Well I had the opportunity of seeing an open heart surgery last week. It was a CABG x4 procedure on a 70 year old male with PMH of IHD,COPD HTN and current smoker. I had the opportunity to do a pre operative assessment on the pt the previous day not knowing I would be seeing his surgery. He was a very pleasant lively male who was eager to be informed about all aspects of the procedure and of the rehabilitation that would follow. The surgery itself was unreal to watch. It was uncomplicated and lasted a total of 3 1/2 hours with 1 1/2 hours on pump. The surgeons made a reference to who they wished they were all as simple and straight forward as this procedure.
The next evening the pt came down from ICU to and was admitted to the ward. He was awake but in extreme pain and very uncomfortable. He was coughing continuously but was unable to bring anything up even though harsh upper airway sounds were easily recognised on auscultation. Day 1 he was only able to SOOB for a very short period of time. Day 2 was much the same with the patient still in alot of pain and very sick from the pain meds.In the bed next door was a day 2 post same procedure whom I had a hard time trying to get to relax and sit down and take it easy.. It just goes to show no matter how easy or straight forward the procedure it is impossible to judge how a pt will cope post Sx.It will be interesting to see how this pt progressed over the weekend....