Cover of The Cardiac Surgery Playbook
Endorsed by the ERAS® Cardiac Society

The Cardiac Surgery Playbook

A Practical Guide to Understanding, Preparing for, and Recovering After Heart Surgery

Daniel T. Engelman, MD · Cheryl Crisafi, MSN, RN · Armando Paez, MD Baystate Health · UMass Chan Medical School-Baystate

Facing heart surgery? Start here.

You have been told you need heart surgery. The questions come fast. This book answers them in plain language, from a team that cares for heart surgery patients every day. All proceeds support the ERAS® Cardiac Society.

Understand your heart

What your operation involves, what your tests mean, and the questions to ask your surgeon, cardiologist and anesthesiologist.

Prepare with confidence

Nutrition, exercise, medications, dental care and infection prevention before surgery, with worksheets for your care team, medications and appointments.

Recover stronger

The ICU, pain and sleep, breathing and walking, cardiac rehab, driving, work, mood, and guidance for families and caregivers.

Questions before heart surgery

Free answers to the questions patients and families ask most, drawn from the book.

How to Prepare for Heart SurgeryWhat to do before open heart surgery: getting stronger, quitting smoking, eating and drinking rules, packing your bag, and readying your home for recovery.Questions to Ask Your Heart Surgeon Before SurgeryQuestions to ask your heart surgeon and team before surgery: the operation, your personal risk, surgeon experience, recovery, medicines, and follow-up.What Happens on the Day of Open Heart SurgeryWhat happens on the day of open heart surgery, from check-in and anesthesia to the heart-lung machine and waking up with tubes and monitors in the ICU.Open Heart Surgery Recovery: What to ExpectA plain guide to recovery after open heart surgery: the ICU, the hospital ward, going home, sternal precautions, and a week-by-week timeline for healing.How to Prevent Infection After Heart SurgeryLearn how infection is prevented before, during, and after heart surgery, how to care for your chest incision at home, and which warning signs need a call.Cardiac Rehab After Heart Surgery: What to ExpectWhat is cardiac rehab? Learn what happens in a supervised program after heart surgery, why it matters, when it starts, and how to keep your progress going.Depression and Emotions After Heart SurgeryFeeling sad, worried, or short-tempered after open heart surgery is common. Learn why it happens, signs of depression, what helps, and when to get help.Chest Pain After Open Heart Surgery: Is It Normal?Is chest pain normal after bypass or open heart surgery? Learn common causes from healing tissue, how heart pain tends to differ, and when to get help.Coronary Artery Bypass Surgery (CABG): What to ExpectA plain guide to coronary artery bypass surgery (CABG): why it is done, where the grafts come from, bypass versus stents, the hospital stay, and life after.Heart Valve Surgery: Repair or ReplacementA plain guide to heart valve surgery: stenosis and regurgitation, repair versus replacement, mechanical versus tissue valves, TAVR, and caring for a new valve.Recovery Week by Week After Open Heart SurgeryA week-by-week timeline for recovery after open heart surgery, from the hospital through the first three months: energy, walking, incisions, driving, and work.Heart Surgery: A Guide for Caregivers and FamilyHow to support someone through heart surgery: what to do before, on the day, in the hospital, and in the first weeks at home, plus how to care for yourself.Driving, Showering, and Sleeping After Heart SurgeryPractical answers for after open heart surgery: when you can drive, how to shower with a chest incision, how to sleep comfortably, and how to get out of bed.Medicines Before and After Heart SurgeryWhy your medicine list changes around heart surgery: which drugs are paused, what blood thinners, beta blockers, and statins do, and how to keep track.Atrial Fibrillation After Heart SurgeryAFib is the most common complication after heart surgery. What it feels like, why it happens, how it is treated, how long it lasts, and when to call your team.Caring for Your Incision and Breastbone After Heart SurgeryHow to care for chest and leg incisions after heart surgery, when you can shower, what normal healing looks like, the sternal precautions, and when to call.Eating and Nutrition Before and After Heart SurgeryHow to eat before heart surgery to build strength, what to eat while healing (protein, fluids, salt, poor appetite), and the heart-healthy pattern for life.Warning Signs After Heart Surgery: When to Call and When to Go to the ERWhich symptoms after heart surgery mean call 911, which need a same-day call to your surgical team, and which can wait. Plus: surgeon or cardiologist?TAVR Versus Open Heart Valve Surgery: Which Is Right for You?How TAVR compares with surgical aortic valve replacement (SAVR): recovery, pacemakers, valve durability, what happens when a valve wears out, and what to ask.Minimally Invasive and Robotic Heart SurgeryWhat minimally invasive heart surgery means, the main approaches including robotic, which operations suit them, the trade-offs, and who is a candidate.Anemia, Iron, and Blood Transfusion Before Heart SurgeryWhy treating anemia and low iron before heart surgery matters, how patient blood management limits transfusion, what to ask, and options to avoid transfusion.Memory, Confusion, and Foggy Thinking After Heart SurgeryWhy some people are confused in the first days after heart surgery (delirium), why thinking can feel foggy for weeks, what families can do, and when to call.Sex, Travel, and Returning to Work After Heart SurgeryWhen it is safe to resume sex after heart surgery, when you can fly and travel, and when you can go back to work, with the general timelines surgeons use.Pain Control After Heart Surgery: What to Expect and How to Manage ItHow pain is managed after open heart surgery: scheduled acetaminophen, nerve blocks, fewer opioids, how long pain lasts, and when to speak up.Breathing Exercises After Heart Surgery: Protecting Your LungsWhy deep breathing matters after open heart surgery, how to use an incentive spirometer, how to cough with a pillow, and which lung symptoms to report.Going Home After Heart Surgery: Discharge Day and the First 48 HoursDischarge day after heart surgery, what to have ready at home, and a simple plan for the first two days: walking, medicines, meals, and whom to call.Caring for a Leg or Arm Incision After Bypass SurgeryAfter bypass surgery the leg or arm harvest site needs care too: what is normal, why the leg swells, stockings and elevation, and signs of infection or a clot.Aortic Aneurysm and Aortic Surgery: What Patients Should KnowAn aortic aneurysm is a bulge in the body's main artery. When watching is safe, when repair is advised, what a dissection is, and what recovery involves.Mitral Valve Repair: What to ExpectWhy a leaking mitral valve is usually repaired rather than replaced, what the surgeon does, minimally invasive and robotic options, and recovery.Diabetes and Blood Sugar Control Before and After Heart SurgeryWhy blood sugar matters around heart surgery, the targets at each stage, which diabetes medicines are paused, why you may need insulin, and how to treat a low.

Free printable checklists

Who wrote it

Daniel T. Engelman, MD, is a cardiac surgeon with more than 27 years of experience and an international leader in care before, during and after heart surgery. He is Professor of Surgery at UMass Chan Medical School-Baystate and founder and president of the ERAS® Cardiac Society. He led the 2019 international guidelines for enhanced recovery after cardiac surgery, published in JAMA Surgery, and was senior author of the 2024 expert consensus statement with The Society of Thoracic Surgeons, published in The Annals of Thoracic Surgery.

He wrote the book with Cheryl Crisafi, MSN, RN, a cardiac surgery nurse with more than 40 years of experience, and Armando Paez, MD, Chief of Infectious Diseases at Baystate Medical Center. More about the authors.

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