CORONARY ARTERY BYPASS SURGERY

If your heart catheterization shows that you have significant coronary
artery disease, your doctors may decide that you need coronary artery
bypass surgery. This surgery involves using blood vessels from other
places in your body to "bypass" the blockages in your coronary arteries. As
a result blood flow is restored to your heart muscle.

During and immediately after the surgery

Your surgeon probably used the saphenous vein, the internal mammary
artery or both to bypass your blockages. If the saphenous vein was used,
you will have an incision in your leg where the vein was removed. The
surgery usually takes from three to six hours depending on how many and
which kinds of grafts (bypasses) are best for you.

Recovering at home

Now that you are home, you need time to heal. Along with the healing
process will come good days and bad days. Eating properly and taking your
medications are important factors that will facilitate your recovery. It is
also important to get rest and begin to increase your physical activity.

Diet

At first, you may not have much of an appetite, but eating will increase
your strength. While in the hospital, you may have noticed that the foods
served to you were not always heart healthy. This is because initially the
most important thing is that the food appeals to you so you will eat. Once
you regain your appetite, eating a heart healthy diet becomes more
important.

Medications

It is very important that you know the names of your medications and
when to take them. Refer to the Cardiac Drug Handbook for more details on
medications.

Emotions

It is very normal to be emotional after heart surgery or any health crisis.
Feelings of depression, anger, and fear are quite common; Family members
are likely to experience these feelings as well. This is a normal part of
the healing process and will resolve with time. It is important to be able
to talk about your feelings and discuss your heart surgery and recovery
with others. It is also important to return to activities that you enjoy.
Hobbies such as craft work, playing cards or reading can be resumed
almost immediately. See your Cardiac Rehabilitation specialist or
physician for information on support groups or counseling.

Incisional Care

It is important to pay attention to your incision. Some general guidelines
for proper incisional care are:

• Showers (10 minutes or less) are allowed if your incisions are dry

• and healing

• Quick baths are ok, but too much moisture can cause premature

• dissolving of stitches

• Avoid extreme water temperatures

• Gentle soap and water are permitted, but do not scrub with a

• washcloth until skin is healed

• Lotions, ointments or dressings are not recommended

• Slight itching, numbness or tightness of incsional area are normal

• Notify your doctor if you experience the following signs of

• infection:Increased drainage or opening of the incision

• *ncreased redness or warmth around incision

• Fever greater than 100 degrees Farenheit or 37.5 degrees

• Centigrade

• If you notice swelling of your feet or ankles, try propping your

• feet up and do not cross your legs. Walking regularly and support

• hose are also recommended. Call your doctor if swelling worsens

Home Activity

For the first six to eight weeks after surgery, you may feel tired or weak.
During this time you can to gradually resume your activities and develop
an exercise program. At first, take daily walks and resume household
chores such as cleaning and fixing meals as you feel you are able. Space
your activities, allowing time to rest if you get tired. Avoid lifting,
pushing or pulling heavy objects (greater than 20 pounds) until you doctor
tells you to resume these activities.

Over exertion

If you do too much activity in a day, your body will let you know. This
might be right away, or it may take a day or so to catch up with you.
Symptoms of over exertion include:

• Extreme fatigue

• Chest discomfort

• Excessive shortness of breath

• Lightheadedness

• Rapid or irregular heartrate

If you experience these symptoms, sit or lie down and rest. If symptoms
persist longer than 20-30 minutes, call your doctor.

Is It Safe To Have Sex?

Resuming sexual activity is an important part of getting your life back to
normal, but it can also cause fear and anxiety for you and your partner. The
most common fear is that sex will be too strenuous and cause a heart
attack. Generally, having sexual intercourse with your spouse or regular
partner is no more strenuous than briskly walking a half mile or climbing
two flights of stairs. If performing these activities leads to angina,
shortness of breath or extreme fatigue, see your doctor before resuming
sexual activity. You and your partner should be open and honest about your
thoughts and feelings. It is also wise to avoid positions that put pressure
on the breast bone, arms and chest, and wait at least a half hour after
eating.

Certain heart medications, in addition to anxiety, can interfere with
sexual arousal and performance. Speak with your doctor or Cardiac
Rehabilitation staff member if you have any questions or concerns.