Cardiovascular Surgery Department | Cleveland Clinic

Posted: Published on August 6th, 2018

This post was added by Dr P. Richardson

AppointmentsWhat to Expect

Patients come from across the country and around the globe to the Miller Family Heart and Vascular Institute for heart surgery. We want to make the process as easy as possible for you. The surgical review is a three step process.

At every step in the process we are here to answer your questions.

Toll-free877.843.2781 (877-8Heart1)

Use our secure online form to submit an appointment request 24/7. We will receive it and follow-up with you as soon as possible.

Mon. - Fri., 8 a.m. - 5 p.m. (ET):toll-free877.843.2781 (877-8Heart1)

At all other times call Patient Access Services locally 216.444.8302 or toll-free 800.553.5056.

Go to Desk J4-1, 9500 Euclid Avenue, Cleveland, Ohio.

Cleveland Clinic Heart and Vascular Institute physicians, surgeons, and researchers continue to research into new treatments and therapies with the goal of improving patient care and outcomes into the future.

Patients who choose to come to Miller Family Heart & Vascular Institute for heart surgery can expect to be operated on by the best surgeons and cared for by the finest nurses and medical staff in the world.

The Heart Surgery Program at Cleveland Clinic has been fine tuned from years of experience with patients and their families. We are proud to provide a program that meets the patient's and family's needs from our first meeting to discharge home.

This is a general description of the heart surgery program. More specific instructions are included in the information you will receive during your visit, hospital stay and before you go home. Please feel free to ask questions to our health care team at any time during your stay.

About 2,000 thoracic and cardiovascular patients are scheduled through our TCI program each year. This means patients come to Cleveland Clinic a few days before surgery as an outpatient to complete the pre-surgery evaluation and receive information to prepare for surgery. The TCI program allows patients to spend more time with their families instead of being admitted to the hospital several days before surgery.

The TCI Center is located at the Thoracic & Cardiovascular Surgery Outpatient Center in J4 - 1.

Patients come into the TCI Center for a one or two-day evaluation process that includes meeting with:

The TCI NurseThe TCI nurse works with your surgeon. He or she will perform a limited exam, review your records and provide you with instructions for your surgery. Instructions include:

The Cardiothoracic AnesthesiologistYou will meet one of our Cardiothoracic Anesthesiologists who is specially trained to administer anesthesia for cardiac surgery patients.

Your CardiologistYou will meet with a cardiologist who will perform a preoperative cardiac exam, answer your questions and review your medications.

The cardiologist will review your medical records and test results. He or she may order additional tests, if necessary. These tests may include a cardiac catheterization, echocardiogram, electrocardiogram, chest x-ray, blood-work or urinalysis.

Your SurgeonEvery attempt is made for you to meet your surgeon on the day of your preoperative visit. If this is not possible, we will schedule a more convenient time for you to meet the surgeon and discuss your surgery.

Where to check inThe night before surgery you will be told what time and where to report for surgery. Please limit the number of family members. You and your family will be asked to register with the receptionist at Desk J1 - 2, Miller Pavilion Surgical Center and Family Waiting area (in the Miller Family Pavilion, 1st Floor). Look for "Red Coat" staff members if you need assistance with directions - or ask any Cleveland Clinic employee - we are here to help. Your Direct Route is a website that you can access from your cell phone to help you with getting to the Cleveland Clinic - and around the campus.

Surgery takes place on the fourth floor of the J building in state-of-the-art operating rooms that are specially designed for heart surgery. The operating room nurses and cardiothoracic anesthesia teams work with your surgeon to ensure your safety and comfort during surgery.

Waiting During SurgeryWhile you are in surgery, your family waits in the Miller Pavilion Surgical Center and Family Waiting area. Your family will receive a communication device/pager so we can contact them when surgery updates are available. Please wait in the Surgical Center and Family Waiting area until you are called to attend the Family ICU Class. The CVICU Nurse Coordinator will provide your family with additional instructions about what to expect during the day.

Family ICU ClassThe Family ICU Class is held on the day of surgery to provide your family with important information about what to expect the day of surgery. Your family will also receive information about visiting in the Cardiovascular Intensive Care Unit (CVICU). It is a good time to ask questions. Classes are twice daily, usually held at about 10 a.m. and 3 p.m., Mondays through Fridays in room Q1-204C located just off the Great Hall in the Glickman Building (down the hall from the waiting area). Classes are taught by the Cardiovascular ICU Nurse Coordinators. These CVICU Nurse Coordinators are also available to facilitate communication between families and members of the health care team.

