How Long Is Hospital Stay After Open-Heart Bypass Surgery?

Day five, six or seven is when most bypass patients go home. That is the usual hospital stay for open heart surgery. Some patients go home earlier. Others need a few more days. Here is what each day involves.

According to Dr. Vishal Khullar, a Cardiac Surgeon in Mumbai, “Counting days is the wrong way to look at it. What matters is whether the patient is breathing comfortably, walking unaided and eating normally. A patient who meets those three points on day five is as ready as one who meets them on day seven.”

ICU first. Then the ward. Then discharge.

• ICU, days 1 to 2: Wires, drips and a monitor above the bed. Readings for heart rate, blood pressure and oxygen update on the screen. The breathing tube is removed early.
• Ward, after the ICU: Walks begin, short ones, with a nurse’s help. Deep-breathing practice begins. Solid meals return.
• Discharge checks: The care team picks the day, case by case. Another procedure during the same operation, or a complication, can mean a longer stay.
• Total stay: About a week for most patients. In one pilot unit, bypass patients stayed anywhere from 3 to 8 days.

The operation itself is covered on the heart bypass surgery page.

Five to seven days is an average. A few things can push it either way.

• How serious it is: Bypass surgery is a major operation, but it is routinely performed at cardiac centres. Most patients recover well, and many go on to live for years after surgery.
• Setbacks: A complication can keep a patient beyond the usual week. The care team watches for them daily.
• Extra procedures: Valve work or another repair during the same operation lengthens the stay.
• Faster-recovery steps: Some units remove the breathing tube early, plan pain control carefully, get patients walking soon and restart normal meals early. Pilot programmes built on these steps aimed to shorten stays.

Common worries about the operation are answered in these bypass surgery myths.

Recovery continues at home. Healing carries on for weeks.

• Pain: Soreness near the incision, and tight muscles in the shoulders and upper back, are expected for about a month. Prescribed painkillers handle it. By weeks 4 to 6 it eases. Severe pain, or pain that is getting worse, should be reported.
• Hardest part: For many patients, the wound is not the biggest challenge. Sleep is the problem, and tiredness. Appetite stays low through the first month and moods swing.
• Normal life: Most people return to daily activities after about a month. Full recovery takes about 6 to 12 weeks. Work usually follows at around 2 months. No driving or travel for at least a month. The long term benefit depends on continuing medicines, following a healthy diet and exercising.
• Long-term effects: Most short-term side effects go away in 4 to 6 weeks. The longer-term concern is the graft itself, which can become blocked by plaque. Follow-up testing is generally advised at about 5 years, or sooner if symptoms return. Tell the doctor at follow-up.

Milestones for each week are laid out in the weekly recovery guide.

Expect about a week in hospital, with a day or two in the ICU. Going home depends on recovery, case by case. A complication or an extra procedure can add days. Soreness eases by 4 to 6 weeks. Normal activities return after about a month. Full recovery takes about 6 to 12 weeks. 

1. National Heart, Lung, and Blood Institute (NIH). Coronary Artery Bypass Grafting: Recovery
2. The enhanced recovery programme pilot: can we achieve better outcomes and shorter stays for cardiac surgical patients? Journal of Cardiothoracic Surgery, 2013 (PMC)

Disclaimer: This blog is for educational and informational purposes only and should not be considered professional advice.