If you and your cardiac surgeon have decided together that elective (non-emergency) coronary bypass surgery is the best treatment for your heart disease, there are certain preparations that you will make in coordination with your care team. These preparations may include diagnostic tests, dietary and medication restrictions, exercise restrictions, and gathering of any personal items you will need during your stay at the hospital. You will want to have a plan in place for how you will get to the hospital and how you will return home and be cared for when your hospital stay is complete.
Planning for Hospitalization
In advance of your surgery, you will want to identify a family member, friend, or neighbor who can take you to the hospital for your surgery and also someone who will pick you up later when you are discharged (typically about five days after surgery). You will also need to identify a caregiver who can help you in the weeks immediately following your surgery. In most cases, patients will not be able to drive for six weeks and will also not be able to lift heavy objects.
As with any procedure, coronary artery bypass graft surgery carries risks. The risk of serious complications is generally low, but risk will vary depending on the age and health of the individual patient. This may be a good time to discuss with your loved ones the types of medical treatment you would, or would not, like to have if you are unable to communicate your wishes. You can record these wishes for your healthcare providers and loved ones in a document called a living will.
In the days just prior to your admission to the hospital, you will want to begin gathering the personal items you will need while you are there:
- Any medications you will need to take while in the hospital. Be sure your surgeon is aware of all medications you are taking, including those prescribed by other physicians.
- Eyeglasses, contact lenses, dentures, and any similar items. You will be asked to remove these items for surgery, but you will want to have them with you for your hospital stay.
- Comfortable clothing: After your surgery, and when you are moved out of the intensive care unit (ICU), you will want to have comfortable clothing and pajamas for the remainder of your hospital stay.
If you are preparing to have coronary bypass surgery, you may be asked to undergo several tests in the weeks, days, and hours prior to surgery. These tests may include, among others, blood tests, a chest x-ray, and an angiogram - a test that will give your surgeon detailed information about the blockages in your arteries.
You will be advised by your care team as to your dietary restrictions. Typically, you will be asked to refrain from eating or drinking after midnight the night before your surgery. This requirement is to prevent nausea and vomiting associated with the anesthesia that will be used to “take you under.”
Be sure your surgeon and care team are aware of all medicationsyou are taking. Also advise them of any vitamin or herbal supplements you are using, as these can affect, for example, your risk of bleeding after surgery. Your surgeon will give you instructions as to which medications you should continue and which you should stop taking – and when – before the procedure. If you are taking anticoagulants such as warfarin (Coumadin), which prevent your blood from clotting, you will be asked to stop taking these medications. Generally, you will continue your daily aspirin. Any medications you are advised to take or continuing taking should be swallowed with only a sip of water.
Be sure to carefully follow your surgeon’s instructions about which medications you should take or stop taking, and when. If you have any concerns related to medications, discuss them with your care team. Not following recommended medication guidelines could be dangerous to your health.
Personal Care Instructions
Your care team will provide you with any instructions for specific pre-surgery preparations you should make. For example, you may be asked to bathe carefully with a special antiseptic soap.
Admission to the Hospital
You may be admitted to the hospital the day before or early in the morning of the day of your surgery. If you are admitted the day before surgery, you will have a preoperative work-up, which includes a medical history, physical examination, and various tests. The workup provides your cardiac surgeon with important information about your health before the procedure. You will meet with your anesthesiologist, the medical professional who will order and administer medications that will temporarily put you “asleep” during the procedure. You may also attend a class or meet with a member of the surgery team to learn about the procedure, what will happen when you awaken and what to expect for the remainder of your hospital stay.
If you are to be admitted the day of your surgery, your surgeon’s office will coordinate your preoperative work-up a day or two before the procedure. The anesthesiologist will meet with you and prescribe the medications that will put you under general anesthesia during the surgery.
After you have been prepared for surgery, you will be moved to the operating room. Click here for information about how bypass surgery will proceed in the operating room, who will be present, and what medical equipment will be necessary to support you and the care team during the surgery.
Note: In some cases, in patients who need urgent surgery for a heart attack or unstable angina, there is no time for the patient to prepare. Admission to the hospital will take place immediately.
For more information on what outcomes to expect from coronary bypass surgery, visit Benefits and Risks of Coronary Bypass Surgery. As you prepare for surgery, you may find it helpful to review Questions to Ask Your Doctor About Coronary Bypass Surgery to identify any last pre-surgery questions you may not have covered with your surgeon.