Family SpokespersonRemember to designate one individual as the family spokesperson to provide an efficient flow of consistent information and to ensure patient confidentiality.

Receiving Updates about the Patient's SurgeryYour family will receive an update on their pager notifying them that the major portion of the cardiac procedure has been started.

Please note the amount of time it takes to perform the surgery can vary greatly. Emergency situations and unexpected findings may result in long wait times. We also hope your family will understand that delays result from our commitment to providing each patient with the best care. Please be prepared for unexpected delays by bringing reading or writing materials, small games or audio-players to occupy yourself while waiting. We will do our best to make sure that you and your family are as comfortable as possible during your stay.

The waiting area is located near the Center for Consumer Health Information, located at our Lyndhurst Campus, 1950 Richmond Road TR401, Lyndhurst, Ohio 44124. Here you will find educational resources and public computers to research health information, access MyChart, and other health related websites.

After surgery on the heart is complete, the surgeon will update the family. Please listen carefully and take notes as you talk to the surgeon. Have a list of questions ready to ask the surgeon.

After speaking with the surgeon, it will be about 2 hours before you can check in to visit the patient. During this time, the patient will still be in the operating room for the closing process. Then the patient will be transferred to the Cardiovascular Intensive Care Unit (CVICU), where it may take about 1 additional hour for the admission and recovery process. Your surgeon will tell your family what CVICU you will be in.

Your family will report to either the J5 or J6 CVICU Family Waiting areas 2 hours after speaking with the surgeon. Your family will be asked to check in with the receptionist and let him or her know that this is your first visit.

A receptionist is present in the Lounge from 9 a.m. - 9:30 p.m. Monday-Friday, and 9 a.m. - 5 p.m. Saturday, 9 a.m. - 5:30 p.m.Sunday. If you visit during these hours and the receptionist is not in, please wait. If you have been waiting longer than 10 minutes, please use the beige wall phone to call the unit. The phone numbers for each unit are posted next to the phone.

Cardiovascular Intensive Care Unit (CVICU) Immediately after your surgery, you will be cared for by a team of specially trained nurses in the Cardiovascular Intensive Care Unit (CVICU). Their goal is to help you recover as quickly and safely as possible. Along with your surgeon, members of the cardiothoracic anesthesia and surgical teams who took care of you in the operating room will continue to follow your progress in the CVICU.

You will receive more information about the CVICU and what to expect in your heart surgery binder.

Patients recover on a post-cardiovascular surgery nursing floor (also called a telemetry unit or step-down unit). There are six, 24-bed Post-Operative Units located on the 5th and 6th floor. Each patient room is private single occupancy.

During this time, you will begin your recovery phase. You will be encouraged to do as much as you can for yourself to assist in regaining strength and independence.

The balance of pain control and increasing activity will help you recover at a faster pace. More information on pain control after heart surgery.

Your health care team includes doctors, nurses and other healthcare professionals who specialize in your condition and treatment. The team will follow your progress and help you recover as quickly and safely as possible.

Please refer to your binder for recovery information during your hospital stay. You will receive a patient recovery plan that will show you what to expect as you progress.

Patients and family members are provided many resources for support and education on the nursing unit:

Cardiovascular Surgery ClassesThere are three classes designed to help patients and families learn how to prepare to travel home, how to progress activity and recovery, and how to live a healthy lifestyle after heart surgery. These are great opportunities to answer questions and Days and times of classes are listed in your binder.

Miller Family Heart & Vascular Institute BinderYou and your family members are given a binder (notebook) before surgery. This binder has tabs that detail what to expect before surgery, during your hospital stay, hospital recovery, and recovery at home. You and your family will continue to review the information in the binder that was given to you before surgery. You will review discharge instructions, medication information, and a diagram of your surgery with your cardiologist and nurse before you go home. You will continue to use this binder at home to answer your questions and guide your recovery.

Health Education VideosYour room will have a large flat-screen color television. A complete directory of all available health education videos is available in your room. Ask your nurse for a TV guide if you need one. Health education videos are available on demand. You will receive information in your binder on how to request videos to view. Some videos will be suggested for your safety and patient education. Cardiovascular Channel 33 is a TV channel with more than 70 videos about heart and blood vessel diseases, treatments prevention and disease management. For more information call 216.444.2657.

Heart Surgery Videos at HomeAll patients receive directions on how to access heart surgery recovery videos on your home computer. These videos review discharge instructions and lifestyle issues after heart surgery. You and your family may review the videos at home; they review education received during your hospital stay.

We have also created a series of videos addressing common questions or concerns that people often ask once they return home.

