Heart Surgery: Is Discharge Within One Week Acceptable?

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Is it really okay to be discharged within 7 days after heart surgery? This is a concern for many heart patients and their families. Being discharged just a few days after surgery can understandably make people feel uneasy. Open-heart surgery, with its alarming incision alone, is intimidating, especially when some patients still seem weak. I’ll discuss some post-operative precautions that I hope will be helpful, so you won’t panic after discharge.

There will be many discomforts after surgery. Heart surgery recovery is a process that can’t be rushed. Follow doctor’s orders strictly and seek specialist treatment promptly if symptoms occur.

Cardiac surgery recovery involves several stages:

In-hospital recovery: 1-2 days in ICU, 1-3 days in transitional care, and 1-2 days in a regular ward (5-7 days total post-op hospital stay).
Assisted out-of-hospital recovery: We usually recommend patients stay at a nearby hotel for 2-5 days after discharge to observe how they adapt without constant medical care. For those who can afford it, completing this stage at a rehabilitation facility is a better option.
Home recovery: Patients should be able to fully care for themselves about 2 weeks after returning home, though discomfort may persist. It typically takes 3-6 months to return to a near-normal lifestyle. Understanding these stages helps patients and families avoid panic.

Regarding the first stage, every patient is different. Some are discharged after 3 days, while others may stay for 30 days or more due to complications like infections, poor heart or lung function, or abnormal test results. Those discharged within 7 days should understand that they’re among the patients with good treatment outcomes and smooth recovery. In large cardiac centers like Anzhen Hospital, such patients are the majority.

Discharge criteria are based on post-op echocardiograms, chest X-rays, blood tests (including liver and kidney function, nutritional status), daily observations of recovery (speech, diet, mobility, bowel movements), and incision healing. After such major surgery, test results won’t be entirely normal, but minor fluctuations are considered acceptable (e.g., a white blood cell count of 13,000 might be deemed basically normal when the standard is <10,000). Completely normal indicators may only be achieved in the second stage of out-of-hospital recovery.

Even when discharged, patients and families may worry about out-of-hospital recovery. Don’t worry; what’s needed now is confidence.

Post-op patients will be weak with poor nutritional status. Families should ensure a nutritious diet for faster recovery.
Encourage patients to get out of bed and move around to promote lung and intestinal recovery. This is crucial, which is why rehabilitation facilities are recommended. If family members can assist with this, there’s little to worry about.
Some oral medications need to be taken long-term. Discharge instructions will cover medication details, or contact information will be provided for guidance.
Monitor temperature, blood pressure, and heart rate daily. An electronic blood pressure monitor is convenient and effective. Remember to control blood pressure and blood sugar well for smooth recovery.
Some patients may experience worsened symptoms upon leaving the hospital, such as chest tightness, difficulty walking, or fever up to 38°C. This is often due to withdrawal syndrome, where patients feel they “can’t walk” without medical care. However, some patients may genuinely experience discomfort due to increased pleural effusion, incision swelling, or new atrial fibrillation. In these cases, we recommend immediate evaluation at a nearby hospital or emergency room.
Traditional open-heart surgery involves a 10-15cm midline chest incision with the sternum wired shut. It takes at least three months for the bone to heal. Lie flat as much as possible and use a chest binder for 3 months to prevent chest wall pressure from reopening the incision. Older patients, diabetics, or those with poor nutrition should consider using a sternal plate chest binder for better protection.
For well-healed incisions, home care with alcohol and sterile gauze is sufficient. If there’s significant redness, swelling, or discharge, consult a local surgical clinic or contact your surgeon.
Follow-up exams are recommended at 3 months, 6 months, and 1 year post-op. After that, annual echocardiograms are advised if there are no abnormalities. Post-op pericardial effusion may occur; small amounts don’t require treatment and can self-absorb. Large amounts causing compression symptoms need pericardiocentesis. Post-op shortness of breath is common due to poor lung recovery, requiring later pulmonary function training. Pleural effusion can also cause chest tightness and may need thoracentesis if severe. These follow-ups are necessary to ensure a smooth transition to the third stage of recovery.