Coronary-Artery Bypass Grafting

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Coronary-artery bypass grafting is a surgical procedure used to create new routes around blockages in the coronary arteries (the arteries of your heart). The procedure involves removing blood vessels from other parts of the body and attaching them to the blocked arteries. This allows blood flow to be rerouted around the blockages.

When is it used?

This procedure is used when plaque (a buildup of fatty matter) collects in the coronary arteries, causing a narrowing or blockage that reduces blood flow to the heart. This can lead to angina (pain, pressure and tightness in the chest) and heart attacks. Coronary-artery bypass grafting can restore blood flow to the heart, reducing angina pain and helping to prevent future heart attacks.

Do I need to do anything special before the surgery?

If you are taking aspirin or any other blood-thinning medicine, contact your doctor for special instructions a week before the surgery. Do not eat or drink anything after midnight on the night before surgery. Please leave valuables, including large amounts of money, at home so they will not be lost when you are being moved to different rooms for treatment and recovery.

Also, do not wear rings or other jewelry to the hospital because they will need to be removed before the surgery. In addition, please bring a list of the medicines you are taking and the dosages (the amount your doctor has asked you to take), as well as the medicines themselves. Follow any other instructions you are given.

How is the procedure performed?

First, you will be connected to tubes for injecting fluids and medicine into your bloodstream. You will then be given anesthesia, a medicine to make you sleep and prevent you from feeling pain during the surgery. Next, an incision (cut) will be made down the middle of your chest, and your breastbone (sternum) will be divided. This will allow your doctor to reach all areas of your heart. As medicines are being used to stop and protect your heart, you will be connected to a heart-lung machine to circulate your blood.

Next, a vein or artery will be removed from another part of the body. An artery located behind the ribs is often used. If needed, a vein from the leg (or sometimes an artery from your arm) can also be used. An opening will be created just below the blockage and the artery or vein will be sewn to this opening. This will be done for each blockage. Your heart will then be restarted, the heart-lung machine will be disconnected and your chest will be sewn closed.

What will I feel during this procedure?

The anesthesia will make you sleep throughout the surgery, so you should not feel any pain. After you wake up, you will begin receiving medicine to reduce discomfort. You will continue receiving this medicine throughout your hospital stay and will be given a supply to take home.

What happens after the procedure?

When you wake up, you will be in the intensive-care unit. You will have a tube in your mouth that is connected to a breathing machine. This tube will be removed as soon as you are awake enough to breathe on your own. In addition, you may notice that you are attached to a heart monitor as well as tubes for medicines and fluids. You will also be attached to a bladder catheter, a tube for draining urine. These tubes and devices will be removed as soon as they are no longer needed.

You will learn deep breathing and coughing exercises to expand your lungs and prevent fluids from collecting in them. As soon as you are feeling well enough, you will be able to get out of bed and start walking around. By the time you go home, you should be able to perform activities, such as walking, climbing stairs, showering and dressing yourself.

Is there anything special I need to do when I go home?

To help your breastbone heal properly, avoid heavy lifting and sudden tugging or pulling. It will take up to three months for your breastbone to heal. Ask your doctor for special instructions.

To build strength and endurance, walk short distances and perform light exercises, slightly increasing activity each day. Additionally, you will be able to shower and use soap and water to wash the incision in your chest and gently pat it dry. If you develop signs of infection, such as redness, swelling, pus or fever, call your doctor right away. Record your weight, temperature and pulse daily. Tell your doctor if you gain more than three pounds suddenly or experience shortness of breath, fever, an irregular pulse, increased chest pain, movement in your breastbone or increased coughing.