Cardiac RehabilitationThe cardiac rehabilitation staff will discuss activity guidelines for you to follow after going home. The Home Activity Class will present guidelines for activity progression and management of activity-related symptoms. Patients and family members should attend. Look in your binder for days, times and locations. The Preventive Cardiology and Rehabilitation Program is available for you to attend as an outpatient after you are discharged from the hospital.

Computer AccessThe use of wireless computer devices IS permitted in public locations and patient areas in the Miller Pavilion. In addition, there are public computers located in the family waiting lounges and in the Patient & Family Health Education Center on the first floor. The Miller Family Heart & Vascular Institute website is a helpful resource for you and your family before and after your hospital stay.

Visiting hours on the nursing unit are unrestricted. However, it is important to take into consideration the patient's need for rest.

We appreciate your understanding and cooperation in helping us provide the best care for our patients. The following guidelines will help the patient and you during visitation:

To protect patients safety and privacy, the following are not permitted in the CVICU:

Patients always come first at Cleveland Clinic. In the CVICU, there are times when visitation may need to be postponed or shortened so we can continue to keep the patients' needs and safety our number one concern. You will be asked to leave the patient's room and wait in the Family Lounge when patient procedures are being performed and at other times when the doctor or other health care team members feel that visitation is not in the patient's best interest.

Your family member may have an endotracheal tube (breathing tube) in his or her throat, which is connected to a respirator to assist breathing. While it is in place, the patient will not be able to talk or swallow. You are encouraged to ask questions that only require a yes or no response, so the patient can shake or nod in reply. The endotracheal tube will be removed when the patient is fully awake and breathing independently. Once the endotracheal tube is removed, the patient will be able to talk. Keep in mind that the patient may be groggy and may not be able to communicate with you.

The medical equipment used in the CVICU and surgical units has alarm settings to alert caregivers to possible changes in a patients condition. These alarms are very sensitive to the patients movements and coughing, and may not reflect any real problem.

Don't forget to take care of yourself! We know how difficult it is to have a loved one in the hospital, and how uncertain things may seem. During these times, family members tend to ignore their own needs, and may even be afraid to leave the hospital. But, it is important that you take care of yourself. Eating properly, getting rest and taking care of your personal needs are important. We encourage you to talk about your feelings with our health care team - we will do our best to help you.

The surgical team will determine when the patient will be transferred from the CVICU to a step-down nursing unit.

If you have any questions or need assistance, please call the CVICU Nurse Coordinator by dialing 63272 on any beige house phone.

Once the patient has been transferred from the CVICU to a step-down nursing unit, please keep the following tips in mind:

Your cardiologist and surgical team will determine when you can go home. Your expected discharge date will be posted in your room.

The average hospital stay after surgery is about 5-6 days, depending on the type of procedure that was performed and your rate of recovery. Your health care team will follow your progress and help you recover as quickly as possible.

Once a discharge date has been set, you can make travel arrangements. If you are traveling home by plane, we recommend that you make sure your ticket is refundable should your discharge date change.

On the day of discharge, please have your family member arrive well before 11 a.m. to participate in your discharge planning and home-going instructions. If this is not possible, you may go to the Discharge Lounge after you are discharged from the unit.

You will have an appointment in the Post-Op Clinic 3-5 days after you leave the hospital. If you live outside of the Cleveland area, please plan to spend a few nights in a local hotel so you can be seen in the clinic. The appointment is very important. We will make sure your recovery is going well and that your medications are correct. If you are traveling by plane, please plan to fly home about 14 days after your day of surgery.

Learn how to make travel arrangements to Cleveland Clinic after heart surgery.

When you travel home after surgery:

Your health care team is available to answer your questions. Keep a paper and pencil nearby and write your questions down. Phone numbers are provided in your binder to assist you with further questions when you return home.

For many people after surgery, a cardiac rehabilitation program provides an excellent opportunity to continue the recovery you began in the hospital:

Phase I - Cardiac Health Rehabilitation ProgramExercise specialists see the patient in the hospital to assess activity needs and begin activity progression. Home activity instructions are given to encourage progressive activity. Cardiac Rehabilitation Activity classes are also available to help answer questions by the patient and family.

Phase II - Preventive Cardiology and Rehabilitation ProgramBuilds on what you learned during Phase I: continue a regular exercise program, learn about heart disease, and learn strategies to change your lifestyle to prevent further progression of your disease. It also provides support and guidance as you recover from your surgery. Phase II cardiac rehabilitation is covered by most insurance companies.

To learn about programs in the Cleveland area:

For programs outside the Cleveland area:

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Cardiovascular Surgery Department | Cleveland Clinic

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