About heart surgery

A heart operation is needed to treat problems associated with heart disease, for fixing heart problems that you may have been born with, or for fixing damage done to the heart or vessels. It also includes heart transplantation.

Before my heart surgery

Pre-Admission Visit

You will have an appointment at the Pre-Admission Clinic 1 to 3 weeks before your operation. This visit is very important to assess your health and help you prepare for your operation and recovery. Plan for your visit to take 2–5 hours. On the day of your pre-admission visit, take your medications and eat as usual, unless you were given other instructions.

Pre-Admission Clinic at Toronto General Hospital
Eaton Building – Ground Floor, Room 400

What should I bring to my pre-admission appointment?

  • Your health card (OHIP card). If you do not have an OHIP card, please bring another form of government-issued photo ID, such as a driver's license or passport.
  • Any other insurance cards. You will need the policy number of your extended health insurance, if you have any.
  • Your spouse/partner, a trusted friend or family member (to offer you support and be a second set of ears).
  • All the medications you take in their original containers. This includes prescription medications, over-the-counter medicines, vitamins, supplements and herbal or natural products.
  • A copy of your power of attorney for personal care and/or advanced directives.
  • A list of any questions that you may have about the operation and recovery.
  • The name or phone number of your pharmacy, as well as any medical specialists that you have seen in the past 3 years.
  • If you have had a cardiac stress test, echocardiogram and/or a pulmonary function test in the past 3 years, it would be helpful to bring a copy of the final report with you to this appointment.

What happens during my pre-admission visit?

  • You will have blood tests and routine skin swabs. The swabs are taken from your nose and other areas of your body to check for germs that can cause infections.
  • You may also need an electrocardiogram (ECG) to check your heart and a chest x-ray to check your lungs.
  • You will meet many health care providers during your pre-admission visit. Please feel free to ask them any questions that you may have.
  • A pre-admission nurse will review your health history and give you information to prepare you for your operation, including directions for cleaning your skin, eating before your operation, taking your medications and pain management.
  • A pharmacist will review your medications.

Depending on your needs, you may also meet:

  • An anesthetist who will review your health history, discuss your anesthetic plan and pain relief after your operation.
  • A member of the medicine team, if you have other complex health problems.
Preparing for my heart surgery


  1. DO NOT drink alcohol for 24 hours before your surgery.
  2. If you smoke, DO NOT do so for 24 hours before your surgery.
  3. Remove all nail polish and body piercings.
  4. You must have a shower with soap and water to clean your skin the night before and the morning of your surgery to reduce the chance of infection after your surgery.
  5. Eat light dinner the evening before your surgery. DO NOT eat fried foods.
  6. DO NOT eat solid food after midnight the night before your surgery.

Stop smoking before your surgery: learn how smoking and tobacco can affect your recovery after surgery, and how quitting can improve your health.


Arrive 2 hours before your scheduled operation time.

Surgical Admission Unit (SAU) at Toronto General Hospital
Peter Munk Building – 2nd Floor

All hospital entrances are open by 6:00 am. However, Elizabeth St. and University Ave. are easiest to access.

After my heart surgery

After your surgery, will be taken to the Cardiovascular Intensive Care Unit (CVICU).

What can I expect to have on my body?

You will be attached to some or all of these machines and tubes:

Incisions, tubes or drainsWhat to expect
heart monitor illustration Heart monitor: We use a machine to watch your heart rate. We put electrodes (small round sticky pads) on your chest. We attach wires to the electrodes and connect the wires to the heart monitor.
Breathing Tube: We put a breathing tube through your mouth and into your airway. The breathing tube is connected to a breathing machine called a ventilator. The ventilator breathes for you during surgery and part of the time that you are in the CVICU.
Oximeter: This is a machine that helps us check the oxygen in your blood. We put a probe on your finger.
chest tube illustration Chest drainage tubes: Your surgeon places 2 or more chest tubes near your chest incision (cut) to remove fluid, blood and air that build up in your chest after surgery.
arterial line illustration Arterial line: This line goes into an artery in your wrist during surgery. It looks like an IV but we use it to check your blood pressure and to get blood samples.
IV illustration Intravenous (IV): You have at least one IV in your arm and another one in the side of your neck.
urinary catheter illustration Bladder catheter: We put a small tube into your bladder to collect and measure your urine (pee).
Back at home

Recovery from a heart operation is an individual experience. Everyone will recover at their own pace. Your daily routines may be changed for some time. After a heart operation, patients often experience physical sensations or feelings that decrease as they recover. We have listed common feelings and some ideas that will help.

