Patients should prepare in advance for a hospital stay of at least three to four days. The patient is usually admitted on, or a day before, the scheduled date for an open-heart surgery. In the hospital, the patient will undergo a battery of tests. Even if these tests were already performed days or weeks before surgery, they may be performed again just before surgery to be sure that the patient’s medical condition has not changed. They include:

• Chest x-ray. A radiation-based imaging test that offers the physician a picture of the general size, shape, and structure of the heart and lungs.
  
  
• Lung function test and studies to detect obstructions of the carotid arteries. 

Eight hours before surgery, all patients are placed on NPO (non per os; nothing by mouth) status. That means they are not permitted to eat, drink or take anything by mouth until after their surgery. Smokers will have been instructed to completely avoid smoking for at least two weeks before their surgery to prevent problems in blood flow, clotting or breathing. Certain medications may need to be reduced or stopped temporarily, so patients should discuss their medication schedules with their heart surgeon before surgery.

Immediately before surgery, the patient will be given specific pre–operative medications and be “prepped” for surgery. First, the chest area is shaved. Next, the surgical team creates a sterile environment by swabbing the patient’s chest with an antiseptic solution and covering the area with sterile surgical drapes. An intravenous (IV) line will also be started, usually in the forearm or back of the hand.

The patient is then given a sleep-inducing medication through the IV. The patient will continue to breathe a mixture of oxygen and anesthetic gas (general anesthesia) to make sure that he or she remains asleep throughout the entire surgery.