Question. Why have I been advised to have a bypass operation and not have stents put in?
Answer In many patients with coronary artery disease only surgery can be used to effectively treat the condition. In some others, stents or surgery can be used. If this is the case, the cardiologists and surgeons jointly discuss the results of the angiogram at a multidisciplinary meeting (MDM) and advise on the best treatment for the individual patient. In doing this, they consider the risks of the treatment and how effective it will be, particularly in the long-term. In most cases, surgery has been found to improve long term survival of patients compared to stents.
Question. I have been told to stop some of my medications before surgery, why is this?
Answer Some drugs such as Asprin or Clopigogrel may cause increased bleeding after surgery so it is considered wise to stop them for about a week prior to surgery. However, in some patients it is felt safer to continue these tablets until surgery. The hospital staff will advise you on what is best for you when arranging the date for surgery.
Question. I have been told my operation is important for my health. Why do I have to wait for it to be done?
Answer Currently only 1000 cardiac operations are commissioned in the unit each year, however, over the past number of years the need in Northern Ireland has consistently been greater than that. This means that the waiting time for elective cardiac surgery is up to 6 months and patients requiring urgent in-patient surgery might wait 3 to 4 weeks. The Belfast Trust is very unhappy with these waiting times and has requested further investment from the NI Health and Social Care Board to increase the number of operations that we do and bring these waiting times down.
Question. What should if my symptoms get worse while I am waiting for surgery?
Answer If your symptoms are getting worse it is important that you see your GP. They may adjust your tablets or ask your cardiologist to see you. There are occasions when the doctors are concerned about a patient on the waiting list and advise hospital admission to stabilise the condition.
Question. When can I drive after surgery?
Answer If your operation is uncomplicated, you can usually drive 6 weeks after the surgery. You do not have to advise the DVLA but you should inform your insurance company.
Question. When can I fly or go on holidays after my operation?
Answer Guidelines advise that, in the absence of complications, it is safe to fly 10 days after cardiac surgery. Most people will be able to enjoy a holiday around 8 weeks after surgery and it is usually good advice to wait until you have had your post-operative surgical review appointment before booking a holiday. If you already had a holiday booked before you knew you needed surgery, you might still be able to go on it but you should discuss this with your cardiologist or surgeon when you see them.
Question. Why might my operation be cancelled because there is no ICU bed?
Answer Cardiac surgery is different from other types of surgery in that all patients need to go to ICU afterwards. This is for several reasons. The patients are still under anaesthesia and are on a ventilator. The function of the heart is frequently depressed following surgery and can take some hours to recover and by ventilating the patient by a machine here is less work for the heart to do. The body temperature is lowered during heart operations to protect vital organs such as the brain and it takes time for the temperature to return to normal. If the patient was awake during this process, they would shiver and this would increase the work their heart had to do. Most patients can come off the ventilator and leave the ICU by the next day but some patients can take longer than expected reducing the availability of ICU beds.