FeelingHow to help
Weakness, nausea and poor concentration

In general, you may feel weakness and fatigue, nausea and lack of appetite and may experience poor concentration.

What to do:

  • Listen to your body. Balance your activities
  • Be patient. Your energy level will improve as your red blood cell level and strength increase.
  • Talk to staff about how you feel.
  • Gradually increase activities.


  • Overexert yourself. Your body will give you signs that you are doing too much.
Faster heart rate

You may feel a faster heartbeat than usual. Occasionally pounding or skipping a beat.

What to do:

  • Stop and rest if your heart feels as if it is racing and see your family doctor or nurse practitioner.
Incision discomfort

You may feel discomfort, soreness, and aching in and around your incisions or ribcage, between the shoulder blades, the back of your neck, or your legs or overall stiffness.
What to do:

  • Take pain medication to ease your discomfort. Your walking and other activities will be easier to do if you feel more comfortable.
  • Try to keep good posture.
  • Change positions often (sitting, standing, walking).
  • Make sure you get enough exercise.


  • Lie in one position for too long
Incision numbness

You may feel numbness and burning sensations caused by damage to nerves during your operation, slight redness, swelling, or bruising and discoloration along incision lines, swelling or a lump at the top of the chest incision and/or itching, numbness, and burning in and around incisions.

What to do:

  • Watch for signs of infection.
  • Wash incisions with mild soap and water.
  • Use a clean, cool cloth on your incision to help relieve itchiness.


  • Apply creams, ointments, lotions or powder to incisions for the first few weeks.
Leg swelling

If you had a bypass, you may experience swelling of your legs, especially the foot and ankle area where the vein was removed. This will improve as the other veins in the leg build up to take over for the one that was removed.

What to do:

  • Elevate your legs above hip level when sitting or lie down to help relieve swelling.
  • Continue your walking program.


  • Cross your legs while sitting.
  • Stand in one position for long periods of time.
Clicking in breastbone

You may experience a slight clicking in your breastbone (sternum) when you move or take a deep breath. This feeling will disappear in 4 weeks or so as your breastbone heals.

What to do:

  • Let someone else do heavy or strenuous activities during the recovery period.


  • Lift, carry, push or pull anything over 10 pounds (4.5 kg) for 6 weeks after your operation.
Poor sleep

You may experience restless sleep including frequent wakening and stiffness. You may not feel rested.

What to do:

  • Make yourself comfortable with pillows.
  • Stay active during the day.
  • Take rest periods during the day.
  • Take pain medication before you go to bed.
Constipation and abdominal bloating

You may experience constipation and abdominal bloating due to your pain medications and the effect of the anesthetic.

What to do:

  • Eat high fibre foods such as fruit and vegetables.
  • Talk to your pharmacist or family doctor if you need a mild laxative.
Numbness or tingling in ring finger

You may experience tingling or numbness in your ring or little fingers which is caused by stretching of the nerves in the arm when the chest is opened during the operation.

What to do:

  • Move your wrist and fingers normally.
Follow-up appointments

First Appointment: Where and when

Within the first week after your operation, you will have a follow-up appointment with your family doctor.

Second Appointment: Where and when

Your second appointment will be at your cardiologist's office about 4 weeks after your operation.

Third Appointment: Where and when

About 6 to 8 weeks after your operation, you will have an appointment with your surgeon.

My contacts

Who do I call with general post-operative questions?

Call your surgeon's office:

Dr. Jennifer Chung
Phone: 416 340 4745

Dr. Robert James Cusimano
Phone: 416 340 4928

Dr. Anthony Ralph-Edwards
Phone: 416 340 4309

Dr. Vivek Rao
Phone: 416 340 3562

Dr. Tirone David
Phone: 416 340 5062

Dr. Christopher Feindel
Phone: 416 340 5909

Dr. Maral Ouzounian
Phone: 416 340 4218

Dr. Terrence Yau
Phone: 416 340 4074

Who do I call if I experience complications?

Call 911 to take you to the nearest Emergency Department if you:

  • Have chest pain, tightness, or shortness of breath.
  • Have "the worst headache of your life" that does not go away by taking pain medication.

Call your surgeon's office if you notice the following symptoms:

  • Your incision is red, warm to the touch or has discharge or a bad smelling odour.
  • You have a fever (a temperature of 38°Celsius or higher for 2 days).
  • You have pain that is not relieved by your pain medication.
  • You have a sharp pain or tenderness in the back of your calf or numbness and tingling to your foot.

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