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CVP or PCWP = Right or left ventricular end-diastolic pressures

When you are awake and able to breathe on your own, the breathing tube will be removed. This is called being extubated. After the tube is removed, you will be monitored closely to make sure your breathing is normal. Usually this happens a few hours after surgery, but can be delayed depending on the status of your heart, concerns over blood pressure or bleeding, or your ability to breathe on your own after the operation. Delays in extubation are not necessarily concerning, depending on their cause. Every patient wakes up from heart surgery in their own way, and variations sometimes can be expected, especially if you have preexisting lung or kidney disease, or decreased heart function.

Once you are extubated, you will be encouraged to participate in breathing exercises. You also will be asked to communicate your pain level with your nurse so that your medication can be adjusted if necessary. It is very important to breathe deeply and cough (against a firm pillow) frequently after surgery because your lungs were not being inflated and deflated while you were on the heart-lung machine during the procedure. Taking deep breaths can help your lungs fully inflate and will help prevent complications like pneumonia or fluid build-up around them. Once you are ready, your nurse will help you out of bed to a chair and you will be able to start walking. Early activity is important to help reduce surgical complications, such as pneumonia, blood clots in your legs, and muscle weakness.

Once your surgery team feels that you are ready, you will be transferred from the ICU to another unit in the hospital. 

Over the next few days, you will be working on recovering in the hospital. The goal is steady forward progress every day until you are comfortable and strong enough to leave the hospital. Your hospital recovery may include daily labs and chest x-rays, walking in the hallways, removing your drainage tubes, and monitoring your vital signs, glucose, and breathing status. 

Your urinary catheter will be removed so that you can urinate on your own, but you may be constipated (difficulty having a bowel movement) after surgery. This is due to a number of factors, including your narcotic pain medication, your anesthetic, and not eating much. Do not be surprised if it takes 3-4 days after surgery to have a bowel movement.