CABG

Heart bypass surgery creates a conduit or "bypass" around the blocked part of a coronary artery to restore the blood supply to the heart muscle.

The surgery is commonly called Coronary Artery Bypass Graft, or CABG

PRE-OPERATIVE
CABG is performed to restore blood flow to your heart by bypassing coronary (heart) arteries that have been narrowed or blocked by the build-up of plaque. In CABG, a surgeon uses a piece of an artery or vein from another part of your body to reroute blood around the blocked or narrowed portion of your coronary artery or arteries. Your surgeon will perform a physical examination and review your medical history before your procedure. Be sure to bring a list of any medications, dietary supplements, allergies any other problem with anesthesia or herbal supplements that you take with you to your doctor's appointment. You also may undergo several pre-operative imaging tests, in which the arteries that deliver blood to your heart are evaluated. Eg. 2D Echo & CAG The day before your procedure, you will get admitted to complete paperwork, have a blood sample taken, be weighed, and have a chest xray. You have to undergo complete body preparation as body bath with antiseptic solution , full body shaving & hair to be shampooed. You will be in fast for 8-10 hours.

 Take a shower or bath again on the day of surgery with the anti-septic solution we gave you. At the hospital, you will change into a gown. You will receive an IV, and when its time to go to the operating room, medications will be given to you as ordered. As a part of your pre-operative preparation respiratory preparation & post operative exercises will be taught to you by physiotherapist. You & your close relative have to give surgical & anesthesia consent for medico-legal aspects. Post operatively you will be kept in ICU and on fasting for 24 hrs & nutritional needs will be met by administration of IV fluids & medication. You will have drain tubes and catheter for Minimum 2days

INTRA-OPERATIVE

Half an hour back to your scheduled time you will be shifted to operation theatre along with nursing staff. In OT you will be received in pre-op area & your file will be verified for completion of documentation. As soon as surgical team is ready you will be shifted to the specified OT & you will be on your supine position & you will be anaesthetized. Midline sternotomy incision will be taken on you

POST-OPERATIVE

ICU Stay: You will have to stay 12-24 hrs post operatively in ICU or as recommended by the Surgeon/Anaesthetist.
Exercise: Deep Breathing exercises Chest Exercises Spirometry Limb Exercises( Active & Passive ROM , - Flexion, Extension, Circumduction)

 Early Ambulation: Sitting at the edge of the bed with feet dangling (12nd day) Bed side ambulation ( 2nd 3rd day) Pace walking

 Diet:

Low Fat diet

Not more than 12 - 15% of total calories should come from fat.

Plenty of vegetables & fruits ( High Fibre).

 DO NOT CONSUME
Deep fried foods like bhajiyas, samosa, kachori, batatawada etc. Bakery products Dry fruits , coconut , groundnut, til. Red meat, shellfish, egg yolk, organ meat Sugar, jaggery, honey, jam, sweets, fruit juices, Wine, Whisky & Beer Sodium and fluids are restricted as per the disease A good amount of vitamins A, C, E, selenium, zinc, Manganese, B-carotene as these anti-oxidants play a vital role against free 02 radicals which initiate atherosclerosis

Medication:
Aspirin S/E : Gastritis, Bleeding tendencies. Nitroglycerine: S/E: Headache In case of angina at 5 min interval you can take 3 tablets SL If no pain relief for 15 min consult Dr immediately Beta Blockers: Ca Channel blockers: Oral hypoglycemic agents / Insulin
Take prescribed medications at the same time Do not self medication Do not use over the counter drugs

Follow-up:
1st visit after 15 days : For staple removal Or as per protocol After 6 weeks with Ix : - X ray - CBC/ ESR - Electrolytes - Lipid profile - FBS/ PPBS After Angioplasty : Stress Test

 Discharge Instruction:
You may Not have much appetite Have some swelling, Have difficulty sleeping at night Have problems with constipation Have mood swings and feel depressed. Notice an occasional "clicking noise" or sensation in your chest Experience muscle pain or tightness in your shoulders

Care of the Incision:

Do not apply oils, lotions, ointments, creams or powder to the incision.

Care of the Surgical Leg / Radial graft site:

Check your leg daily for swelling Elevate the leg

Watch for oozing or redness Wear Stockings

Rest

Travel

Driving:

Lifting:

Use of Chest corset

Bowel Movement: Avoid constipation/straining.

If you are to be, You must begin, By assuming responsibility, You alone are responsible, For every moment of your life , For every one of your acts. - Antoine de Saint- Exupery

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