Will I be awake?
No. You will be under general anesthesia throughout the procedure.
Where will my family be?
Because the surgery must be performed in a sterile environment, family members are encouraged to remain close by in a hospital waiting room.
Where will I go directly after surgery?
Patients are typically observed for 24 to 36 hours in the cardiac intensive care unit (CICU). The CICU has limited visitation hours.
What is it like in the CICU? How will I feel after the surgery?
When you first wake up in the CICU, you will be groggy or slightly disoriented. This is normal. You will still have a tube in your mouth, connecting you to breathing monitors and apparatus. Until you are able to breathe on your own, you will have difficulty talking (because of the tube) and will be unable to eat.
There are numerous monitors and machines in the CICU; it is not as quiet or cozy as a normal hospital room. Nurses will be watching your vital signs (temperature, pulse, breathing) constantly to make sure that you are recovering as expected. You may initially find your hands strapped down so that you cannot disconnect any of the monitoring wires. Once your condition has stabilized (approximately 24 to 36 hours), you will be moved to a regular hospital room, where you can have more frequent visitors and rest more peacefully.
How long will I be in the hospital?
The overall hospital stay, including both the CICU and a regular hospital room, is generally between four and six days if you undergo a traditional bypass surgery. You could be in the hospital for less time – three to four days – following minimally invasive surgery.
Will I have a special rehabilitation program?
Your doctor will place you on a specialized postoperative rehabilitation and prevention program, which usually includes supervised exercise, dietary and lifestyle changes. You should be careful to protect the area around the leg or arm from which the vein was harvested. This may take a few months to return to normal.
Will I be in pain after the procedure?
You will receive medications in order to cope with the immediate surgical recovery. However, your doctor should talk to you about the difference between pain from the incision versus pain due to low blood supply to the heart muscle following surgery. If you have any questions about chest pain, contact your doctor. Even if you have had prior surgeries, be aware that bypass patients undergo a more painful recovery than do other surgery patients.
When can I walk?
You will be encouraged to walk before you leave the hospital.
When can I drive?
Patients are generally able to drive approximately three weeks after surgery. Driving is, in general limited by the comfort and stability of the scar to the chest rather than cardiac issues.
When can I resume sexual activity?
In most cases, sexual activity can be resumed approximately four weeks after surgery. Your doctor may give you an indicator, such as being able to climb two flights of stairs without stopping, before you resume sexual activity.
When will I be able to return to work?
Depending on the amount of physical exertion required for your job, you will likely be able to work within 12 weeks, and possibly even sooner.
When can I stop the medications that I was on before the surgery?
This will have to be discussed with your doctor. You will likely need several medications for a few months, and you will likely need to have your cholesterol controlled with statins. Bypass surgery does not cure the underlying problem that caused arteriosclerosis, but it does give you time to prevent further problems.
Sources
Minimally Invasive Heart Surgery. American Heart Association Web site, 2000.
Coronary Artery Disease Treatment – Surgery. Cleveland Clinic Heart Center Web site, April 2001.
Minimally Invasive Direct Coronary Artery Bypass, MIDCAB. Brown University Division of Biology and Medicine Web site.
Mack MJ, MD. Minimally Invasive and Robotic Surgery. Journal of the American Medical Association , February 2001:568-572.
Baumgartner WA, MD. What's New in Cardiac Surgery. Journal of the American College of Surgeons . March 2001:345-355.
Mayo Clinic Health Letter , May 1994.
Dr. David Allie, M.D., Cardiovascular Institute of the South;
HealthAnswers (Orbis-AHCN); Ask the Doctor, Infinity Heart Institute;
Virtual Hospital, Iowa CHAMPS;
Dean Santerre, Anatomy of the Human Heart;
Dr. Joseph Galichia, Heart Homepage.
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