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Heart bypass surgery - discharge

Off-pump coronary artery bypass - discharge; OPCAB - discharge; Beating heart surgery - discharge; Bypass surgery - heart - discharge; CABG - discharge; Coronary artery bypass graft - discharge; Coronary artery bypass surgery - discharge; Coronary bypass surgery - discharge; CAD - bypass discharge; Coronary artery disease - bypass discharge

Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to go around a blockage to reach your heart. The surgery is used to treat coronary heart disease. This articles discusses what you need to do to care for yourself when you leave the hospital.

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How to take your pulse
Taking your carotid pulse

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When you Were in the Hospital

Your surgeon took a vein or artery from another part of your body to create a detour, or bypass, around an artery that was blocked and could not bring enough blood to your heart.

Your surgery was done through an incision (cut) in your chest. If the surgeon went through your breastbone, the surgeon repaired it with wire and a metal plate, and your skin was closed with stitches. You also had an incision made in your leg or arm, where the vein was taken to be used for the bypass.

What to Expect at Home

After surgery, it takes 4 to 6 weeks to completely heal and start feeling better. It is normal to:

Self-care

You should have someone stay with you in your home for at least the first 1 to 2 weeks after surgery.

Learn how to check your pulse, and check it every day.

Do the breathing exercises you learned in the hospital for 4 to 6 weeks.

Shower every day, washing the incision gently with soap and water. DO NOT swim, soak in a hot tub, or take baths until your incision is completely healed. Follow a heart-healthy diet.

If you feel depressed, talk with your family and friends. Ask your health care provider about getting help from a counselor.

Continue to take all your medicines for your heart, diabetes, high blood pressure, or any other conditions you have.

Know how to respond to angina symptoms.

Activity

Stay active during your recovery, but start slowly.

DO NOT drive for at least 4 to 6 weeks after your surgery. The twisting involved in turning the steering wheel may pull on your incision. Ask your provider when you may return to work, and expect to be away from work for about 6 to 8 weeks.

DO NOT travel for at least 2 to 4 weeks. Ask your provider when travel is OK. Also ask your provider before starting sexual activity again. Most of the time it is OK after 4 weeks.

You may be referred to a formal cardiac rehabilitation program. You will get information and counseling regarding activity, diet, and supervised exercise.

Wound Care

For the first 6 weeks after your surgery, you must be careful about using your arms and upper body when you move.

Brushing your teeth is OK, but DO NOT do other activities that keep your arms above your shoulders for any period of time. Keep your arms close to your sides when you are using them to get out of bed or a chair. You may bend forward to tie your shoes. Always stop if you feel pulling on your breastbone.

Your provider will tell you how to take care of your chest wound. You will likely be asked to clean your surgical cut every day with soap and water, and gently dry it. DO NOT use any creams, lotions, powders, or oils unless your provider tells you it is OK.

If you had a cut or incision on your leg:

When to Call the Doctor

Call your provider if:

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References

Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2014;130(19):1749-1767. PMID: 25070666 www.ncbi.nlm.nih.gov/pubmed/25070666.

Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126(25):3097-3137. PMID: 23166210 www.ncbi.nlm.nih.gov/pubmed/23166210.

Fleg JL, Forman DE, Berra K, et al. Secondary prevention of atherosclerotic cardiovascular disease in older adults: a scientific statement from the American Heart Association. Circulation. 2013;128(22):2422-2446. PMID: 24166575 www.ncbi.nlm.nih.gov/pubmed/24166575.

Kulik A, Ruel M, Jneid H, et al. Secondary prevention after coronary artery bypass graft surgery: a scientific statement from the American Heart Association. Circulation. 2015;131(10):927-964. PMID: 25679302 www.ncbi.nlm.nih.gov/pubmed/25679302.

Morrow DA, de Lemos JA. Stable ischemic heart disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 61.

Omer S, Cornwell LD, Bakaeen FG. Acquired heart disease: coronary insufficiency. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 59.

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Review Date: 7/25/2018  

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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