Coronary Artery Bypass Graft

WHAT YOU SHOULD KNOW:

A coronary artery bypass graft (CABG) is open heart surgery to clear blocked arteries in your heart. CABG surgery improves blood flow to your heart by bypassing (sending blood around) the blocked part of an artery. This restores blood flow to your heart and helps prevent a heart attack.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may develop an infection. You may bleed more than expected and need a blood transfusion. You may have fast, irregular heartbeats. Your heart may not get enough oxygen and have trouble pumping blood through your body after surgery. Your signs and symptoms may come back. You may need another CABG.

  • You may get a blood clot in your leg or arm. This may become life-threatening. You may have fluid buildup around your heart. This fluid puts pressure on the heart and prevents it from working properly. You may also have fluid buildup around your lungs. This may make it hard for you to breathe after surgery. These problems can be life-threatening.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

  • Medicines: These may be given before, during, or after your surgery.

    • Blood thinners help prevent blood clots. Blood thinners make it more likely for you to bleed or bruise.

    • Antibiotics help prevent an infection caused by bacteria.

    • Heart medicine helps strengthen and regulate your heartbeat.

During your surgery:

  • An incision will be made in your chest. The ribcage will be cut or spread apart so your caregiver can reach your heart. Your caregiver may safely slow your heartbeat to attach the graft. Your heart may be connected to a bypass machine. This machine pumps blood to your body and keeps blood out of your heart during surgery.

  • A separate incision will be made to remove the graft. The graft is a piece of healthy blood vessel taken from somewhere else in your body, such as your leg. The graft vessel will be sewn to your artery above and below the block. This allows blood to flow around the blocked area to your heart muscle. After surgery, the blood will be allowed to flow through your heart. The incision where the graft came from will be closed with stitches and covered with bandages. Your chest incision will be closed. A bandage will cover your incisions to keep the area clean and dry to prevent infection.

After your surgery:

You will be taken to a room to rest until you are fully awake. Caregivers will monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are okay, you will be taken to your hospital room.

  • A chest tube is placed during surgery to drain air and extra fluid from around your lungs. This allows your lungs and heart to work properly. The chest tube is attached to a container. Call a caregiver right away if the tube comes apart from the container. Let the caregiver know if the tubing gets bent, twisted, or the tape comes loose. The chest tube may be removed 24 to 48 hours after surgery. Your caregiver will monitor how much fluid collects and decide when to remove it.

  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out. Caregivers will remove the catheter as soon as possible to help prevent infection.

  • Deep breathing and coughing will decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath. Then let the air out and cough. Repeat these steps 10 times every hour.

  • Extra oxygen may be needed if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

  • You may need to wear pressure stockings or inflatable boots after surgery. The stockings are tight and put pressure on your legs. The boots have an air pump that tightens and loosens different areas of the boots. Both of these improve blood flow and help prevent clots.

  • You may need to walk around the same day of surgery , or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • Medicines:

    • Pain medicine may be given to decrease pain. Do not wait until the pain is severe before you ask for more medicine.

    • Blood thinners help prevent blood clots. Blood thinners make it more likely for you to bleed or bruise.

    • Antibiotics help prevent an infection caused by bacteria.

    • Heart medicine helps strengthen and regulate your heartbeat.

    • Potassium supplements may be needed if your potassium is low. Low potassium levels can affect the rhythm of your heart.

    • Stool softeners make it easier for you to have a bowel movement and help prevent constipation.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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