CABG (Coronary Artery Bypass Graft)

DEFINITION
 A type of surgery that improves the blood flow to the heart. It is performed when the client does
not respond to medical management of coronary artery disease or when vessels are severely
occluded.

PROCEDURE
 A coronary artery bypass graft involves taking a blood vessel from another part of the body –
usually the saphenous vein, internal mammary artery or other arteries from the body – and
attaching it to the coronary artery above and below the narrowed area or blockage. This new
blood vessel is known as a graft. This creates a new path for oxygen-rich blood to flow to the
heart muscle.

POST OP
Transfer from the cardiac surgical unit
1. Monitor v/s, LOC, and peripheral perfusion
2. Monitor for dysrhythmias
3. Auscultate lungs & asses respi status
4. Encourage client to splint the incision, cough, deep-breathe and use incentive spirometer to
raise secretions and prevent atelectasis
5. Monitor temp and WBC, which if elevated after 3-4 days indicate infection
 6. Provide adequate fluids and hydration as prescribed to liquefy secretions
7. Assess suture line and chest tube insertion sites for redness, purulent discharge and signs of
infection
8. Assess sternal suture line for instability, which may indicate infection
9. Guide the client to gradually resume activity
10. Assess the client for tachycardia, postural(orthostatic) hypotension, and fatigue before, during
or after activity
11. Discontinue activities if the BP drops more than 10-20 mmHg or if the pulse increases more
than 10 bpm
12. Monitor episodes of pain closely

Home Care Instructions

1. Limiting of pulling or pushing activities for 6 weeks ff discharge
2. Maintenance of incisional care & recording signs of redness, swelling or drainage
3. Progressive return to activities at home
4. Avoidance of crossing legs, wearing elastic hose as prescribed until edema subsides,
elevating limb where graft was obtained when sitting in chair
5. Use of prescribed meds
6. Dietary measures
7. Resumption of sexual intercourse on the advice of HCP after exercise tolerance is assessed

PROGNOSIS
 Depends on a variety of factors, and successful grafts typically last 8–15 years
 Full recovery from traditional CABG may take 6 to 12 weeks or more. Less recovery time is
needed for nontraditional CABG.