Coronary Artery Bypass Graft Surgery: How to Prepare
How do you prepare for CABG surgery?
There are many things that you can and must do in the days and weeks
coronary artery bypass graft (CABG) surgery. Your
surgeon will give you specific instructions on how to prepare for your CABG
CABG surgery is an invasive procedure that has a fairly
long recovery time, so it is important that you prepare carefully for your
surgery as well as for the days and weeks following your surgery. Try to make
your life simpler during the recovery period by doing things such as paying
bills ahead of time and arranging for someone to assist you in the days
following your surgery. It is also important to plan for any complications that
could arise. A lot of the preparation that you do before your surgery will help
you afterward, while you are recovering.
In the 2 or 3 weeks prior to surgery, attend any
scheduled appointments with your surgeon. You will need to have several tests
done before your surgery. Most of these tests are done so that your doctors can
evaluate and compare your health before and after CABG surgery. The tests can
also help your doctors anticipate any special needs. To be ready by the day of
your surgery, the tests need to be done days or weeks before.
Tests done days or weeks before surgery
Blood count (hematocrit): This blood test can
reveal whether you are anemic (have a low red blood cell count). A very low
blood count may need to be increased before or during surgery with a blood
Prothrombin time (PT, also referred to as INR) and
thromboplastin time (PTT) values: These blood tests measure your blood's
ability to clot. Typically, you will have these tests if you have recently
stopped taking blood-thinning drugs, to make sure the drugs are no longer
affecting your blood's ability to clot.
Other blood tests: Other
tests may be done to assess your kidney and liver functions and provide
information on the health of these organs.
Chest X-ray: This test
provides a picture of the size and shape of your heart and aorta and whether
your lungs appear normal.
Cardiac catheterization: This test allows
your doctor to picture your coronary arteries and identify the location of
blockages to help plan your CABG surgery.
Medicine and CABG surgery
You may need to stop taking certain medicines a week or more before surgery, so talk to your doctor as soon as you can.
Tell your doctors all the medicines, vitamins, supplements, and herbal remedies you take. Some of these can increase the risk of bleeding or interact with anesthesia. Your doctor will tell you which medicines to take or stop before your surgery.
If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
On the day of your CABG operation, you should have only a
sip of water with any medicine so that you keep your stomach empty.
If you have diabetes, your
doctors may need to adjust your medicines to prepare for your CABG surgery.
Since CABG surgery requires you to stop eating several hours before your
procedure, your blood glucose level may drop so low that your regular
medicines (which lower your glucose level) may not be needed. Talk to your
doctors about the type and severity of your diabetes, as well as which
medicines you are taking.
Arrange for transportation the day of your
surgery, for someone to help you at home during your first week out of the
hospital, and for someone to help with chores and errands for 1 to 2 months
after your surgery. You may be too physically tired and sore after your surgery
to do many things for yourself.
Prepay any bills that will be due
soon after your surgery. You will probably want to concentrate on recovering,
not on everyday affairs.
Arrange your personal matters, including a
will, living will, and nursing preferences. In rare cases, serious complications of
CABG surgery (including death) can happen. So you should plan for this
possibility and make sure that you have made your end-of-life wishes
should discuss complications of CABG surgery a few weeks beforehand with both
your surgeon and your family. In particular, you may wish to clarify your
desires about matters such as life support (such as a breathing tube or
medicines to keep you alive) and resuscitation measures (such as chest
compressions and electric shock) in case of an emergency.
Also, you may want to consider becoming an organ and tissue donor. If you
are an organ and tissue donor, your liver, lungs, kidneys, and other organs can
be donated to another person who needs them in case you die during your
surgery. Although only a very small percentage of all CABG surgeries done
result in death, it is important to prepare in case this happens.
The day before your surgery
Remind the person who will drive you to the
hospital what time you need to be there. It is important to arrive on time, as
several preoperative tests and administrative tasks must be done.
Follow the instructions
about exactly when to stop eating and drinking. If you don't, your surgery may be canceled. If
your doctor has instructed you to take your medicines on the day of surgery,
do so using only a sip of water.
Relax, but do not drink alcohol. It may
dangerously interfere with medicines you will be given on the day of your
Use disinfecting solution (that your doctor may have given
you) to clean your skin. This will minimize the risk of infection near your
Select comfortable clothes to wear to and from the
hospital. After the surgery, your wounds and muscles will still be sensitive,
and comfortable clothing is less likely to irritate them.
bag that you will bring to the hospital. In general, hospital staff recommend
that you pack lightly.
What to bring to the hospital
Contact and emergency
including glasses, hearing aids, dentures, or other personal items that you need to function
Comfortable clothes that are easy to put on and take off
to wear to and from the hospital
What NOT to bring to the hospital
(The hospital will usually provide you with shampoo,
conditioner, soap, lotion, toothbrush, toothpaste, and shaving
Items you can bring if you want
Entertainment such as magazines or books to pass
the time before and after surgery
When you prepare for your CABG surgery, you can take
an active role. By asking questions and educating yourself, you can take
control of your experience. In your weeks of recovery after your surgery, you
will be glad that you did.
Gray RJ, Sethna DH (2012). Medical management of the patient undergoing cardiac surgery. In RO Bonow et al., eds., Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 2, pp. 1793–1810. Philadelphia: Saunders.
Hillis LD, et al. 2011 ACCF/AHA Guideline for coronary artery bypass graft surgery: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 124(23): e652–e735.
Primary Medical Reviewer
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
How this information was developed to help you make better health decisions.