Day-of-Surgery Timeline: From Pre-Op Check-In to ICU Handoff
Introduction
The day of open heart surgery unfolds in carefully timed steps. For patients and families, not knowing what happens next can fuel anxiety. By understanding the timeline - from hospital check-in through ICU handoff - you can feel more prepared, trust the process, and focus on supporting recovery.
Arrival and Check-In (T - 2 to 3 Hours)
Patients usually arrive 2–3 hours before the scheduled incision time. During this phase, hospital staff will:
- Verify identity, consent, and insurance details
- Confirm medical history, allergies, and recent test results
- Review medications and fasting instructions
Family Tip: Arriving on time helps you finish paperwork calmly and gives time to confirm details with the surgeon and ansthesiologist.
Pre-Op Preparation (T - 1.5 to 2 Hours)
In the pre-op unit, nurses and the surgical team prepare the patient by:
- Starting an IV line for fluids, antibiotics, and anesthesia
- Recording vital signs (blood pressure, heart rate, temperature)
- Reviewing the pre-op checklist to ensure all labs and imaging are ready
- Marking the surgical site and conducting a "time-out" safety verification
Anesthesia Induction (T - 30 to 60 Minutes)
Inside the operating room, the anesthesiologist:
- Administers general anesthesia via IV and breathing tube
- Places invasive monitoring lines (arterial and central venous)
- Inserts a urinary catheter and nasogastric tube for post-op care
Family Tip: Families often see the patient briefly before anesthesia. A short goodbye can bring reassurance to both sides.
Surgical Phase (Incision to Heart-Lung Bypass)
Once anesthesia is complete, the surgeon begins by:
- Performing the chest incision and sternotomy
- Administering heparin and placing cannulas for the heart-lung machine
- Carrying out the main repair or bypass grafting procedure
Weaning from Bypass & Closure (T + 2 to 4 Hours)
After completing the repair:
- The heart is gradually weaned off the bypass machine
- A TEE (transesophageal echocardiogram) checks heart function and grafts
- Heparin is reversed with protamine
- The sternum is closed with wires
- Chest tubes and temporary pacing wires are placed for recovery
Transport & ICU Handoff (T + 4 to 6 Hours)
The patient is moved to the Cardiothoracic ICU where:
- The ICU team reviews surgical and anesthesia reports
- Ventilator settings, medications, and vital signs are stabilized
- Families typically receive an update within 30 minutes of ICU arrival
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Understanding the day-of-surgery timeline brings clarity, reduces fear, and builds trust in your surgical journey.
If you're weighing options or want a personalized surgical review, consider requesting a MyVerus Report or scheduling a second opinion.
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