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THE DIFFERENT STAGES OF THE CARDIAC SURGERY

- Opening the thorax and accessing to the heart
- The extra corporeal circulation
- Stopping the heart: cardioplegia
- The operation
- Stoppage of the extra corporeal circulation and resumption of the cardiac activity
- The post-operative intensive care
- The stay in hospital
- Convalescence and re-education

Convalescence and re-education

Convalescence is very often necessary because of the occurrence of a fatigue (asthenia). This fatigue is due to the existence of a very frequent anaemia after surgery, a prolonged confinement to bed and a slowing of the physical activity due to the stay in a hospital environment and to the cardiac illness itself.

Besides, this fatigue is often caused by the anxiety linked to surgery and the hospital stay.

Convalescence is also necessary when an intensive kinesitherapy must be continued (case of the patients with a chronic respiratory insufficiency) or if a complication exists requiring a very regular surveillance.

The convalescence period aims at encouraging the resumption of a normal physical activity.

Re-education has several objectives:

- To allow the patient to recover a place in society, with the help of a psychological rehabilitation,

- To decrease the sequelas of the surgery and a possible handicap bound to the patient (respiratory insufficiency, overweight…) or to the heart illness itself. Thus, the patient benefits from a respiratory and cardiovascular rehabilitation,

- Management of the cardiovascular risk factors: fighting the tobacco addiction, high blood pressure, cholesterol, diabetes and overweight.

With regard to tobacco, it is IMPERATIVE to completely stop its consumption. Several methods can be proposed, among which the use of nicotine patches or anti-depressant drugs.

But sometimes, patients can achieve their rehabilitation period at home, with setting up of a rigorous program of respiratory rehabilitation under a kinesitherapist's responsibility, and with a nurse's very regular visits. The consulting physician must also play a very active part.

The complete resumption of the professional activities is generally achieved within 4 to 6 weeks after surgery.

Theoretically, the continuation of the professional activities is possible, but must be discussed according to the impact of the cardiac illness on the heart and the evolution of this illness.

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File last reviewed on dec 18, 2011