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After the op

Red_Baron profile image
11 Replies

Hi,

I’m due to have aortic root replacement surgery and have a question about what happens immediately after the operation. I’ve been told the procedure is 4-5 hours and you are then taken to intensive care. They’ve said the stay in ICU is circa 24 hours. Does anyone have any insight as to how long it is before you “wake up”? I’ve read that they keep you unconscious for up to 24 hours in order to “let everything settle”.

Is that what others have heard/experienced?

Thanks

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Red_Baron
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ros69 profile image
ros69

Not quite the same surgery but my husband had triple bypass in November, he went down to surgery about 1.30 p.m. and when I called about 7.30 p.m.he was awake etc. We saw him next day in ITC where he was sitting in a chair and has attempted to eat his lunch (throat too sore from tubes) - the next day he was in HDU - was there for 3 days (should have been two but there was no bed in a ward and he was home on the Friday, walking out of the ward and to a waiting taxi. In his case and most of the patients in the hospital heart unit seemed they wanted them awake, sitting up and walking as soon as possible - hope this helps ?

Red_Baron profile image
Red_Baron in reply toros69

That’s really helpful. Thank you

Nic25 profile image
Nic25

Hi Red Baron. I had an AVR and aneurysm repair in December. Went down to theatre first thing (about 7.30am), woke up about 7-8pm in ICU. It was end of visiting hours but the brilliant team allowed my wife to stay so she could be there for when I awoke. But it is often different for everyone. Apparently although I have no recollection a lady in the bed beside me was "out" for much longer and when back on the ward one chap had been knocked out for a couple of days becaise he'd had a reaction to the fentanyl pain killer they use, though I believe that is pretty rare. Hope that helps but if you're worried do speak to the surgical team about your concerns. And good luck! Hope it goes well and we'll all here be gunning for you. Nic x

Recoder_Bill profile image
Recoder_Bill

Hi Red_Baron,

As others have said, “It depends …”, I can only tell you what happened to me. First, let me say I’ve had a lot of surgery over the years, so I may ramble a bit but I hope it will all make sense.

I was diagnosed with a pseudo thoracic aortic aneurysm in October 2018.

I already had a mechanical aortic valve implanted in 2005. To treat the pseudo aneurysm, at the beginning of November 2018, I had the existing mechanical aortic valve, the aortic root and the hemi-arch replaced. The new mechanical valve was integral to the synthetic aortic root which was made of Dacron and the hemi-arch was made of Dacron also.

As you can imagine this was major surgery. I was in the operating theatre for over 12 hours but then they were replacing the hemi-arch as well as the aortic root so it might well be more than the 4-5 hours you have mentioned. I went down to the theatre about 09:00hrs and came out about 21:15 hours. At least a proportion of that time was spent in Deep Hypothermic Cardiac Arrest (DHCA) which meant they had to chill my body, especially the brain, and then warm me up again afterward, a slow process.

Then I was transferred to the Post Operative Critical Care Unit (POCCU) and then on to the High Dependency Unit (HDU) ... they didn't have general wards, only HDUs so I was there until I went home about 10 days later … I might have gone to some intermediary CCU after POCCU, I can’t remember … my partner was with me all the way but she’s not around at the moment to ask.

I was in POCCU for one day I think and during that time I don’t remember a thing … well, I have a vague recollection that the surgeon came and chatted to me for a bit but I have no clear memory. My partner told me when she first saw me I was still intubated and had tubes and wires hanging out everywhere and was not conscious. These appendages were rapidly reduced to a minimum as I came back into the real world.

So to answer your question, I guess I “woke up” after a day and half’ish but to be fair it was a progressive experience and so one has to ask “At what point is one fully awake?” Be warned, you may get hallucinations but personally I found that fun if a bit scary at the time.

As others have said the medical staff are very keen to get you up, walking and out of there as soon as you are able to sustain yourself; the longer you stay in hospital the greater the chances are of picking up some bug and you don’t want that.

I don’t know how much detail you want to know, some people prefer to know as little as possible and just get through it, whereas I need to know as much as possible.

Hope the above helps and that all goes well.

Where are you having the surgery done? I was at the Liverpool Heart and Chest Hospital under the care of Mr. Mark Field, a great guy … and his team too.

Regards,

Phil.

Red_Baron profile image
Red_Baron in reply toRecoder_Bill

Thanks Phil - the op will be at Harefield. I suppose I want to know as much detail as possible but also don’t (if that makes sense) and just want them to get on and do it. Sounds like you were well taken care of. All the best

Queenofthehive profile image
Queenofthehive

I had an Aortic arch repair and an aortic valve repair in October. I had my operation on the Friday morning and I did not "wake up" until the Monday/Tuesday (can't remember exactly when). Your experience, however, will be different to mine as mine was an emergency operation to mend an aortic dissection and there were post-operative complications (respiratory failure and a kidney injury).

What you need to be prepared for is that you won't know beforehand, and they won't know, how long it is until you wake up. It will depend on what happens during the operation, whether you have post-operative complications and how you respond when they start to wake you up.

Also you need to be prepared for what waking up means. It is worth finding out what kind of pain medication they will use and whether there are any side effects. I had fentanyl and it can lead to hallucinations. Therefore you will be semi-conscious at first but not fully awake and you may not remember much of your time in ICU afterwards. It really isn't like you see it in the movies!!

However, once you are wake, the ICU staff will have you up and about in no time. As soon as I was able, the ICU physio was there getting me to first stand up and then take a short walk.

As others have said, if you have any questions ask your surgical team and read the guides they give you on what to expect after surgery. Good luck!!

Red_Baron profile image
Red_Baron in reply toQueenofthehive

Thanks - really helpful....I’ll watch out for the hallucinations!

Ianc2 profile image
Ianc2

Have a chat with the anaesthetist regarding his thoughts on hallucinations. I had some rather epic results the moment I tried to sleep, to the point where I did not want to close my eyes, and my recovery was delayed accordingly, until they decide to knock me out and I was very pleased to wake up and find that they had gone.

Red_Baron profile image
Red_Baron in reply toIanc2

Thanks - I will

Fortepiano profile image
Fortepiano

With my valve replacement I was out for about 21 hours; last year I had my sternal fixtures removed and was anaesthetised for about 30 minutes. In both cases I went to sleep and then woke up, and certainly couldn't have told you the difference in time, though obviously I felt very different after a major and a very minor op!

I agree with Queenofthehive - you are only half awake at first after cardiac surgery. My husband says I would go to sleep in mid-sentence and I don't really remember ICU. Just relax and go with the flow.

All the best

Red_Baron profile image
Red_Baron in reply toFortepiano

Thanks for this. It’s really helpful. Hope you’re recovering well

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