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Coronary Artery Bypass Graft Surgery

After Surgery

• When you wake up, you will be in the Cardiovascular Intensive Care Unit (CVICU). The nursing staff will be at your bedside to care for you.

• The nurse will assist you to turn from side to side every two to three hours. This promotes comfort and prevents lung problems.

• Because you will not be fully awake, you will breathe through a tube in your throat with the assistance of a breathing machine. While the tube is in place, you will not be able to speak. As soon as you are fully awake, the breathing machine and tube will be removed. You will have tubes and wires attached to your body:

• Chest tubes collect blood and fluid

• A catheter (tube) in your bladder drains urine

• A monitor records your heart rate

• Wires placed during surgery will be connected to a temporary pacemaker to assist with fast or slow heart rates as needed

• IV (into the vein) lines are used during and after your surgery to give you fluid, medicines and blood if needed

• The tubes and wires will be removed when you no longer need them

• Once your breathing tube is removed, the nurse will have you begin coughing and do deep breathing exercises to prevent mucous and fluid build-up in your lungs and avoid complications, such as pneumonia.

• Your nurse will show you how to splint your incision with a pillow when coughing.

• You will learn how to use a hand-held device (incentive spirometer) to promote deep breathing. It is important to cough and use your incentive spirometer 10 times every hour while awake.

• Pain relief can help you be more active and speed your recovery. Let your nurses and doctors know if your pain medicine is working. Rate your pain on a scale of zero (no pain) to 10 (worst pain)

• All heart surgery patients will have a pain relief pump. The pump is connected to a very thin catheter outside the chest wound along the length of the incision. The pump delivers an ongoing flow of non-narcotic numbing medicine directly into your incision site. A clear dressing and tape holds the catheter in place while a belt with a small pouch supports the pump and the tubing. This results in less pain, less use of narcotics, and a quicker recovery.

Diet
Your first meal on the day after your surgery will be clear liquids. Then you will progress to solid foods. A dietitian may visit you to explain any specific diet guidelines.

Activity
The day after surgery, your activity is increased. You will first dangle your legs at the side of your bed and sit in a chair. Then your nurse will assist you with a short walk in your room. You will slowly progress to walks in the hall. You will feel weak and wobbly at first. Always ask your nurse for help with walking to the bathroom or in the hallways.

You will be in the CVICU one to two days. Sometimes your condition may require a longer stay.

Transfer to the Cardiac Stepdown Unit
As you continue to improve, you will be transferred to the Cardiac Stepdown Unit. Your heart will continue to be monitored. You will play a more active role in your recovery.

Slowly increase your activity. Walk in the halls three to four times each day and sit in the chair for meals. Use your incentive spirometer and to cough and deep breathe 10 times every hour while awake.

Wound Care and Bathing
With help, you will bathe at the bedside or at the bathroom sink. Once your tubes and drains have been removed, you may take a shower with help. Your chest incision may appear bruised and be discolored from the antiseptic used to wash your skin before surgery.

Review Date: 03/07