Heart surgery

Heart surgery is a surgical procedure aimed at correcting structural or functional disorders of the heart that affect the heart valves or major blood vessels. During the operation, normal blood flow within the heart is restored and the heart’s ability to pump blood effectively throughout the body is improved. Heart surgery is performed when other treatment methods are not sufficiently effective or suitable.

PREPARATION FOR SURGERY AT HOME

Visit a dentist, as infections in the oral cavity can spread bacteria into the bloodstream and cause a life-threatening heart infection (endocarditis).
Keep your blood pressure and blood glucose levels as stable as possible. Poorly controlled diabetes increases the risk of complications, including wound infections, impaired kidney function, and a longer hospital stay.
Stop smoking. Smoking and the use of e-cigarettes reduce blood oxygen levels, impair lung and blood vessel function, and slow wound healing, increasing the risk of infections and pulmonary complications. It is recommended to quit at least 4 weeks before surgery. If needed, nicotine patches may be used, as they are safer than smoking in the perioperative period.
Please do not shave hair from the surgical area yourself. On the morning of surgery, a nurse will remove hair using a special clipper to prevent micro-injuries and reduce the risk of infection.
Remove nail polish and gel nails to ensure accurate measurement of blood oxygen levels. Please leave rings, including wedding rings, at home.
Come to surgery in good health. You should not have upper respiratory tract infections, exacerbations of chronic illnesses, skin infections, or menstruation at the time of surgery.

Medication use before surgery at home

Please stop taking the following medications according to the instructions given by medical staff:

blood-thinning medications: Lixiana/edoxaban, Plavix/clopidogrel, Brilique/ticagrelor, Marevan/warfarin, Eliquis/apixaban, Xarelto/rivaroxaban — these increase the risk of bleeding during surgery;
Ozempic/semaglutide — slows gastric emptying, increasing the risk of stomach contents entering the airways during anesthesia;
Jardiance/empagliflozin — may increase the risk of dangerous metabolic disturbances during surgery.

Continue taking other medications according to your prescribed treatment plan.
If you have questions regarding medications, please call 731 8432 or 731 8433.

Please bring to the hospital

daily medications in their original packaging; patients with diabetes should bring insulin syringes, asthma patients their inhalers, and smokers nicotine patches;
necessary assistive devices: hearing aids, CPAP device, walking cane;
identification document (ID card or passport);
personal hygiene items (toothbrush, toothpaste, shampoo if desired);
light, non-slip slippers; if desired, pyjamas or a dressing gown; clean T-shirts; women should bring a soft bra to be worn around the clock after surgery to support the breastbone;
a mobile phone, charger, and headphones to avoid disturbing other patients.

Arrival at the hospital

Arrive at the hospital between 08:00 and 10:00 and go to the department wearing your outdoor clothing. We recommend being accompanied by a family member or escort. A wheelchair can be obtained from the lobby if needed.
Upon arrival, first go to the registration desk (entrance from N. Lunini Street), from where you will be directed to the Department of Cardiac Surgery on the 3rd floor of Building J.
Do not eat in the morning. Take medications (except those listed above) with water. If you have diabetes, eat moderately in the morning and take medications according to your usual schedule.
The average hospital stay is about 10 days, but the duration may vary depending on your recovery.
Please do not bring large sums of money or valuables to the hospital.
Smoking and alcohol consumption are prohibited in the hospital.
Patients may visit the café on the 2nd floor and the R-Kiosk on the 1st floor; a refrigerator and kettle are available for patient use in the department’s lounge.
The wards of the Department of Cardiac Surgery are double rooms.
At Tartu University Hospital, the daily inpatient fee is €5, payable for a maximum of 10 days of hospitalization.
If you have any questions or are unable to come to the hospital on the scheduled date, please call 731 8432 or 731 8433.

Information for relatives

Immediately after the operation, information about the patient’s condition can be obtained by phone at 731 8434. When completing the preoperative documents, please designate one contact person who will communicate information between the hospital and other family members or acquaintances.
Visits to the intensive care unit must be arranged in advance with the staff by calling the same phone number. Please do not bring flowers to the intensive care unit, and keep mobile phones on silent mode.
Recommended visiting hours in the department are Mon–Fri 14:00–19:00 and Sat–Sun 10:00–17:00. Visitors are asked to leave outerwear in the cloakroom (open Mon–Fri 7:00–19:00, Sat–Sun 9:00–18:00).
If your relative is staying in a general ward, information about their condition can be obtained from the duty nurse by calling 731 8433.

PREOPERATIVE AND POSTOPERATIVE PERIOD OF HEART SURGERY IN THE HOSPITAL

The day before surgery

Upon arrival at the department, the nurse will ask you to complete and sign the necessary documents (including the pre-anesthesia questionnaire), and preoperative examinations will be performed: blood tests, ECG, measurement of vital signs, and X-ray. The surgeon will explain the details related to the operation and answer your questions. The anesthesiologist will talk to you about the upcoming anesthesia, the operation, and the postoperative period. A physiotherapist will teach you breathing and coughing exercises and how to sit up from bed.
You may eat and drink as usual.
Your personal belongings will be documented and stored in a locked storage room. They will be returned to you when you return to the general ward.
We recommend emptying your bowels, as postoperative bed rest and medications slow bowel activity. A laxative will be provided if necessary.
Before going to sleep, wash your body and hair with antibacterial soap, then change into hospital pajamas without underwear. Sleeping medication will be provided if necessary.

