Cardiac Surgery: Bypass and Thoracotomy ERAS

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

ERAS Pathway:

• Prior to surgery 

• Intraoperative bypass surgery  

• Intraoperative thoracotomy surgery  

• CICU 

• Inpatient to discharge 

• 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  

• 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 

If you have any questions regarding this content or identify a broken link, please email evidencebasedpractice@cmh.edu.

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.