What immediate preparations should I make before surgery?
Don't eat after midnight of the night before surgery. If you have
diabetes, consult your physician before fasting.
Discuss your current medications with your physician. She may
advise you to stop taking certain medicines (e.g. anticoagulants)
for a few days to a week before the procedure. Ask her if it will
be all right to take aspirin.
Stop smoking to improve blood flow and breathing.
You will not be returning to the same room after surgery, so
leave all valuables at home. Do not wear any jewelry or contact
lenses to the hospital. There is usually no safe place to leave
eyeglasses, dentures or detachable bridgework. If you require
these items, give them and your wedding ring to a relative, who
can return them to you after the operation.
Whom will I see in the hospital?
You will meet with several members of the surgical team which
may include, the surgeons, the anesthesiologist (who administers
medication to make you sleep during the surgery), a cardiac nurse,
a respiratory therapist, a physical therapist, and a nutritionist.
Each will explain his role in the surgery. and healing processes.
This is the time to seek clarification of any issues which are
All surgery has potential risks. In coronary artery bypass surgery,
there is small risk of heart attack, stroke, or death. There is
also a small risk of infection in the leg or chest wounds. Rare
occurrences include: breathing or other lung problems, bleeding,
and nerve injury. Your doctor will explain all the risks, and
ask you to sign a consent form.
Many hospitals welcome family members at this meeting and encourage
them to ask questions and voice their concerns.
What happens before the operation?
You will have: blood tests (a few tubes), a chest x-ray, urine
analysis and an electrocardiogram (abbreviated EKG or ECG) This
last test records your heartbeats. Sometimes, these tests are
performed prior to admission.
You will be weighed before and after the operation to determine
if you are retaining fluid.
Your chest, groin, and leg hair will be shaved to help prevent
Who will be in the Operating Room?
In the OR, you will see the professionals you've met as well as
other members of the surgical team, including the perfusionist.
This specialist monitors the "heart-lung" machine that keeps your
blood supplied with oxygen and keeps the blood circulating. during
the operation. Your blood pressure, temperature and respiration
will be closely monitored, as well.
What happens during the operation?
Before the surgery begins, the surgical team will clean and drape
you and prepare a sterile environment.
Then a surgeon will begin the operation by making an incision
in your chest, and then dividing and separating apart your breastbone.
Ice water is placed on the heart to cool it down. Tubes are then
attached to the heart and connected to the heart lung machine.
Blood will travel from the upper chambers of your heart, to the
machine and then throughout your body.
Once the heart-lung machine has taken over for your heart, the
surgeons will clamp the main artery (aorta). Then they remove
the bypass vessel and attach it to the blocked coronary artery.
They do this by sewing the graft vessel to the coronary artery
beyond the blockage. If they are using the saphenous vein, they
will sew one end to the coronary artery, and one end to the aorta.
If the mammary artery is being used, the second step is unnecessary.
The mammary artery is already connected to the aorta.
After the grafting is completed, you will be taken off the heart
lung machine. Your heart and lungs will take over again; and the
surgeon will rejoin the breastbone with stainless steel wires.
How long does the operation take?
The operation lasts from 3 to 6 hours. You will then go to the
Intensive Care Unit (ICU) to recover and be monitored. Your family
may visit you there after a couple of hours. Let them know in
advance, that you will not look your best. You may be pale and
puffy, and you will be surrounded by tubes and wires. You may
still be asleep.
What happens in the ICU?
When you awaken in the ICU, you may feel groggy, thirsty, cold,
or in pain. The nurse. can give you a pain killer.
You will have a breathing tube in your mouth. Try to relax. The
nurse will test your breathing.. As soon as you are breathing
on your own, the tube will be removed. You will not be able to
talk while the tube is in your mouth, but the nurse will teach
you how to communicate for that brief period of time.
At first, you may be disoriented and confused. You may not readily
know whether it is day or night or how much time has passed. That
is normal. The disorientation doesn't last long.
You will have a fever after the operation. This may last for
three or four days.
After the breathing tube is removed , you will be able to swallow
liquids. You will be able to eat solid foods in a day or two.
How long does recovery take?
If you have external stitches, they will be removed from your
chest about a week after the operation. The stitches will be removed
from your leg a few days later. These wounds will change color
several times during the healing period, which is about six weeks.
How long will I remain in the hospital?
The usual hospital stay is around five days to a week. You may
make one or two room changes after the ICU, as you slowly gain
Within a day or two you will be able to sit in a chair. Usually,
you will be walking a day later. Moving about will help the healing
process. Walking also prevents the formation of blood clots and
reduces ankle swelling.
A nurse or a respiratory therapist will give you coughing and
breathing exercises. This is part of the healing process.
You will continue to have EKGs, chest x-rays and blood tests
throughout your stay.
What happens when I leave the hospital?
You will be taught how to care for your incision to help it heal
and prevent infection.
You will have follow-up visits with your doctor who will monitor
Arrange in advance for a friend or family member drive you home
from the hospital.
During the recovery period, you should take showers instead of
baths. Pat, rather than rub yourself dry. You will be most comfortable
in clean, soft, cotton garments.
Your doctor will advise you when you may return to work.