Open Heart Surgery: Recovery

Recovery from open heart surgery, both in the hospital and beyond, is a long, involved process. The duration depends on the specific medical issue being treated, with a minimum of six weeks to be expected. It’s important to closely follow any instructions you get and participate actively with rehabilitation. Be aware of mood and emotional symptoms that may need to be addressed.

Surgery Follow-Up

Since open heart surgery is an approach to several different treatments—rather than a singular surgery—recovery times can vary. It is used in surgeries to correct a variety of heart conditions, including heart failure, heart attack, coronary artery disease (CAD), and atrial fibrillation (AFib).

In most cases, you will leave the hospital after one to three days, though this can be extended. You may be cleared to leave when you’re able to breathe without assistance, pain can be managed without IV medicine, you can walk to the bathroom, and lab results and other assessments show stable results.

During your recovery, your healthcare providers will want to ensure the surgery site is healing properly while monitoring heart function. Follow-up appointments are therefore an essential part of this process. Here’s a quick breakdown of a typical schedule:

• Initial appointment: At discharge, you’ll be asked to schedule the first follow-up appointment within three to seven days. A healthcare provider or certified nurse practitioner (CNP) will make sure there are no signs of infection while checking heart rate, blood pressure, and other aspects of cardiac function.  
• Additional follow-up: Around six to eight weeks, you’ll be back in for a check on progress. As before, the focus is to monitor how well your heart is working and assess whether additional steps will be needed. The medical team will also advise you about the kinds of activities you can and cannot do safely.
• Long-term monitoring: Based on your progress, additional follow-up appointments will be necessary. You’ll need to see your healthcare provider at least once a year for continued evaluation.

Cardiac Rehabilitation

Oftentimes, an aspect of open-heart surgery recovery is cardiac rehabilitation, which involves developing exercise and dietary habits to boost outcomes. Typically, this work occurs in four phases:

• Phase 1: While you’re still in the hospital, and once you’ve initially recovered, you’ll be asked to walk around or climb stairs while supervised by staff. Here, too, you’ll receive important patient education.
• Phase 2: This occurs in an outpatient facility and starts within weeks two and six following surgery. Typically, these hour-long sessions occur three or more times a week for 12 weeks. The focus is to increase your heart’s functional capacity through exercise, while also educating about medications, exercise, and dietary changes. 
• Phase 3: This phase is essentially a continuation of phase 2, with the focus of instilling an ongoing exercise program, ensuring good dietary habits, and talking about other lifestyle factors that can impact heart health. Depending on your case, healthcare providers may recommend you skip phase 2 and go straight to 3.
• Phase 4: The final phase of rehabilitation is focused on maintaining a solid exercise regimen, keeping up with good dietary habits, and ensuring a healthy, positive lifestyle.

Recovery Timeline

While there will be some variation based on the specific treatment—as well as your individual case—recovery from open heart surgery tends to follow a consistent timeline. In the weeks and months following the operation, you’ll start regaining the ability to perform daily and recreational activities. Here’s a quick outline of what you can expect:

The First Six Weeks

In this time, you’ll be able to start light exercise like walking or cycling, light gardening, and climbing stairs. Do not try to lift items that are more than 10 pounds. Be careful and mindful. Take regular rest breaks if you’re taking part in activity. Wait at least 30 minutes after eating before you take a walk or cycle.

You can shower but should hold off on baths until the incision(s) have healed. Unless you hear otherwise from your practitioner, you shouldn’t drive during this time (typically, not until after about four weeks).

With your healthcare provider’s approval, you may return to work in a limited capacity at about four weeks, though many require at least six weeks.

Six Weeks to Three Months

After six weeks, you’ll be largely recovered and you’ll then be able to resume heavier housework and gardening, business or recreational travel, aerobic exercises without weights, driving, and dog walking.

The expectation, more or less, is that you can start moving towards pre-operation levels of activity. That said, don’t push it and seek out your healthcare provider’s clearance if you want to try anything more strenuous or new.

Three Months and Beyond

After three months, you’ll be able to engage in more rigorous and heavier exercise and activity. As always, be very mindful of how you’re feeling and try not to overdo it.

