Heart Surgery: What to Expect

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Heart surgery has important steps before, during, and after the procedure to ensure a safe outcome. With so much that needs to happen, it can feel overwhelming for you and your loved ones. Knowing more about each step of the process can help you feel more comfortable and better prepared for the experience.

We've created a helpful guide outlining what is involved, including what you will need to do to prepare. Here at Columbia, our amazing cardiac surgery team will be with you every step of your journey.

Referrals

Depending on your insurance, you may need a referral to see a cardiothoracic surgeon. This referral usually comes from your cardiologist. You may also receive a referral from your primary care doctor.

You may also make a self-referral by calling (212) 305-2633 or completing our appointment request form. If you know what surgeon you'd like to work with, you can also make an appointment by calling the surgeon's office directly. (Click here for a complete staff list.)

The Day of Your Appointment

Please arrive on time for your appointment and bring any imaging and reports, if you haven’t provided them in advance. We strongly recommend that you send your records before the visit to give your surgical team time to review and prepare.

These reports include:

Cardiac catheterization
Echocardiograms
Cardiac computed tomography angiography (CTA)
Magnetic resonance imaging (MRI)
Transesophageal echocardiogram (TEE)

You should also bring a list of your medications and their dosage.

Confirm Your Insurance Coverage

Upon calling to schedule an appointment, the team will determine your surgeon's participation with your insurance plan. The team will verify eligibility, benefit coverage, deductible and coinsurance responsibilities. Please confirm with the office that the surgeon accepts your insurance. You should also check with your insurance company to determine which route you should take to ensure coverage.

How to Find Us

The Division of Cardiothoracic Surgery is located at the
NewYork-Presbyterian/Columbia University Irving Medical Center campus, in the Milstein Hospital Building (MHB) at 177 Fort Washington Avenue (between 165th and 168th Street in Manhattan).
The office is on the 7th Floor, Suite 435.
Parking is available in the Staff/Visitors parking garage at the corner of 165th Street and Fort Washington Avenue.
- You may also take advantage of valet parking in the circular driveway in front of the Milstein Hospital Building.

When you enter the building, you will receive a visitor's pass at the front desk. Proceed to the elevator bank to the left. On the 7th floor, follow the "Cardiothoracic Surgery Service" signs to Suite 435.

After arriving at the office, you can check in and complete any necessary forms, including your presurgical checklist. These forms help us develop an appropriate health care action plan based on your needs.

Meeting Your Surgeon

Now it's time to meet your surgeon. This is your chance to ask questions, review your health history, and learn about the procedure. Please expect a 3-4 hour visit for consultations and testing.

You will have a brief clinical exam by the surgeon or a member of their team. Your surgeon will discuss whether surgery is appropriate for your needs.

If you are a candidate for surgery, your surgeon will explain the type of surgery recommended, including the specific risks, benefits, and recovery process.

If you decide to have surgery, you can schedule the date and time for your procedure (approximately 1-2 weeks later). You will also be asked to sign an "Informed Consent for Surgical Operation" form that provides permission for treatment.

Your surgeon will be in contact with your referring cardiologist. If your cardiologist is not affiliated with NewYork-Presbyterian/Columbia University Irving Medical Center, a cardiologist will be chosen by your surgeon to provide your care during your stay at the hospital. With your consent, our team will provide updates to your outside doctors throughout the process.

Insurance Coverage/Prior Authorization/Financial Counseling

Most insurance companies require precertification for hospitalization, so make sure to verify with your insurance provider.

Our office will contact your insurance company to verify coverage and to obtain prior authorization for your surgery.
We will also confirm your plan benefits, coinsurances and/ or deductible obligations that your insurance company requires you to satisfy.
If your plan requires coinsurances and/or deductible payments, we will contact you prior to your scheduled surgery to request a prepayment. Please keep in mind that this payment may only cover a portion of your total financial responsibility.

Please note that your surgeon's office will obtain prior authorization (also known as precertification) for the surgical procedure only. You are responsible for verifying coverage for all other aspects of your hospital stay.

To verify that NewYork-Presbyterian participates with your insurance please contact us at shoppableservices@nyp.org.
To verify that our Anesthesia office participates with your insurance, please call 646-317-3150.

Our financial counselor will contact you the week prior to your surgery to discuss pre-payments, co-insurance, and deductible responsibilities.

For any questions about your financial responsibilities or the prior authorization process, please contact:

Michele Castro
Financial Counselor, Open Heart Surgery Program
212-305-0826

To answer financial questions in advance, please call the Admitting Office at 212-305-7091.

Pre-Admission Testing (PAT)

Once you have been scheduled for surgery, it's time for your Pre-Admission Testing (PAT). PAT is a series of consults/tests that provide a clinical baseline before surgery to help determine the best treatment for you during and after your operation.

Where do I go for PAT?

PAT is located on lower level 1 of the Vivian and Seymour Milstein Family Heart Center (Heart Center) at 173 Fort Washington Avenue (between 165th and 168th Street in Manhattan).

What tests/consults are part of PAT?

Electrocardiogram (EKG)—measures the heart's electrical conduction system CT Angiogram
Carotid artery duplex scan
CT chest-abdomen-pelvis (CAP CT)
Chest X-ray (If needed)
Blood work and urine studies
Pulmonary function tests (If needed)

If you have not had a cardiac catheterization or angiogram prior to your preoperative visit, you may be admitted a day before your surgery to have this test, which measures pressures in your heart and assesses your coronary arteries to determine blockages.

How Do I Prepare for My Surgery?

In the days before surgery, there are a few simple steps you can take to enhance your successful and speedy recovery. These suggestions can help you feel better and heal faster.

Stop Smoking

If you smoke, this is as good a time as any to stop. Smoking makes you more prone to developing pneumonia and pulmonary complications after surgery. It also makes your heart work harder and accelerates the atherosclerotic process. You must quit smoking at least 3 weeks before surgery.

Medications

Your surgeon will give you instructions based on your current medications and health conditions. You may need to stop taking some medications before your surgery. Always consult with your physician before stopping any medication. Some examples of medications that may need to be stopped include:

Blood Thinners — It is advisable to discontinue blood-thinning medications—such as Coumadin, Plavix, Motrin, Brilinta, etc., 5 days before surgery. Medications for diabetes (such as glyburide, metformin, insulin, etc.) should not be taken on the day of surgery.
GLP-1 receptor agonists —> Weekly medications like Trulicity and Ozempic should be held a week before surgery.
Aspirin — In most situations, aspirin can now be continued prior to surgery.

Nutrition

Nutrition is essential to good health and is especially important before your hospitalization for surgery. Maintaining healthy nutritional habits may help with a quick recovery. A balanced diet, adequate in calories, proteins, vitamins, and minerals, should be consumed. If you have been following a therapeutic diet as part of your medical treatment, continue to do so and inform your physician.

Alcohol

Stop drinking alcohol–liquor, beer, and wine–two days before surgery.

More Heart Surgery Guides

For more information, call us at (212) 305-2633 or use our appointment request form.