Recovery after Open-Heart Surgery

Study information presented throughout this timeline is a summary of the SternaLock Blu Study results and should not be construed as a substitute for reviewing all the actual study information with your physician. All results that reference the SternaLock Blu product are based on comparison to standard wire closure.4, 5

After Surgery, you will be moved from the operating room to the Cardiovascular Unit (CVU) or Intensive Care Unit (ICU), until you wake up. 1

While your heart may be repaired during surgery, your breastbone still has a long healing process ahead. The following timeline provides guidance for recovery and potential sternal precautions that your surgeon may enforce. Sternal Precautions are preventative guidelines provided by your surgeon to protect the breastbone and reduce breastbone complications during the recovery process. Regardless of the method of sternal closure your surgeon chooses to use, there will be activity restrictions during your recovery. Post-operative healing times and ability to return to daily activities vary for each patient; only a physician can determine what activities are acceptable for your recovery.

Risks specific to your heart surgery should be discussed thoroughly with your heart surgeon; as a medical device manufacturer, Zimmer Biomet does not practice medicine.  Risks associated specifically with SternaLock Blu sternal closure include the risk of screw or plate breakage, instrument breakage,  and delayed or incomplete bone healing.2 For more information on risks associated with sternal closure, see risks associated with sternal fixation using SternaLock Blu.

Ask your surgeon about additional risks associated with heart surgery.

During recovery, your surgeon may advise you to increase your activity gradually. Based on your surgeon’s guidance, you may choose to do light household chores, such as laundry, shopping, cooking and light gardening. However, it is important that patients do not lift, pull or push objects heavier than their surgeon recommends.

While transitioning back to normal activities, your surgeon may advise that you avoid any activity or position that causes pain or pressure on your chest. Notify your doctor if you have shortness of breath, fatigue, dizziness or other symptoms that cause discomfort.

The SternaLock Blu study followed patients out six months and showed that patients treated with SternaLock Blu spent less time in rehab hospitals and skilled nursing facilities. 4, 5, 8

Your doctor may recommend a rehab hospital or skilled nursing facility as part of his/her standard discharge orders, regardless of your method of closure. A patient’s comfort returning to normal actives may depend on numerous variables including, but not limited to, the method of sternal closure.

To promote breastbone healing, it is important to reduce physical stress during recovery. Following a sternotomy, patients may have an area of the breastbone where the bone did not fully heal back together, called a non-union, which can lead to chronic pain. For instance, when a patient coughs, one side of the breastbone may rub against the other side of the breastbone causing pain. You may hear clicking or popping of the breastbone when you move because of the bone not healing properly. If you experience discomfort or breastbone popping sensations, contact your doctor.

The SternaLock Blu Study found that 88% of patients treated with SternaLock Blu had no pain at 3 months as compared to 76% of patients treated with wire closure. 4, 5

Activity levels and healing times may vary for each patient. Some patients continued to experience some level of pain, regardless of closure method.

Recovery Timeline

ICU

Intensive Care Unit (ICU)1

Since your breastbone has been separated and you are recovering from surgery, you will be primarily limited to bed rest in the ICU following surgery.

Most patients are moved to a general care unit the day after surgery but it is common to remain in the ICU for longer.

HospitalStay

Hospital Stay1

Following surgery, you will stay in the hospital to continue your recovery until you are ready to go home. During your hospital stay, you will learn ways to improve your recovery, such as managing chest pain while coughing and getting into and out of bed.

 

Before you can leave the hospital, you must meet several discharge criteria, such as:

  • Stable vital signs
  • Assisted mobility
  • Adequate pain management without IV
  • Sufficient breathing
  • Chest tube removal
Discharge

Discharge1,3, 7

At discharge, your surgeon will review sternal precautions you should take to protect your breastbone while healing.

Most patients will go home after the hospital. When you are home, it is important to continue your breathing exercises and remember to stabilize your chest while coughing. Patients requiring additional care may go to a rehab facility instead of their home.

At this time-point, surgeons may advise that patients can do the following:

  • Shower carefully but avoid soaking in a bath
  • Avoid stretching or twisting torso
  • Dress yourself while seated
  • Sleep on back and take caution when getting out of bed
4to6weeks

4-6 Weeks after Surgery1,3

A follow-up appointment with your physician is usually scheduled 4 – 6 weeks after surgery. At this time, most patients are introduced to cardiac rehab and begin to focus on long-term lifestyle changes to facilitate the healing process.

At 6 weeks after surgery, the SternaLock Blu Study found that 74% of patients treated with SternaLock Blu had no pain at rest versus only 59% of patients treated with wire closure.4,5

Some patients may continue to experience some level of breastbone/sternum pain regardless of their closure method.

At this time-point, surgeons may advise that patients can do the following:

  • Perform light housework
  • Climb stairs using railing
  • Ride a stationary bike
  • Reach one arm at a time (not both)
  • Lift small objects less than 10 lbs.

