your eyes, the anesthesiologist will administer an eye ointment, which is intended to replace the tears moistening your eyes constantly as they are not secreted during anesthesia. This ointment temporarily disrupt your vision when you wake up in intensive care.
During general anesthesia, the working of your intestine (transit) is interrupted, but your stomach continues to secrete the fluid needed for digestion. This liquid accumulates in the stomach and could give you nausea and vomiting when you wake up.
To avoid this, the anesthesiologist will put a probe through the nose into the stomach (gastric tube). This will usually be removed the day after surgery, in intensive care after checking transit recovery. You should not worry about urine disposal as a urinary catheter will be placed in the operating room during anesthesia.
Catheters (small tubes) are placed in the vessels of the arm and neck. They are meant to give you fluids, medications, take samples of blood, and connect you to monitoring systems.
At the end of surgery, the surgeon places drains in the chest to prevent blood, secretions or air accumulation around the heart and prevent its compression. Finally, the surgeon will place small threads on the heart surface to control its pace with an external battery (pacemaker).
All these “pipes” are placed during general anesthesia in the operating room.