With Cardiopulmonary Rehab Physiologist Meredith Cleveland, BS, CCRP
Facing heart surgery is understandably daunting.
But with minimally invasive cardiac surgery, the incision is smaller, the pain is less, the recovery is shorter, and the return to an active life is faster.
A relatively new minimally invasive cardiac surgery technique, called “MICS,” reaches the heart through a 3-inch incision between the ribs, rather than accessing it via an 8- to 12-inch incision down the center of the chest and slicing the sternum in two, as is done in traditional open-heart surgery. MICS can be used for range of procedures, from valve replacement and repair, to corrective surgery for arrhythmias and defects.
On average, MICS recovery takes 2 to 4 weeks — versus the 6 to 12 weeks’ recovery for an open-heart procedure. But each patient journey is unique and can be shaped by age, pre-operation health and fitness, genetics and how well the rehab plan is followed.
If a minimally invasive cardiac procedure is in your future, here’s what you can expect during the weeks following the surgery.
More Information
Many cardiac and thoracic procedures can be performed minimally invasively or robotically. Know your options. Click here, or call (941) 917-7777.
Rest & Recovery
Patients recovering from minimally invasive heart surgery usually spend 2 to 5 days in the hospital after the procedure — significantly less than the 5- to 7-day stay typically following an open-heart surgery. After a minimally invasive heart surgery, you'll be taken to the intensive care unit (ICU), where you’ll stay for a day or two, while your body begins to recover and medical care providers measure your breathing, blood pressure and heart rate.
After the ICU, you will be moved to a regular hospital room. Your care team will continue to monitor your vital signs and incision sites for infection, and will work with you to formulate a pain management plan. (Though significantly less painful than a traditional sternotomy, MICS may require some pain management during your hospital stay.)
Get Moving
This is also when rehabilitation actively begins. If your recovery is going well and you are able, you’ll begin engaging in mild physical activity, such as sitting up, standing and even going for short, regular walks to promote circulation, muscle strength and proper scar formation. Range of motion and breathing exercises will also help prevent complications and will support a faster recovery.
Before leaving the hospital, your care team will walk you through how to clean and care for your incision sites, and will explain signs of infection to watch for and how to manage pain and medications.
After the Hospital
For most cardiac patients who undergo minimally invasive procedures, outpatient rehab begins roughly 1 to 2 weeks after heart surgery.
“With traditional open-heart surgery, you have to wait longer to do anything, exercise-wise, and we can’t really do a lot until the 8-week mark,” explained exercise physiologist Meredith Cleveland, BS, CCRP, who supervises Sarasota Memorial’s Cardiopulmonary Rehab Services. “But with minimally invasive surgery, they can lift weights, use the treadmill and use the bike much, much sooner.”
During the first day of outpatient rehab, you'll work with your exercise physiologist to establish a baseline, set expectations and goals, and develop your customized rehab plan.
It's all about functional capacity, says Cleveland, and getting back to as active a lifestyle as can be expected. Exercises will help eliminate any lingering shortness of breath or fatigue —common side effects of cardiac issues — and to build confidence in your newly repaired heart. Most patients, Cleveland notes, forget about their incisions in short order.
“They’re getting back to doing what they were doing pretty quickly,” she says. “It’s great.”
A total of 36 hours of cardiac rehab are recommended for most cardiac surgery patients. On average, patients go to rehab for an hour three times a week, working on both cardio and weight training with the rehab team. However, some patients go twice a week, while others opt for as many as five sessions weekly. It comes down to the individual and what the rehab team recommends. Intensity will gradually increase as your body recovers.
Dr. Ornish’s Program For Reversing Heart Disease
Scientifically proven to slow or reverse heart disease, the Ornish Program teaches participants how to make achievable, lasting lifestyle changes by eating healthy, being active and managing stress. Rather than relying on medication or surgery to control chronic disease, try Ornish.
To speak with one of Sarasota Memorial's certified Ornish Program specialists, call (941) 917-6139.
Back to Life
Progress, expectations and goals are re-evaluated monthly. During these meetings, your rehab team will also help you to manage the stress and anxiety that can come with recovering from a major surgery. Being honest about struggles or frustrations, managing expectations and being patient with one's recovery may not always be easy, but your team is there to provide support, answer questions and help you maintain a positive outlook throughout the process.
Depending on your progress and heart condition, cardiac rehab may continue for as long as 15 weeks. The ultimate goal is for you to establish new habits and a healthy routine that you can maintain on your own, so you can get back to living your best life quickly.
For More Information
For a closer look at Cardiac Rehab, click here to read our Q&A with Cleveland. Click here to learn more about minimally invasive heart surgery in an Ask An Expert Q&A with cardiac surgeon Jonathan Hoffberger, MD, medical director of minimally invasive cardiac surgery at Sarasota Memorial Hospital.