Coronary Artery Bypass Graft

What you should know

A coronary artery bypass graft (CABG) is open heart surgery to open blocked arteries in your heart. An artery is a blood vessel that carries oxygen to your body. Parts of your heart may not get enough blood if an artery is blocked. You may have a heart attack if one or more of these arteries is blocked. CABG surgery can improve blood flow to your heart by bypassing (sending blood around) the blocked part of an artery. This restores blood flow to your heart and the rest of your body.

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

• Your incisions may get infected. You may bleed more than expected and need a blood transfusion. You may have fast heartbeats that are not regular in rhythm. Your heart may not get enough oxygen and have trouble pumping blood through your body after surgery. There is a chance that your signs and symptoms may come back. You may need another CABG.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling and stop blood from flowing to your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. 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.

Getting Ready

Before your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• You may be able to donate your own blood before surgery. This is called autologous blood donation. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.
  
  
• You may need to have blood drawn or imaging tests. Ask you caregiver for more information about the tests you may need. Write down the date, time, and location of each test.
  
  
• Your caregiver may give you antibiotic medicine before surgery. This medicine kills germs and may help prevent infection. Your caregiver may give you medicine to thin your blood. This medicine helps prevent blood clots from forming. You may also need medicines to help prevent a fast or fluttering heart rhythm. Ask your caregiver for more information about the medicines you may need before surgery.

The night before your surgery:

• Ask caregivers about directions for eating and drinking.
  
  

The day of your surgery:

• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  

Treatment

What will happen:

• You will be taken to the room where your surgery will be done. Medicine called anesthesia will be given to keep you asleep and free from pain during the 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 where you can rest until you are awake. Do not try to get out of bed until your caregiver says it is okay.

Contact a caregiver if

• You have a fever.
  
  
• You cannot make it to your surgery on time.
  
  
• You have questions or concerns about your surgery.

Seek Care Immediately if

• You have discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain.
  
  
• The discomfort lasts for more than a few minutes or keeps returning.
  
  
• You have pain in your back, neck, jaw, stomach, or arms.
  
  
• You have nausea or a sudden cold sweat.
  
  
• You are dizzy or have trouble breathing.