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Heart surgery

Preparing for your heart operation

Once your doctors have decided that a heart operation is the best treatment for you, you should use the waiting time to increase your overall level of fitness. Increased fitness will help you to recover more quickly after surgery.

 

The three main things you can do are:

  • Quit smoking

  • Control your weight

  • Visit your dentist  



Quit smoking

Smoking is one of the main causes of coronary artery disease and it damages your lungs. Patients with strong, healthy lungs tend to recover from surgery much more quickly than those with lung damage. Many patients find that having a heart operation gives them extra motivation to stop smoking. There is plenty of support available to help you give up for good. Please talk to your GP, pharmacist or call SMOKEFREE on 0800 022 4 332.



Control your weight

Patients who are overweight are more likely to have complications after their operation and to recover more slowly from surgery. The best way to find out if you are overweight is to calculate your body mass index (BMI). You can discuss this with your GP who can also refer you to a local dietitian if needed.  


Read more information about nutrition and healthy eating.


Visit your dentist

All patients undergoing heart surgery should see a dentist prior to their surgery. This is especially important if you are having surgery on one of your heart valves because of the risk of developing bacterial endocarditis.

 

Bacterial endocarditis is a potentially serious condition in which the lining of the heart (endocardium) becomes infected and can stop the heart from working properly. People with diseased valves, replaced heart valves or a congenital heart condition are particularly at risk of this condition because of the damaged areas collecting bacteria.

 

There are many ways that bacteria can enter the body; one is though the gums where there are many bacteria present and the skin is fragile and often broken during routine dental care.

 

This condition is relatively rare and the risk of developing it can be lowered by taking good care of your teeth and gums. Clean your mouth and teeth carefully and visit your dentist regularly. 

 

If you have any queries about dental care or about your heart surgery please contact our 24-hour nurse advice line on 020 7352 8121 bleep 7043. Alternatively, your dentist should be able to advise you and answer any questions about your dental care.  



Pre-admission clinic

Why are you being invited to the pre-admission clinic?

This clinic is an essential part of your programme of care for cardiac surgery as it enables the team to assess your current health status. At this stage, any problems that may be detected can be resolved quickly either by treatment or by carrying out further investigations. This ensures that you are fit enough to have the procedure carried out and also prevents unnecessary delays and cancellations to your surgery. 


What happens on the day?

You will come in for a consultation with the nurse who will take note of your previous medical history, perform a clinical examination, take some blood tests and arrange for you to have any other necessary tests. 


Where are these investigations carried out?

All the investigations are conducted within the hospital and we endeavour to have them all completed on the same day. We advise that you are prepared to be here for the majority of the day and therefore avoid making other appointments. You should also bring some lunch with you or alternatively there are restaurant and coffee shop facilities available at the hospital.


What you should do in preparation for the clinic?

On the day of the clinic you should eat and drink as normal and, most importantly, continue to take your morning medication as prescribed. Please note that for this appointment you will not be required to stay in the hospital overnight. 


What other tests will I need at pre-admission?

  • Electrocardiogram (ECG): this a simple painless test which measures the electrical activity (rate and rhythm) of your heart using sticky electrodes placed on your chest
  • Blood tests: this will help us to assess various areas of your health, such as liver and kidney function, as well as testing for underlying conditions such as diabetes
  • Standard chest X-ray: this will only take a few minutes and lets us look at your lungs as well as the size and shape of your heart
  • Echocardiogram: this test uses sound waves to build up a moving picture of your heart. You will be asked to lie on your side and have some cold jelly on your chest. This is similar to the scan used in pregnancy and is extremely safe and painless. It allows us to learn a lot about the chambers and valves of your heart
  • Carotid Doppler: this is an ultrasound scan of the blood vessels in your neck. If you’ve had a stroke in the past or have heart disease affecting the uppermost vessel of your heart, you may need this test
  • Lung function testing: if you are a smoker or have given up in the last three years, or if you have a chronic lung problem such as asthma or chronic obstructive pulmonary disease (COPD), you will need to have this test to see how well your lungs are working. You will be asked to breath into a mouthpiece, and sometimes a capillary blood test is taken from a needle prick to your ear lobe
  • CT scan / MRI: these tests allow us to look at the structure of your heart and its surroundings in great detail. Your doctor or nurse will explain if you need one of these special tests and why
  • MRSA swabs: you will be swabbed by your clinic nurse for bacteria called MRSA (meticillin-resistant staphylococcus aureusis). This is something that lives harmlessly on some people but can cause problems when you come into hospital. You will have your nose, throat, armpit area and your groin swabbed, and if you are positive for MRSA you will be given treatment to clear this before your surgery
  • Urine testing: your nurse will ask for a urine sample and will test this for a urinary tract infection. This will need treating with antibiotics if found to be positive in clinic


Please bring with you a list of ALL medication you are currently taking and a completed registration form. Read more on bringing in your medicines.


Please aim to arrive 15 minutes prior to your appointment as your tests are organised at set times around your slot. However, if you are running late, it is important that you contact the nurse by calling the 24-hour nurse helpline.



Surgical information seminars - Royal Brompton

All patients on the waiting list for cardiac surgery are invited to optional surgical information seminars. These are held monthly at Royal Brompton Hospital and every two to three months in Alton. The aim of the seminars is to give you an idea of what to expect before and after the operation.


Patients will spend a morning with the team at the hospital and meet the clinicians in charge of their care, as well as other people who are on the same journey. We have a number of speakers, an educational film, and plenty of opportunities to ask questions and address patients’ individual concerns. 


Topics covered at the seminar include:

  • The patient journey through cardiac surgery
  • Explanation and discussion of pre- and postoperative care
  • Physiotherapy and physical exercise 
  • Resuming your lifestyle after cardiac surgery
  • Diet and nutrition
  • Pain control
  • Infection control and wound care
  • Discussion about how the heart works and heart operations
  • Discussions around discharge arrangements and rehabilitation after surgery


A complimentary light lunch is provided at the seminar. Other members of the multidisciplinary team, such as physiotherapists and occupational therapists, will also attend to give short presentations and answer any specific questions concerning their area of expertise.


If you would like to attend a surgical information seminar, please contact Shanaz Ahmad by calling 020 7352 8121 ext 2138 or 07912 093018 (mobile), or by email: s.ahmad@rbht.nhs.uk.



Fit for surgery appointments - Royal Brompton

The cardiac homecare team will contact some patients to arrange a "fit for surgery" appointment either at the hospital or in your own home.


Read more about Royal Brompton's fit for surgery programme.



 

Royal Brompton

Sydney Street,
London SW3 6NP
Tel: +44 (0)20 7352 8121

Harefield

Contact

24-hour nurse advice line: 020 7352 8121 Bleep: 7043

Read more about the adult cardiac nursing teams at Royal Brompton and Harefield hospitals