Open Heart Observation

During my open heart observation I was able to watch a CABG. A CABG is a coronary

artery bypass grafting surgery which is used to improve blood flow to the heart. It is used to treat

Coronary Artery Disease (CAD) which is the narrowing of the coronary arteries of the heart.

This surgery is used to bypass the blocked portion of the bad coronary artery by using pieces of

other healthy blood vessels from other parts of the body. Some areas that are used to take healthy

pieces of vessels are from the leg or an artery in your chest. The doctor then uses the new piece

and attaches it above and below the blocked artery.

There were a lot of tools and equipment used in this surgery. One major piece of

equipment used was the cardiopulmonary bypass machine. The purpose of this machine is to

take over the job of the heart and lungs by pumping blood, adding oxygen and removing carbon

dioxide. This is used during this surgery because the perfusionist stops the heart using

cardioplegia to allow the bypass to be performed. Cardioplegia is a pharmacological therapy that

has high levels of potassium to stop the heart temporarily during the bypass. While the heart is

stopped, there are tubes that are inserted so that the blood can be pumped using this machine.

After the bypass is performed, the surgeon will let the blood that was circulating in the machine

back into the heart and the tubes will be removed. The heart then will restart on its own after a

few mins and if not a shock will be delivered to assist.

One ethical concern for open-heart surgery is obtaining adequate informed consent for a

patient. There are many concerns that should be reviewed before an informed consent. Some

being the age of the patient, the mental status, or for patients who are in distress or anxious about

the surgery. So to avoid an issue, always work with the patient and any present family members

to make sure informed consent is good.

 Nursing management for a CABG is assisting with early ambulation, cough and deep

breathing, monitoring VS, maintaining airway patency, assessing pain and mental status, patient

education about healthy lifestyle, and many more.

Overall my experience in the CABG was really good. I was taught a lot from the nurses

and the perfusionist and was shown how the cardiopulmonary bypass machine works. I was

walked through the surgery and had some important things pointed out to better help my

understanding of the surgery.