Patients are advised to get admitted 2 days prior to the day of surgery .The date of admission and date of operation is scheduled by the doctor in the outpatient service. On admission a doctor from the cardiac surgical team will examine the patient. All patients will have a physical examination, routine checks, blood tests, ECG and Chest X-ray. Other tests like Echo or specialised blood investigations will be done on specific order from the Doctor.

A counselor will discuss the hospital stay, facilities for the relatives and discharge plans after admission. 

The anesthetist will see and assess the fitness of the patient for anesthesia the day before the surgery. 

The hospital rules expect the patient to pay the package charges specified for the procedure at the time of admission except in a case of emergency.

Each patient will be advised regarding the number of units of blood required for surgery .Volunteer donors, preferably friends or relatives of the patient with the same blood group can present themselves to the blood bank the day before surgery and donate the required amount. Donors are requested to report to the Blood bank before 12 noon to facilitate screening tests.

Patients will be transferred from their bed to the pre-operative holding area in the theatre complex atleast 2 hours prior to the procedure. Here the anesthesia team will sedate the patient and insert lines for monitoring and giving fluids. Once the theatre is ready the patient will be taken in, anaesthetised and surgery will commence. 

Relatives can wait in the room or the waiting hall. The surgeon will speak to the relatives once the operation is completed about the procedure and condition of the patient.

The patient will be admitted to the Intensive Care Unit (ICU) where specially trained nurses and respiratory technicians will take care of the patient. Patients will be on a breathing machine called ventilator till he recovers from anesthesia. He or she will be disconnected from ventilator and the tube in the mouth (endotracheal) removed once the condition is stable and patient is fully awake. This will be decided by the ICU medical officer. The usual duration of ventilation is between 4 hrs to 24 hrs. 

Visitors are usually not allowed inside the ICU. To reduce traffic and infection, except for patients who are very sick and small children where the mother or a close family member is allowed. 

The usual ICU stay is 2 days. All the tubes and lines except the one in the neck will be removed and the patient is shifted to his bed.

Breathing exercises and mobilisation are started in the ICU. Post-op exercises are very important for fast recovery and to prevent lung complication. The Physiotherapist will visit each patient twice a day and advice regarding this. 

A Dietician will visit each patient and tailor the dietary requirements to be followed after surgery. 

Patients are usually discharged 8-10 days after surgery .Please check the following with your doctor on discharge.

Medications
Exercise and activities
Resuming work
Diet
Follow-up date

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Patients should make an appointment to meet the surgeon 2 weeks from the date of discharge. It is also important to schedule an appointment with the cardiologist 4 weeks before from the date of discharge. He will monitor the progress and adjust the medications. Patients on oral anticoagulation (warfarin, acitrom) should get their INR checked every month or more frequently in special situations as advised.

Walking Patients are advised to walk atleast 2-5 km/day at the time of discharge. The doctor will also advice each patient on the level of activity he can perform after discharge.

Diet Patient should be on a strick diet protocol after surgery particularly after coronary artery bypass surgery. Dietary advice will be given before discharge.

Resuming work Patient are advised to resume work 4-6 weeks after discharge. Heavy manual work is to be avoided for 3 months. Patients whose work involves only desk activity or supervision can resume work 2 weeks after discharge. Please check with your surgeon at first review.

Driving Two wheeler and 4 wheeler driving is strictly prohibited for 8 weeks after surgery.

Sex Patients can have sex usually 2 weeks after discharge.If the patient can climb one flight of stairs without chest pain or breathing difficulty he or she will probably be able to cope with sex. Try to avoid sex after a large meal, alcohol or when very tired. Try to adopt positions that cause least discomfort to the chest wound. Don't try to make the first occasion after surgery a "Command Performance".

Adventure sports Best avoid for 6 months. Patients on anticoagulation after valve replacement are advised not to participate in any activity or sport where serious injury is a possibility.