Occasionally, if they are still needed after four or five days, a permanent pacemaker will be fitted before you leave for home. If they are no longer needed, then they are removed on the third or fourth day after surgery. They are attached to a device called a pacing box which provides the electrical stimulus to regulate the heart rate during recovery. These are often placed onto the surface of your heart at the end of the operation to help regulate the heart rate. You may also notice thin wires near the drains called pacing wires. The drains are usually removed on the first or second day after the operation.

Whilst the surgeon hopes not to have to do this, it is always safer to do this if needed. Occasionally if there is excessive drainage from the tubes before you wake up, then the surgeon may decide to take you back to theatre to reopen the wound and wash out the area around your heart. You will also notice some drains at the bottom of your wound that help monitor any bleeding that invariably happens to a degree after heart surgery as the blood can be very thin and may not clot (stop bleeding) properly after surgery. Pain is usually controlled with strong painkillers in the first 24-48 hours after the operation, but most patients find that the chest wound is comfortable after that with only paracetamol required to ease the discomfort.

When you wake up you will notice that you still have the various lines inserted by the anaesthetist at the start of the operation but not the TOE probe. The intensive care staff will only wake you once they are satisfied that you are stable.

After your operation you will be moved to intensive care for close monitoring until you wake up.

Aortic arch