Regardless of how you feel, it is important that you give your body the time to heal, before returning to any activities. Always consult your doctor(s) for specific guidance on your level of activity.

6Weeks

6-Weeks after Surgery3

Your breastbone is still healing, but most patients can slowly increase their activity level with the guidance of their doctor.

Patients with SternaLock Blu had less interference with activities and less physical limitations attributed to pain. The SternaLock Blu Study found that at 6 weeks, 70% of scores reported by SternaLock Blu patients indicated they had no difficulty using their arms, compared to 59% of patients who were treated with wire closure.4,5

Activity levels and healing times may vary for each patient. Regardless of how you feel, it is important that you give your body the time to heal, before returning to any activities. Always consult your doctor(s) for specific guidance on your level of activity.

At this time-point, surgeons may advise that patients can do the following:

  • Return to work with no heavy lifting
  • Drive by yourself
  • Heavy housework
  • Light cardio
  • Resume sexual activity
3months

3-Months after Surgery3

As advised by your doctor, you may able to fully return to routine activities.

At 3 months after surgery, the SternaLock Blu Study found that 41% of SternaLock Blu patients had sufficient bone healing versus only 16% of patients treated with wires.4, 5

Activity levels and healing times may vary for each patient. Bone healing time varies and some heart patients may continue to feel pain or discomfort indefinitely.

At this time-point, surgeons may advise that patients can do the following:

  • Return to work full time
  • Perform heavy housework & gardening
  • Begin to lift more than 10 lbs.
  • Resume normal activities such as biking, jogging or swimming
  • Play sports such as bowling and tennis 
6months

6-Months after Surgery4,5

Enhanced stability of the breastbone helps improve sternal healing, which can reduce the risk of sternal complications and lead to improved recovery.6

At 6 months, the SternaLock Blu Study showed that 0% of the patients treated with SternaLock Blu suffered from breastbone complications versus 5% of patients treated with wire closure.4,5

  1. http://ctsurgerypatients.org/pre-post-operative-care/after-heart-surgery
  2. SternaLock Blu IFU 01-50-1215
  3. https://www.sts.org/sites/default/files/documents/pdf/whattoexpect.pdf
  4. CR 0712S (Clinical Study Report) SternaLock Blu Study, 2014-15, an evaluation of rigid plate fixation in supporting bone healing: a prospective, multi-center trial of 236 total patients undergoing full midline sternotomy.
  5. CR 0712E (Economic Study Report) SternaLock Blu Study, 2014-15, an evaluation of rigid fixation in supporting bone healing; a prospective, multi-center trial of 236 total patients undergoing full midline sternotomy.
  6. Pai S., Gunja N.J., Dupak E.L., McMahon N.L., Roth T.P., Lalikos J.F., Dunn R.M., Francalancia N., Pins G.D., and Billiar K.L., In vitro comparison of wire and plate fixation for midline sternotomies. Ann Thorac Surg, 2005. 80(3): p. 962-8.
  7. https://www.ctsnet.org/sites/default/files/images/Side-effects.pdf
  8. SternaLock Blu patients spent a total of 237 total fewer days in rehab hospitals or skilled nursing facilities over 6 months. 705 total days for wire cerclage patients (n=120) vs. 468 total days for SternaLock Blu patients (n=116).
  9. http://ctsurgerypatients.org/pre-post-operative-care/day-of-heart-surgery

The information herein is of a general nature and does not represent or constitute medical advice or recommendations and is for general education purposes only. The information includes descriptions of a medical device that a thoracic (heart) surgeon may choose for patients undergoing open-heart surgery.

Zimmer Biomet manufactures medical devices, including metal plates and screws that may be used by your heart surgeon to hold together the sternum (breastbone) after heart surgery. We do not practice medicine; all questions regarding your medical condition must be directed to your doctor(s).

Results with breastbone (sternum) plates and screws (rigid fixation) will vary due to health, weight, activity and other variables.  Not all patients are candidates for this product and/or procedure.  Only a medical professional can determine the treatment appropriate for your specific condition.  Appropriate post-operative activities will differ from patient to patient.  Talk to your surgeon about whether rigid fixation is right for you and the risks associated therewith, including but not limited to the risks of infection, implant wear, loosening, screw or plate breakage or incomplete bone healing. For a complete list of risks associated with Zimmer Biomet’s rigid fixation system, see Patient Risk Information.

The SternaLock Blu study was funded by Zimmer Biomet.

All content herein is protected by copyright, trademarks and other intellectual property rights, as applicable, owned by or licensed to Zimmer Biomet or its affiliates unless otherwise indicated, and must not be redistributed, duplicated or disclosed, in whole or in part, without the express written consent of Zimmer Biomet.

©2017 Zimmer Biomet