At Home After Coronary Artery Bypass Graft Surgery (CABG)

Tips for the best recovery

A coronary artery bypass graft is a major, life-saving surgery. During a CABG, your surgeon restores critical blood flow to areas of your heart that are blocked. Depending on how your operation and recovery go, your heart can function much better than it did leading up to your surgery, but you need to remember that the underlying coronary artery disease and factors that led to your surgery are still there. 

When you go home after a CABG, you should have 2 goals: to recover from your surgery and hospital stay and to make changes to improve your overall heart health so you can avoid future problems.

Surgical Recovery for Bypass Surgery

Your surgeon will determine when you are ready to go home after a CABG. If you needed a long stay in the intensive care unit, you may be weak and benefit from time at a skilled nursing facility to rehabilitate strength. 

In general, you can go home after a CABG procedure when:

  • You do not need intravenous medication to control your pain.

  • You have stable vital signs.

  • Your incision is stable.

  • You can walk short distances, such as to the bathroom. It’s OK if you need assistance, as long as you have adequate help available at home. 

  • You do not need supplemental oxygen.

  • Your medications are working well and do not need frequent changes.

  • You have stable lab results.

  • You do not have signs of pneumonia or other complications.

  • You no longer need tubes and drains.

Rules to Follow After Discharge

After heart surgery, follow these guidelines to protect your surgical site. Depending on your circumstances, some guidelines may vary. Always ask your surgeon if you need clarification.

  • Do not drive for at least one month. Before you drive, you should be able to move and press on the brakes suddenly without any pain in your chest, sternum, or incision. 

  • Do not lift over 10 pounds for at least 6 weeks. 

  • Avoid twisting, pulling, and movements that put pressure on your sternum.

  • When you shower, clean your incisions gently with soap and water and pat them dry.  Do not take a bath or get into a pool or hot tub until your incisions are completely healed. 

  • Brace your incisions with a pillow when moving and coughing.

  • Continue to use your incentive spirometer throughout the day to keep your lungs clear. 

  • Get active, such as short walks twice a day, but pay attention to your fatigue level. Do not go on walks alone. Stop if you have chest pain, dizziness, a racing heart, or difficulty breathing.

Watch for redness, drainage, swelling, or opening of your wound.

Recovery

Expect your recovery to take 6 to 8 weeks. You may feel fatigue, low appetite, and depression. Recognize that you are on the road to recovery, even if it seems slow.

Cardiac Rehabilitation 

Cardiac rehabilitation, or cardiac rehab, is prescribed by your doctor after a CABG and most often includes 3 sessions per week for 12 weeks, depending on your surgeon’s recommendations. A team of specialists will guide you through a medically supervised exercise program. You will also learn about diet, medications, stress management, and lifestyle changes. 

Exercise for Effective Recovery

To help you exercise safely after a CABG, your cardiac rehab team will:

  • Check your vital signs, including blood pressure before and after exercise

  • Monitor your heart rhythm during gentle cardiovascular activity

  • Start gently and gradually increase your activity level as your heart strengthens

  • Use strength training along with stretching and activities like using a treadmill or exercise bike

Exercise at a moderate activity level. At that level, your heart rate increases, but you can still carry on a conversation. 


Lower Your Risk Factors 

It is essential to understand the risks that contribute to coronary artery disease and put you in danger of more arterial blockages forming. 

Some tips:

  • Quit smoking. Smoking causes inflammation inside your arteries, making them more likely to clog. Chemicals in tobacco products, including nicotine, increase your heart rate and blood pressure, putting stress on your heart muscle. 

  • Limit alcohol. In general, alcohol is safe to resume when it has been at least 2 weeks since your CABG surgery and you are no longer taking pain medications. Keep your alcohol consumption low to moderate. Studies show heavy drinking nearly doubles the risk of death after CABG surgery. 

  • Control blood pressure and cholesterol. Talk to your doctor about ways to control high blood pressure and reduce your cholesterol. Dietary changes and exercise can help. Your doctor may also prescribe medications.

  • Control blood sugar. Surgery can increase your blood sugar, and high blood sugar can damage your heart. If you have diabetes, work with your doctor to find the right balance of diet and medications as you recover. 

  • Reduce stress. Bypass surgery can be extremely stressful. Stress hormones raise your blood pressure and heart rate and cause inflammation, which can damage your blood vessels and heart. Your cardiac rehab team will teach you techniques to reduce your stress response. 

Eat a Heart-Healthy Diet

Your surgeon may recommend a diet high in protein to support healing after surgery. Hydration is also vital to healing. If you are not prescribed a specific diet, eat plenty of fresh vegetables, lean meats, and whole grains to support a healthy heart and reduce your risks. Avoid sugar, added salt, and processed and deep-fried foods. 

Emergency Care

Seek emergency care if you experience:

  • Chest pain and pressure different than incision pain

  • Difficulty breathing that does not get better when you rest

  • Bleeding, including coughing up blood or blood in your bowel movements

  • A fast heart rate over 150 beats per minute

  • Signs of stroke, including drooping of one side of your face, slurred speech, a severe headache, or numbness or weakness in your arms or legs

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