You have several
responsibilities while you are recovering from coronary artery bypass graft
(CABG) surgery, including:
Everyone heals at a different rate. But following your
doctor's orders can help you achieve a fast and comfortable recovery.
It may be
worthwhile to keep all of your medical information together and handy during
your recovery, including:
major aspect of your recovery is caring for the incision (sternotomy) made to
open your chest during CABG surgery. Because it is so important that this
incision heals properly, many limitations are placed on you during your
recovery. You also need to take care of the skin around your arm or leg
incisions. All of your incisions need to be taken care of so that they can heal
quickly and without infection. To do this, you need to:
may cut through your chest bone, or sternum, to perform your CABG surgery.
Unlike other bones in your body, your sternum cannot be placed in a cast while
it heals. Instead, your surgeon wraps heavy wire around it to hold the edges
together. The sternum can heal properly only if the ends are held together
constantly for several weeks. Therefore, you should not engage in strenuous
activities that could shift the two edges apart during the first 4 to 6 weeks
of your recovery.
Two activities that can shift the edges of your
sternum apart and so should be avoided are:
or leg incision may be swollen and painful. This results not only from the
incision that cut through your skin and muscle but also from losing a blood
vessel in your arm or leg that would normally circulate blood in the area of
the incision. It will take a little time for your arm or leg to adjust to the
missing vessel and for your incision to heal.
To help your arm or
leg recover faster and more comfortably, you can:
You will take medicines after your CABG surgery. Your doctor or nurse
will give you written instructions for taking your medicines before you leave
the hospital. These new medicines may be in addition to or instead of the
medicines you were taking before your surgery. Make sure that your doctor or
nurse explains very clearly to you what medicines you should be taking.
Sometimes it's hard to remember to take your medicines. But you can remind yourself by doing things like posting notes where you can see them or using a pillbox.
It is important to watch your weight very closely after your surgery. A
sudden increase in your weight is often a sign of fluid retention. This fluid
retention can point to a problem, such as worsening heart function
and kidney failure.
To monitor your weight, you should:
While you are recovering from your CABG surgery,
you will need to work on increasing your physical activity or exercising. You
need to become more physically active, because you need to restore your full
lung function. You also need to improve the blood circulation throughout your
body. This will help your body heal properly.
If you do not
exercise, you risk getting blood clots in the blood vessels of your
legs. This is a painful condition that can cause several complications,
including blockage of a blood vessel.
Walking is an excellent
exercise after CABG surgery. Walking is safe and someone else can easily walk
with you. Your leg will be sore if your surgeon removed blood vessels from your
leg to use during your surgery. Despite this pain, it is important to your
recovery that you continue to walk.
Cardiac rehabilitation (rehab) programs can start in the hospital or soon after you go home after surgery. Cardiac rehab helps you recover and teaches you how to be more active and make lifestyle changes that can lead to a stronger heart and better health. Cardiac rehab can help you feel better and lower your risk of future heart problems.
A cardiac rehab team often includes a doctor, a nurse specialist, a dietitian, an exercise therapist, and a physical therapist. The team designs a program just for you, based on your health and goals. Then they give you support to help you succeed.
your doctor and rehab specialist to develop a rehab plan. The
following is a general guideline for increasing your exercise:
Although you may be weak, tired, or experiencing chest
soreness as a result of your surgery, many people with coronary artery disease
(CAD) can work their way back up to normal activity levels by participating in
a structured cardiac rehab program or by working with their doctors to
develop a home exercise program.
Your doctor probably told you that
certain aspects of your lifestyle (such as smoking, an unhealthy diet, or high
stress) make your cardiac health worse. Now that you have had your diseased
arteries repaired with open-heart surgery, you want to be sure that your CAD
does not get worse. In particular, it is important to keep your new bypass
grafts healthy. Your doctors, nurses, or rehabilitation team members can help
you take steps to quit smoking, start eating a heart-healthy diet, and reduce
the stress in your life.
You will be able to resume sexual activity after
you recover from surgery. Most people wait about 6 or 8 weeks after surgery.
Some people are afraid to resume sexual activity after a heart attack. They are worried that they will have symptoms such as chest pain or will not have enough energy for sex. They also worry about having another heart attack.
The risk of having a heart attack during sex is low. Sex is the cause of less than 1 out of 100 heart attacks.1 This risk is low if you can do moderate activity without having angina symptoms such as chest pain.
You can ask your doctor to help you know when your body is healed and healthy enough for sex. If you need help dealing with feelings of worry or fear, you can also try professional
When you and your partner decide to start having
sex again, it might be helpful to keep in mind the following:
Levine GN, et al. (2012). Sexual activity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation, 125(8): 1058–1072.
Other Works Consulted
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.
Morris DC, et al. (2011). Management of the patient after cardiac surgery. In V Fuster et al., eds., Hurst’s The Heart, 13th ed., vol. 2, pp. 1504–1512. New York: McGraw-Hill.
April 20, 2012
E. Gregory Thompson, MD - Internal Medicine
& John A. McPherson, MD, FACC, FSCAI - Cardiology
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