Post Operative Care After CABG
Dateline: 06/21/98
Often I've been asked the question "What happens after open heart surgery ?" With the help of some of the wonderful Guides on The Mining Company, we have produced a 'special' on "Care after Open Heart Surgery", with articles on surgical, nursing, cardiological and nutritional points of view. I hope you enjoy the series, please write to me with your comments and suggestions.
In this article, I will focus on the surgical aspects of post-operative care after open heart surgery.
The post-operative patient
For illustrative purposes, let's consider a patient recovering from the commonest open heart
operation performed today, Coronary Artery Bypass Grafting (CABG). The course is similar after
other kinds of open heart procedures too, but each operation has its own special variations and
nuances of care.
An average patient - let's call him John Doe - is in his mid-fifties, a smoker, maybe diabetic, with high serum cholesterol, low levels of physical activity and maybe a family history of heart attacks. How can John make his post-operative period least unpleasant ?
An ounce of prevention is better than a pound of cure
Post-operative care begins well before surgery. John should stop smoking for atleast six weeks
before operation. If diabetic, his blood sugar levels must be measured and brought under control by
adjusting medication dosage. John must be taught deep breathing exercises which will prevent lung
collapse (atelectasis) later on. Walking for atleast short distances, and learning calf muscle exercises
can help reduce the risk of post-operative pulmonary embolism.
What happens in the ICU ?
John Doe would most likely have had two or more bypass grafts inserted, one of which is an
internal mammary artery (IMA) graft. In most centers, a post-CABG patient would be put on an
artificial ventilator to allow some time for recovery from the stress of the operation. Special
medication would include
- drugs to improve the heart's function (like Dopamine, Dobutamine and Amrinone)
- medicines to maintain the heart's normal regular rhythm (anti-arrhythmics)
- insulin to control blood sugar levels
- pain killers to dull the pain of surgery
John's vital signs - heart rate, blood pressure, temperature, respiration - would be closely monitored. In addition, sophisticated monitoring of parameters like cardiac index or left atrial pressure are occasionally needed.
What could go wrong with John soon after the operation ? Read on ...
In addition to the problems I've discussed in this article, there are others which will be covered by the other guides in this special. Here is a list of these articles:
- Nursing care after open heart surgery
- Importance of Weight control after CABG
And don't forget. You can post your comments on this article on the Heart Disease Bulletin Board or discuss it in the Chat Room.
You can also review articles in the following interest areas dealing with heart disease:
- Minimally Invasive Heart Surgery
- MICAS website
- Fetal Heart Surgery
- Congenital Heart Disease
- Heart Disease in Women
Comments ? Feel free to air your views on this article. You can
- send me e-mail
- post on the heart disease bulletin board
- chat about it in the heart disease chat room.
I'll collect and compile interesting postings into a future article, of course with due credit to the authors. So go ahead and speak up your mind !
Let me know:
How did you like this week's article ? Please write to me with suggestions, comments or criticism.
But do write !
Take some time to browse through:
What's new ?
And if you would like to read more about the latest breaking stories on heart disease, visit "The
Newsdesk" ... it's updated every week, and has a lot more exciting stuff.
Suggested Reading on Heart Disease:
If you're looking for some good books to read on heart disease prevention and treatment, drop into
the bookstore. You can order online right there.