On the morning of surgery

Wake up at 6:45 and take a shower. If necessary, the nurse will wake you. If you are second in the surgery order, go to shower at 9:30. Wash your body with antibacterial soap (do not wash your hair in the morning), put on clean hospital pajamas without underwear, and brush your teeth.
Remove jewelry, contact lenses, and dentures. Place dentures in a container and leave them on the bedside table. Do not use creams or cosmetics. Turn off your phone and place it in your bag.
On the morning of surgery, do not eat, drink, chew gum, or smoke to avoid anesthesia-related complications. If you are second in the surgery order, you may, with the nurse’s permission, drink a preoperative drink and up to 200 ml of water until 9:00. Necessary medications will be given by the nurse with a small sip of water.
You will be transported on a stretcher to the procedure room, where the surgical area will be shaved, and then taken to the operating room.

In the operating room

The operating room is cool and brightly lit, with various machines and many instruments. Cannulas will be inserted for medication administration and blood pressure monitoring. Once you are asleep, a urinary catheter will be inserted to drain urine and a breathing tube will be placed to support breathing. The operation usually lasts 3–5 hours, during which the anesthesiologist and surgical team continuously monitor your vital signs.

Postoperative period in the intensive care unit

Patients in the cardiac surgery intensive care unit are under continuous 24-hour monitoring. Your care team includes doctors, nurses, nursing assistants, and a physiotherapist.
There are many devices, catheters, and wires around you in the intensive care unit, which may seem frightening. The staff will gladly explain their purpose and function.
During and immediately after the operation, your breathing is supported by a ventilator. The breathing tube may remain in the airways for some time even while you are awake; during this time, you will not be able to speak. You can communicate using hand movements and by nodding or shaking your head. The breathing tube is removed by the doctor when it is safe, usually 4–6 hours after surgery. Waking up may take from a few hours up to a full day.
Your vital signs are continuously monitored using a monitor. Electrodes and wires measure heart function, breathing, and blood oxygen levels, and an arterial cannula is used to monitor blood pressure. Temporary heart rhythm disturbances may occur after heart surgery and are monitored and treated if necessary.
Initially, medications are administered directly into a vein through a central venous catheter, usually located in the neck or below the collarbone.
After surgery, you will be helped to change position every two hours to promote circulation and prevent pressure sores.
After surgery, you will initially not be allowed to drink as much as you wish. Staff will help relieve thirst by moistening your lips or offering ice cubes.
Drains placed during surgery are usually removed the following day. After that, you will be helped to sit on the edge of the bed, physiotherapy will begin, and you will start eating.
After heart surgery, chest pain may cause shallow breathing, which limits airflow in the lungs and increases the risk of pneumonia. To prevent this, steam therapy and breathing exercises are performed regularly to keep the lungs functioning, improve airflow, and make coughing up mucus easier.
Pain after surgery is expected. Please inform the staff so that appropriate pain medication can be provided to ensure your comfort and smooth recovery.
While in intensive care, you will not urinate independently, as urine is drained via a urinary catheter placed during surgery. This allows accurate monitoring of kidney function and fluid balance, which is especially important after heart surgery.
Experienced nursing assistants will help you with hygiene care in the mornings and evenings. You will be cared for attentively and discreetly.
Noise from machines may sometimes disturb sleep. If necessary, ask the nurse for sleeping medication or earplugs.
Nausea may occur due to anesthesia and pain medication; this is temporary and treatable.
Before transfer to the general ward, several cannulas and the urinary catheter will be removed.

Postoperative period in the general ward

In the general ward of the cardiac surgery department, you will be cared for by nurses, the attending physician, nursing assistants, and a physiotherapist.
After transfer from intensive care, on the first day please move only within your room. You can call for assistance using the call button; please use it when needed, including at night. From the second day onward, you are encouraged to walk in the department corridor, where sofas are available for resting. Movement helps reduce the risk of pneumonia, improves circulation, supports wound healing, and aids overall recovery.
Initially, movement may cause pain, which should subside at rest. If pain persists, inform the nurse, who will provide appropriate pain relief. Pain control supports recovery.
After surgery, appetite may decrease and nausea may occur. Please inform the nurse so appropriate medication can be given if necessary. We recommend eating small portions and choosing protein-rich foods to support recovery.
After surgery, medication to stimulate digestion may be given if necessary, as bed rest and pain medication can cause constipation.
Fatigue and weakness after surgery are common and gradually subside. Your condition may vary from day to day.
Blood pressure, pulse, body temperature, and blood oxygen levels are measured at least twice daily. Blood tests, wound care, and, if necessary, ECG and other examinations are performed regularly to monitor recovery.
After transfer from intensive care, your heart rhythm may be monitored by a temporary pacemaker if needed. With the doctor’s permission, the device is removed as soon as possible.
Showering is allowed with the nurse’s permission once at least 72 hours have passed since surgery and the wounds are in suitable condition. Before washing, you will be provided with clean pajamas and necessary washing supplies.
Morning routines begin at 7:00. Please be awake and washed by 7:30. In the ward, we recommend avoiding strongly scented body creams and perfumes.
Steam therapy and breathing exercises continue to support lung function and reduce the risk of pneumonia. Daily physiotherapy helps restore circulation and strength.
You will be discharged home when blood test results are normal, wounds are healing well, you are able to move independently, and your general condition is good. Before discharge, the doctor will explain further medication use and the nurse will provide wound care instructions. You will receive the necessary documents. Please arrange for a family member or escort to meet you in the ward, as lifting heavy objects is not allowed.

Heart Clinic of Tartu University Hospital, Department of Cardiac Surgery
L. Puusepa 8, Tartu, 3rd floor, Building J
Doctors’ office: 731 8432
Duty nurses: 731 8433
Intensive Care Unit: 731 8434

Department of Cardiac Surgery
Tartu University Hospital
2026