Coronary Artery Bypass Graft S... Health Article

Preparation

The patient is usually admitted to the hospital the day before the coronary artery bypass graft surgery is scheduled. Coronary angiography has been previously performed to show the surgeon where the arteries are blocked and where the grafts might best be positioned. The patient is given a blood-thinning drug—usually heparin—that helps to prevent blood clots. The evening before the surgery, the patient showers with antiseptic soap and is shaved from chin to toes. After midnight, food and fluids are restricted. A sedative is prescribed on the morning of surgery and sometimes the night before. Heart monitoring begins.

Aftercare

The patient recovers in a surgical intensive care unit for at least the first two days after the surgery. He or she is connected to chest and breathing tubes, a mechanical ventilator, a heart monitor and other monitoring equipment, and a urinary catheter. The breathing tube and ventilator are usually removed within six hours of surgery, but the other tubes remain in place as long as the patient is in the intensive care unit. Drugs are prescribed to control pain and to prevent unwanted blood clotting. The patient is closely monitored. Vital signs and other parameters, such as heart sounds and oxygen and carbon dioxide levels in arterial blood, are checked frequently. The chest tube is checked to ensure that it is draining properly. The patient is fed intravenously for the first day or two. Daily doses of aspirin are started within six to 24 hours after the procedure. Chest physiotherapy is started after the ventilator and breathing tube are removed. The therapy includes coughing, turning frequently, and taking deep breaths. Other exercises will be encouraged to improve the patient's circulation and prevent complications due to prolonged bed rest.

If there are no complications, the patient begins to resume a normal routine around the second day. This includes eating regular food, sitting up, and walking around a little bit. Before being released from the hospital, the patient usually spends a few days under observation in a non-surgical unit. During this time, counseling is usually provided on eating right and starting a light exercise program to keep the heart healthy. Patients should eat a lot of fruits, vegetables, grains, and non-fat or low-fat dairy products, and reduce fats to less than 30% of all calories. An exercise program will usually be tailored for the patient, who will be encouraged to participate in a cardiac rehabilitation program where exercise will be supervised by professionals. Cardiac rehabilitation programs, offered by hospitals and other organizations, may also include classes on heart-healthy living.

Full recovery from coronary artery bypass graft surgery takes three to four months and is a gradual process. Upon release from the hospital, the patient will feel weak because of the extended bed rest in the hospital. Within a few weeks, the patient should begin to feel stronger.

While the incision scar from coronary artery bypass graft surgery heals, which takes one to two months, it may be sore. The scar should not be bumped, scratched, or otherwise disturbed. An exercise test is often conducted after the patient leaves the hospital to determine how effective the surgery was and to confirm that progressive exercise is safe.