Coronary Artery Bypass Grafting Recovery from Surgery

After coronary artery bypass grafting (CABG), you will stay in the hospital for about 1 week. You may stay longer if you had other procedures done as well, or if you have a complication.

You will stay in an intensive care unit (ICU) for a day or two, where medical staff may do the following:

• Apply bandages on your chest and wherever the graft was removed
• Attach tubes to drain fluid from your chest and urine from your bladder
• Connect you to an electrocardiogram (ECG) to monitor your heart rhythm
• Implant a temporary pacemaker, and, in some cases, an implantable cardioverter defibrillator (ICD)
• Give you compression stockings to wear on your legs to help maintain proper blood flow and prevent blood clots
• Give you medicines to help with pain during recovery, prevent blood clots or irregular heart rhythms, and control cholesterol and fats in the blood
• Give you oxygen therapy, which delivers oxygen into your nose through nasal prongs or a mask
• Monitor your vital signs, such as your heart rate, blood pressure, and oxygen levels

After you leave the hospital, you will need about 6 to 12 weeks to recover completely. People who undergo minimally invasive CABG need less time to recover than for traditional CABG.

Recovery at home

After you leave the hospital, you will need to continue taking medicines.. It is important to work with your doctor after CABG to help you stay healthy.

Possible short-term side effects

Common side effects from surgery, which should go away in 4 to 6 weeks, include:

• Chest pain around the site of the surgical cut
• Constipation
• Discomfort or itching from healing cuts
• Loss of appetite
• Mood swings or depression
• Muscle pain or tightness in the shoulders and upper back
• Problems sleeping and extreme tiredness
• Swelling of the area where an artery or vein was removed for grafting

Medicines

Your doctor will likely discuss which medicines you may need to take.

• Blood pressure medicines treat high blood pressure.
• Arrhythmia medicines lower the chance of irregular heart rhythms after CABG.
• Blood thinners, or anti-platelet medicines, such as aspirin, help prevent blood clots in the graft or in other parts of your body. Your doctor may start you on aspirin even before you get CABG surgery. Your doctor may prescribe other types of anti-clotting medicines, such as clopidogrel. Possible side effects of this medicine can include bleeding, especially if you are taking other medicines that also thin your blood, such as aspirin.
• Diuretics reduce the amount of fluid in your body. .
• Statins lower the amount of lipid in your blood and manage the cholesterol levels that can cause plaque. If you do not already take statins for heart disease, your doctor may recommend that you take statins before and after surgery.

Regular checkups to monitor your condition

Even if you do not experience any symptoms, you may need testing to check on the graft and other arteries about 5 years after CABG surgery, or sooner if you have new symptoms or have other risk factors. You may take a stress test with an electrocardiogram or echocardiogram, or other heart and lung imaging. If you have symptoms such as chest pain, especially before or during the stress test, your doctor will likely recommend coronary angiography.

Healthy lifestyle changes

Your doctor will discuss heart-healthy lifestyle habits and changes that are important to maintain your health and control risk factors, such as high blood pressure and diabetes. These include:

• Choosing heart-healthy foods
• Aiming for a healthy weight
• Being physically active
• Managing stress
• Getting enough good-quality sleep
• Quitting smoking

Your Guide to a Healthy Heart

Learn practical tips for establishing and maintaining a heart-healthy lifestyle.

Cardiac rehabilitation

Cardiac rehabilitation is a medically supervised program for people recovering from heart problems. Cardiac rehabilitation involves adopting heart-healthy lifestyle changes to lower your risk for more heart and blood vessel diseases. To help you adopt lifestyle changes, these programs include exercise training, education about heart-healthy living, and counseling to reduce stress and help you return to an active life.

Cardiac rehabilitation is provided in an outpatient clinic or in a hospital rehab center. Your team will design a program to meet your needs. During cardiac rehabilitation, you will learn to exercise safely and increase your physical activity. The length of time that you spend in cardiac rehabilitation depends on your condition. Medicare and most insurance plans cover a standard cardiac rehabilitation program that includes 36 supervised sessions over 12 weeks.

Cardiac rehabilitation can benefit you by:

• Improving your health and quality of life
• Reducing the need for medicines to treat heart or chest pain
• Decreasing the chance you will need to go back to a hospital or emergency room for a heart problem
• Preventing future heart problems

The heart-healthy lifestyle changes in cardiac rehab have few risks. Very rarely, physical activity during rehab can cause serious problems, such as injuries to your muscles and bones, or possible life-threatening heart rhythm problems.

Take care of your mental health

Your doctor will likely ask if you have had any changes in your mood or other aspects of your well-being. It is important to be treated for depression to increase your chance of full recovery.

If you have symptoms of depression, your doctor may refer you to a mental health specialist. Treatment may include counseling and medicine.

When to call the doctor

Problems can occur quickly or years after CABG. One possible complication is that the graft will become blocked with plaque and limit or stop blood flow to the heart. If your graft stops working, this may cause a heart attack or other problem with your heart, and you may need additional surgery or PCI.

Know the signs of a heart attack and call 9-1-1 right away. Every minute matters.