Cardiac Surgery: Bypass and Thoracotomy ERAS

Enhanced Recovery After Surgery (ERAS) pathways promote an evidence-based, multidisciplinary approach to patient care that facilitates faster recovery from surgery, reduces hospital length of stay, and minimizes post-operative complications. From scheduling through discharge, all phases of perioperative care are incorporated into ERAS pathways.  

ERAS Pathway:

• Prior to Surgery Algorithm
• Intraoperative Bypass Surgery Algorithm
• Intraoperative Thoracotomy Surgery Algorithm  
• CICU Algorithm 
• Inpatient to Discharge Algorithm
• Cardiac Surgery: Bypass and Thoracotomy Synopsis (provides care standards employed for this ERAS)

Associated tools with this ERAS:

• ERAS overview handout 
• ERAS overview handout - Spanish 

Inclusion and exclusion criteria

Inclusion:

• Bypass cases  
• Coarctation of aorta cases  
• Vascular ring cases  
• Patients > 6 months of age 
• Patients with American Society of Anesthesiologists (ASA) Physical Status I, II, or III

Exclusion:  

• Repeat sternotomy cases  
• Single ventricle physiology  
• Pre-op inpatients

Committee members involved in the development: 

• J. Huffman, MD, FASA | Anesthesiology | Committee Co-chair
• C Taylor, MD | Anesthesiology | Committee Co-chair  
• W. Douglas, MD | Cardiac Surgery | Committee Member  
• A. Panchal, MD | Critical Care Medicine | Committee Member 
• L. Malloy Walton, DO, MPH | Cardiology| Committee Member
• R. Juhl, DNP, APRN, CPNP-AC, CCRN | Heart Center | Committee Member
• S. Lagergren, APRN | Heart Center | Committee Member

EBP Committee Members:  

• T. Glenski, MD, MSHA, FASA | Anesthesiology, Evidence Based Practice | Committee Member 
• A. Melanson, OTD, OTR/L | Evidence Based Practice | Committee Member 

Publication dates: 

• Finalized date: August 2025
• Next expected revision date: August 2028 

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These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.