• What to Expect Immediately After Coronary Bypass Surgery

     
     
     
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    As a coronary artery bypass graft surgery patient, you have just undergone major surgery. Even though specific problems in your heart have been addressed, your body has been through a lot, and you will need time to recover and regain your strength. Everyone’s recovery is unique.

    Your recovery will begin in the hospital’s intensive care unit (ICU) and typically will continue in another area of the hospital for three to five days before you go home. Once you have been discharged from the hospital, recovery typically takes six weeks or more.

    In the Intensive Care Unit (ICU)

    After bypass surgery, you will be moved to the ICU. The hospital’s ICU is specially equipped to monitor your vital signs, and the medical professionals you will meet there have training in safeguarding more vulnerable patients. You may not wake up from the anesthesia for two to four hours. During this time, you will continue to breathe through the breathing tube with help from a ventilator, a machine that will move air in and out of your lungs, essentially “breathing” for you. This will enable you to breathe easily and take good, deep breaths. Your hands will be restrained to prevent you from pulling the tube out. The tube will be removed when you are breathing well on your own. 

    Most patients are able to have short visits from family members in the ICU a few hours after your surgery. Because you will still have the breathing tube in place, you will not be able to talk. You may communicate with notes or by shaking your head.

    When you wake up, you will have several other tubes attached as well, most of which will be removed the day after surgery: 

    • A stomach tube, inserted through the nose down to the stomach. This tube prevents nausea and keeps air from bloating the stomach. You will not feel pain from the tube, but your nose may drip. 
    • A catheter (thin, flexible tube) inserted in your bladder that enables the care team to monitor your urine. You may have a normal urge to urinate while the catheter is in place. For a short time after it is removed, you may feel a stinging sensation when you urinate. 
    • Chest tubes, which are inserted at the end of the operation and drain fluid, preventing fluid from accumulating in the chest cavity. The chest tubes will be removed when the drainage stops. 
    • An arterial line (a plastic needle) in the artery of your arm, which is used to monitor blood pressure, and draw blood samples, if needed. 
    • IV tubes, which supply fluids, medications, and blood as needed. 

    The Day After Surgery

    Typically, on the day after surgery, you will begin to drink clear liquids, and you will receive solid foods as you are able to tolerate them. You may also be able to sit up on the side of your bed. On this first day, you will also begin breathing and coughing exercises that are an important measure for reducing the risk of lung complications such as pneumonia. Many patients will be moved out of intensive care to another area of the hospital. When you are moved, you will wear a small, portable device that monitors your heart rate. This is a telemetry monitor.

    The Second Day After Surgery

    On the second day after surgery, you will typically be expected to walk two or three times. You will begin to eat solid foods as your appetite returns, but the amount you drink will be limited to six to eight cups of liquid over 24 hours. You will sit in a chair for meals.

    Your hospital stay will typically be three to five days after you are moved from the ICU to another unit.

    Recovery at Home

    After coronary bypass surgery, a typical recovery at home is six weeks, though recovery can take anywhere from four to twelve weeks.  

    When you arrive at home, you and your caregiver—a family member, friend, or home health aide you have identified before the surgery - will:

    • Monitor for symptoms of infection in the chest incision, such as fever, rapid heart rate, worsening incision pain, or bleeding from the wound. Your care team will provide you with information about what symptoms may indicate a complication. Contact your doctor right away if any of these symptoms occur.
    • Clean the chest incision and any incisions from the grafts according to your doctor’s instructions. A graft is the blood vessel that was removed from your chest, leg, arm, or other site in the body to be sewn in to reroute blood around a blockage in your heart artery. You will have an incision in your chest from the open-heart bypass surgery, and you will have incisions from any sites from which grafts were taken.
    • See Incision Care After Coronary Bypass Surgery for detailed information on cleaning and caring for your surgical incisions.

    It is important to keep all follow-up appointments with your healthcare providers and to take prescribed medications exactly as indicated. If you have any concerns about your medications, do not stop taking them without contacting your physician. Doing so can be dangerous.

    Your physician will give you clearance for when it is safe to resume certain activities. People who work in strenuous occupations may need to wait longer than those in less strenuous positions to return to work. Most surgeons discourage driving a car for six weeks after coronary bypass surgery. Your physician will also give you guidelines on when you can resume physical activities, including sexual activity.

    Cardiac Rehabilitation

    During the recovery period, you may begin participation in a cardiac rehabilitation program, if prescribed by your physician. You may begin cardiac “rehab” while you are still in the hospital and continue it in the months moving forward. Cardiac rehab is, in part, a structured exercise program that can help you increase your physical activity level while under the direct supervision of medical professionals. The program also includes work with dieticians, occupational therapists, psychologists, and other healthcare providers who can help you recover from your surgery and feel confident that you have the skills to adopt a heart-healthy lifestyle.

    Regaining physical strength and eating a diet of nutrient-rich foods are critical to a successful recovery from coronary bypass surgery and to returning to the lifestyle you want to live. Studies have shown that cardiac rehab is more than just a good idea. It can be a lifesaver. Recent research has found that patients who complete cardiac rehab are more likely to be alive five years after a heart event than those who do not.

    The Months Ahead

    Coronary bypass surgery corrects blockages in the arteries, but it doesn’t cure the underlying heart disease process. Long-term recovery will involve fighting the risk factors that are contributing to your coronary artery disease. Some risk factors, such as family history, can’t be changed, but others such as dietary and exercise habits can be. Medical professionals and support groups are available to help you make lifestyle changes.

    For more information on what long-term recovery from bypass surgery will require and the steps you will take with your care team to combat the underlying disease process, please visit Long-Term Recovery and Support After Coronary Bypass Surgery.