Heart Surgery Recovery: What To Expect

If you need heart surgery, you’re probably already thinking ahead to recovery. You might be wondering how long it’ll take to feel like yourself again or when you can get back to your usual routine.

Recovery looks a little different for everyone. It can vary based on age, health history and the surgical method — for example, open-heart versus minimally invasive. Your surgeon can give you a good idea of what to expect in your case.

But there are some general milestones that you can anticipate. Cardiac surgeon Michael Zhen-Yu Tong, MD, takes us through the timeline from your surgery day onward, with a focus on recovering from open-heart surgery.

Heart surgery recovery timeline

Recovery starts while you’re in the hospital and continues when you’re back home. “Most people need about 12 weeks to recover from heart surgery,” Dr. Tong says. “But much of the healing happens early on. By about six weeks, you should feel like you’re 80% recovered.”

So, what does each stage of recovery look like? Dr. Tong shares what you can expect in terms of mobility, diet, pain management and more.

While you’re in the hospital

After surgery, you’ll spend one to two days recovering in the intensive care unit (ICU) before moving to a regular hospital room for a few more days. “The average hospital stay is about five days,” Dr. Tong says.

During this time, your care team will help you:

• Get moving: Within six hours, your breathing tubes will be taken out and you’ll sit up in bed. “The next day, we’ll help you sit in a chair,” Dr. Tong says. “The day after, you’ll stand and take a few steps. By post-op day three or four, you’ll be walking the halls.”
• Ease back into eating: “Your gut will be pretty sluggish the first couple days after surgery,” Dr. Tong explains. “So, we’ll start you on clear fluids before progressing to thicker fluids. You’ll transition to small portions of real food by day three or four.”
• Manage pain: You’ll likely have a button you can push to receive pain medication. It gives you a set dose that’s safe for you, right when you need it. After a day or two, you’ll transition to oral pain medications. Your care team will discuss your options.
• Get ready to go home: A physical therapist will assess your condition and determine your needs for when you’re back home. “We want to make sure you’re truly ready and can live at home safely again,” Dr. Tong emphasizes.

Most people can go home directly after surgery, sometimes with a plan for a physical therapist to make visits. Physical therapy helps you strengthen your muscles, improve balance and move safely. In some cases, a short stay at a skilled nursing facility before going home can help ease the transition.

Hospital discharge to six weeks

The next stage of recovery starts when you leave the hospital and lasts until about six weeks post-op. You’ll be moving around more while also taking precautions. Healing is the name of the game here. As you get back to house chores and socializing, start small and take plenty of breaks. Don’t overdo it.

During this time, you’ll:

• Start sleeping better: It’s hard to get good sleep in the hospital. “Once you’re back home, in your own environment and your own bed, you’ll sleep much better,” Dr. Tong notes. “And sleeping in any position that’s comfortable to you is fine.”
• Shower normally: You should be able to shower once you’re home. It’s OK to let water gently run over your incision, but don’t blast it with water or scrub it. Pat the area dry. While showers are fine from the get-go, wait three weeks to soak in a tub.
• Resume a normal diet: “It usually takes a week or so for your diet to get back to normal,” Dr. Tong says. But he cautions that your gut is still recovering, and pain meds can cause constipation. “So, avoid eating too much at once. Ease in slowly.”
• Adjust pain meds: Dr. Tong notes that most people who are taking opioids in the hospital no longer need them by discharge. Instead, your doctor may recommend taking certain over-the-counter pain relievers and using lidocaine patches.
• Hold a pillow to your chest: Do this when you sit up, stand up, cough or sneeze. It helps protect your incision. You may use one arm to help push yourself up, but don’t use both arms because that puts too much pressure on your chest.
• Keep moving: Physical activity supports recovery. “I encourage my patients to walk every day,” Dr. Tong says. “It’s better to do a few short walks, say five minutes each, than to do one big one and wear yourself out. Do a little more each day.”
• Limit upper body movement: While walking is good, it’s not yet time to resume upper body workouts. “Don’t lift, push or pull anything that’s 10 or more pounds,” he states. “And don’t do vigorous house cleaning.”
• Wait to drive or go back to work: You’ll need to wait at least six weeks to drive or return to work. These restrictions are important to keep you safe and help your breastbone heal.

You might be anxious to do all of your usual tasks. But the wait is worth it. “For most surgeries, we cut through the breastbone to reach the heart,” Dr. Tong explains. “Afterwards, we bind the bone back together, and it takes time to set.”

“If you’re doing too much and there’s instability in that bone, it won’t set properly. That means it’ll only be held together by scar tissue, which can cause chronic pain or even infection.”

Six to 12 weeks after surgery

Once you hit the six-week mark, you’ll start feeling more like yourself. And you’ll be able to get back to many of your usual activities. Your breastbone will be mostly healed by this point.

From six to 12 weeks post-op, you’ll be able to:

• Start cardiac rehab: “This is essentially like going to a gym and doing a cardio workout,” Dr. Tong says. “But there’s a cardiologist monitoring you and helping you gradually get stronger.”
• Lift more weight: Now, you can lift, push or pull up to 25 pounds. “That means it’s generally safe to carry a small bag of groceries,” he adds. “But if you’re loading up for the month, that’s a different story!” Use caution, and when in doubt, don’t do it.
• Resume driving: Six weeks is the milestone when most people can start driving again.
• Go back to work: Most people can return to work at six weeks. But if you’re in a job that requires heavy lifting, you may not be able to perform all of your duties yet. Talk with your doctor about what’s safe for you.

12+ weeks after surgery

“The final benchmark is usually around 12 weeks,” Dr. Tong says. “Assuming you’re healing as expected, we lift all restrictions and you can do whatever you’d like. You should feel like you’re about 95% recovered.”

How you feel now depends a lot on how you felt before your surgery. If you didn’t have any symptoms and generally felt fine before, you’ll return to feeling like your old self. “On the other hand, if you were very short of breath, dealing with chest pain and not able to do much, you’ll feel much better now than you did before,” he clarifies.

When to seek medical care

Call your surgeon right away if you have any signs of an infection or improper healing at your incision site. These include:

• Murky drainage
• Skin that feels warm to the touch
• Skin that’s red or discolored (larger than a quarter in size)
• Clicking sounds along the breastbone

Go to the emergency room if you develop a fever.

Dr. Tong says that it’s generally normal to experience the following while healing:

• A small amount of clear drainage
• A tiny bit of redness/discoloration around the incision
• Itching

“When in doubt, though, seek medical care,” he urges. "Your hospital may have a post-op hotline available 24/7 to guide you."

Follow-ups and long-term management

You won’t be managing recovery alone. Your care team will see you for several follow-ups, with the first one just a week or so after discharge. Be sure to stick to the schedule they give you and stay in touch with any questions or concerns.

Just as important as those recovery follow-ups? All the things you do in the months and years after you’ve recovered to get the most benefit out of your surgery. Your cardiologist will tailor advice to your needs. This may include eating heart-healthy foods, exercising regularly and taking medications to manage heart disease risk factors.