At this point, you’ll be able to participate in a full range of workouts and sports, you can take on more strenuous home and garden projects (such as shoveling snow, lifting heavy bags of soil, and scrubbing the floor).

Coping with Recovery

As with any major medical treatment, many people will feel an emotional fallout after open heart surgery. It’s not uncommon for those in recovery to experience anxiety, sadness, excessive fatigue, inability to sleep, and reduced appetite.

This is especially the case after you’ve returned home from the hospital, where, for many, depression can set in. In most cases, these feelings will subside as you recover in the first couple months; however, for others, the feelings can be way more intense.

What can you do if you’re struggling following open-heart surgery? Here are some quick tips:

• Talk to your healthcare provider. Let your medical team know if you’ve lost interest in favored activities, are feeling empty inside, or have become despondent about recovery, or other emotional responses or symptoms of depression. They may be able to refer you to other professionals or prescribe drugs that can help with these issues.
• Set up a routine. Throughout recovery, it helps to establish a regular schedule. Try ensuring that you get up at the same time every day, stay regular with meals, and see if you can’t incorporate a daily fitness regimen (so long as it’s safe and within the bounds of your stage of recovery).
• Seek out family/friend support. The company of friends and family can also be a source of comfort while you’re in recovery. In the run-up to your surgery, make sure to let family and friends know what you’ll be going through. Emphasize that this may be a difficult time for you and that you may need them to advocate for you or support you.
• Set realistic expectations. Disappointment in your own progress can be toxic as you’re recovering. Educate yourself about the process of recovery, and, based on that, to be realistic about what you can expect. When you hit a milestone of recovery, no matter how big or small, do something nice for yourself to celebrate.
• Consider counseling. If you’re finding depression, sadness, or other emotional and psychological symptoms persist despite your own efforts, consider getting professional help. Many therapists and psychiatrists specialize specifically in those who’ve undergone medical treatment and can help you combat the fallout.  

Wound Care

Regardless of the specific surgery indicated, you may have one or more incisions healing in the time following treatment. Ensuring these wounds heal without infection is absolutely integral to proper recovery. There are several things you should do to prevent complications:

• Don't remove bandages for two days. Unless the wound is oozing, Steri-strips and bandages should be left on and kept dry for the first two days. Let your practitioner know if there are discharges from the incision site.
• Bathe gently. After returning home from the hospital, and as long as there is no discharge, taking a shower is safe so long as you use mild soap. Baths aren't advised while the wounds are healing. Be very gentle with the incisions, don’t scrub, and pat them dry gently.
• Perform daily checks, Throughout the course of healing, keep an eye on the incisions for signs of infection every day. Contact your healthcare provider immediately if there’s increased tenderness or pain, redness or swelling, or fluid discharge around the incision. In addition, fever may also be a sign of infection.
• Protect from the sun. For up to a year following the surgery, make sure to protect the incision and/or scar from direct sunlight. Make sure to get your practitioner’s OK before applying sunscreen as some may not be good to apply on a wound.
• Avoid some products. As your healthcare provider will tell you, don’t apply creams, oils, lotions, or powders to the wound site until you have their approval.

Notably, if open heart surgery has been used to perform coronary artery bypass graft (CABG), a vein from your leg may be harvested for use in the repair. In these cases, keep in mind that your leg will also have an incision. You’ll want to keep an eye on progress there, too. Here’s a quick breakdown of what you can do to prevent issues:

• Don’t cross your legs
• Avoid staying seated or standing for long periods of time
• Elevate the affected leg when sitting
• Monitor for leg swelling
• If indicated, wear compression stockings when not sleeping

A Word From Verywell

While the road back regular life following an open-heart surgery may be lengthy and can be difficult, it’s one that very many people have traveled successfully. As intense as the prospect of heart surgery can be, know that, from initial consultation to final follow-up, you won’t be alone.

Alongside dedicated specialists and medical staff, don’t forget that you also have the support of loved ones and friends. In this sense, you’ll be just one part of a concerted, collective effort aimed at getting you back to health and wellness. Given what’s at stake, it’ll certainly be worth it.