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What Is ERAS Cardiac?

Content Type: Implementation | Patient

This page was reviewed by the ERAS Cardiac Editorial Team and is provided for general education only. Always talk with your care team about your individual treatment plan and recovery needs.

Summary

Enhanced Recovery After Surgery (ERAS) Cardiac is a care approach that helps people recover more comfortably and safely after heart surgery. It brings together your whole care team, including surgeons, anesthesiologists, nurses, dietitians, and therapists, to prepare you for surgery, reduce stress on your body, and support faster healing.

Goal

To help you recover sooner and feel stronger after heart surgery by improving every stage of care—before, during, and after—through teamwork, planning, and education.

Explore the three main stages of your ERAS Cardiac journey below. Each section explains what your care team focuses on and how you can take an active role in recovery.

  • Learning About Your Surgery: Your team will explain what to expect and how you can help your recovery go smoothly.
  • Eating Well and Preparing Your Body: Getting good nutrition before surgery supports healing afterward.
  • Managing Health Conditions: Your team will help you manage things like diabetes, high blood pressure, or smoking to reduce risks.
  • Getting Stronger Before Surgery: Gentle exercise or “pre-hab” programs can build strength and stamina.
  • Treating Low Iron or Anemia: Correcting anemia before surgery helps your body handle recovery better.

  • Less Invasive Procedures: When possible, smaller incisions mean less pain and faster healing.
  • Comfort and Safety During Surgery: Your anesthesia team uses methods that help you wake up sooner and feel more comfortable.
  • Careful Fluid and Blood Management: Your team keeps your fluids balanced and organs protected.
  • Preventing Infection: Proven steps are taken before, during, and after surgery to keep the surgical area healthy.

  • Getting Moving Early: Walking and gentle movement help prevent complications and speed recovery.
  • Removing Tubes and Drains Sooner: These are taken out as soon as it is safe to help you feel more comfortable.
  • Managing Pain Safely: A mix of medications and techniques helps control pain while reducing side effects.
  • Eating to Heal: Good nutrition after surgery helps your body regain strength.
  • Teamwork in Recovery: Nurses, doctors, therapists, and other specialists work together to guide your progress.

  • Following a Plan: Everyone on your care team uses the same evidence-based approach to keep care consistent.
  • Staying Involved: You play an active role by asking questions, walking, eating well, and following recovery tips.
  • Tracking Progress: Hospitals and teams measure results so ERAS programs continue to improve over time.

Educational Materials

ERAS Principles & Implementation

A recorded session from the 2021 ERAS Cardiac Virtual Meeting. Members of the international ERAS network discuss the foundational principles of enhanced recovery and the steps for successful implementation.

ERAS Program Summary: Franciscan Health

Dr. Marc Gerdisch reviews the key components of his enhanced recovery program, including optimizing analgesia, mobility, and the overall patient experience.

Can We Build a National ERAS Program?

A recorded session from the 2021 ERAS Cardiac Virtual Meeting in which experts discuss what would be required to standardize ERAS nationally, including potential challenges and opportunities.

ERAS 2023: Challenges & Opportunities

Dr. Olle Ljungqvist summarizes the evolution of ERAS from its origins to today, highlighting future directions for enhanced recovery in cardiac care.

ERAS Cardiac VEC Disclaimer

The Virtual Education Center (VEC) and all included content are provided for general education about enhanced recovery after cardiac surgery. The information has been reviewed by healthcare professionals but is not meant to replace medical advice, diagnosis, or treatment. Every patient’s situation is unique. Always talk with your own doctor or care team about what is best for you.

For questions or comments about the ERAS Cardiac VEC, please contact us.

References

  1. Williams JB, McConnell G, Allender JE, et al. One-year results from the first US-based enhanced recovery after cardiac surgery (ERAS Cardiac) program. The Journal of thoracic and cardiovascular surgery. 2019;157:1881-1888.
  2. Fleming IO, Garratt C, Guha R, Desai J, Chaubey S, Wang Y, Leonard S, Kunst G. Aggregation of Marginal Gains in Cardiac Surgery: Feasibility of a Perioperative Care Bundle for Enhanced Recovery in Cardiac Surgical Patients. J Cardiothorac Vasc Anesth. 2016 Jun;30(3):665-70. doi: 10.1053/j.jvca.2016.01.017. Epub 2016 Jan 16. PMID: 27321791.
  3. Li M, Zhang J, Gan TJ, Qin G, Wang L, Zhu M, Zhang Z, Pan Y, Ye Z, Zhang F, Chen X, Lin G, Huang L, Luo W, Guo Q, Wang E. Enhanced recovery after surgery pathway for patients undergoing cardiac surgery: a randomized clinical trial. Eur J Cardiothorac Surg. 2018 Sep 1;54(3):491-497. doi: 10.1093/ejcts/ezy100. PMID: 29514224.
  4. Zaouter C, Oses P, Assatourian S, Labrousse L, Rémy A, Ouattara A. Reduced Length of Hospital Stay for Cardiac Surgery-Implementing an Optimized Perioperative Pathway: Prospective Evaluation of an Enhanced Recovery After Surgery Program Designed for Mini-Invasive Aortic Valve Replacement. J Cardiothorac Vasc Anesth. 2019 Nov;33(11):3010-3019. doi: 10.1053/j.jvca.2019.05.006. Epub 2019 May 11. PMID: 31153719.
  5. Engelman DT, Ben Ali W, Williams JB, Perrault LP, Reddy VS, Arora RC, Roselli EE, Khoynezhad A, Gerdisch M, Levy JH, Lobdell K, Fletcher N, Kirsch M, Nelson G, Engelman RM, Gregory AJ, Boyle EM. Guidelines for Perioperative Care in Cardiac Surgery: Enhanced Recovery After Surgery Society Recommendations. JAMA Surg. 2019 Aug 1;154(8):755-766. doi: 10.1001/jamasurg.2019.1153. PMID: 31054241.
  6. Noss C, Prusinkiewicz C, Nelson G, Patel PA, Augoustides JG, Gregory AJ. Enhanced Recovery for Cardiac Surgery. J Cardiothorac Vasc Anesth. 2018 Dec;32(6):2760-2770. doi: 10.1053/j.jvca.2018.01.045. Epub 2018 Jan 31. PMID: 29503121.
  7. Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: A Review. JAMA Surg. 2017 Mar 1;152(3):292-298. doi: 10.1001/jamasurg.2016.4952. PMID: 28097305.
  8. Gregory AJ, Noss CD, Chun R, Gysel M, Prusinkiewicz C, Webb N, Raymond M, Cogan J, Rousseau-Saine N, Lam W, van Rensburg G, Alli A, de Vasconcelos Papa F. Perioperative Optimization of the Cardiac Surgical Patient. Can J Cardiol. 2023 Apr;39(4):497-514. doi: 10.1016/j.cjca.2023.01.032. Epub 2023 Feb 4. PMID: 36746372.

AI Assistance Statement

This summary was developed with assistance from artificial intelligence and reviewed, edited, and approved by the listed editor(s). Reference: OpenAI (2025). ChatGPT (November version) [Large language model]. 
https://chat.openai.com