At Home After Coronary Artery Bypass Graft Surgery (CABG)

Understanding CABG and
Caring for Yourself at Home

CABG stands for Coronary Artery Bypass Graft, a major, life-saving surgical procedure used to treat coronary heart disease. It involves creating a new pathway around blocked or narrowed arteries in the heart to improve blood flow and oxygen supply to the heart muscle. 

When you go home after CABG, you should have two goals: follow your doctor’s recovery plan, and focus on both your physical and emotional well-being so you can make a complete recovery and get back to enjoying your life.

What is CABG?

CABG is performed when the coronary arteries, which supply blood to the heart, are blocked or narrowed, often due to the buildup of plaque (fatty deposits). This blockage can restrict blood flow and oxygen to the heart, leading to symptoms like chest pain (angina) or even a heart attack. 

During CABG, a surgeon takes a healthy blood vessel from another part of the body, such as the leg vein or chest artery, and uses it to bypass the blocked or narrowed section of the coronary artery. The graft is then attached to the artery above and below the blockage, creating a new path for blood flow. 

By restoring blood flow, CABG can relieve symptoms, improve heart function, and prevent further damage to the heart muscle. 

What to expect after CABG

Following CABG surgery, patients typically stay in the hospital for several days. Patients are typically closely monitored in an intensive care unit (ICU) before transferring to a regular room. Your surgeon will determine when you are ready to go home after CABG, generally when you:

• No longer need intravenous medication to control your pain

• Have stable vital signs

• Have a stable incision

• Can walk short distances, like to the bathroom (if you need assistance, make sure you’ll have help at home)

• Do not need supplemental oxygen

• Have medications that are working well, and you don’t need frequent changes

• Have stable lab results

• Don’t have signs of pneumonia or other complications

• No longer need tubes and drains

If you have difficulty meeting these goals, spent a long time in the ICU after surgery, or do not have help at home, you may need to recover in a rehabilitation or skilled nursing facility. When deciding which recovery options are best for you, your surgeon will consider these factors and your overall health.

Managing CABG recovery at home

CABG surgery will greatly improve your health, but it might not feel that way for the first few weeks after your surgery. Most patients feel tired and sore. You might have pain in your chest and shoulders, and at the site where the healthy blood vessel was removed.

Don’t be discouraged. You’ve just had a major surgery, and it will take your body time to heal. Most patients start feeling improvement around four to six weeks. While you recover, remember to follow your doctor’s instructions exactly. This will help ensure the best health outcome and fastest recovery, and minimize your risk of hospital readmission after CABG.

Your discharge paperwork will include your doctor’s instructions for caring for yourself at home. Call your care team if you cannot locate these instructions or have questions — they are always happy to help you. Generally, your instructions will cover the following:

Activity

Get rest. If you feel tired, rest. Getting adequate sleep helps your body heal.

Don’t drive. Before you drive, you should be off any pain medicine that impairs your ability to operate a vehicle. You should also be able to press the brakes suddenly without any pain in your chest, sternum, or incision. Ask your doctor when you can drive again. 

Take it easy. For at least six weeks, avoid strenuous activity, like jogging, weight lifting, and aerobic exercise. Do not lift anything heavy for at least six weeks. Even a gallon of milk is too heavy, so let someone else bring in the groceries.

Don’t strain. For three months, avoid twisting, pulling with your arms, and any movement that strains your sternum, chest, and upper arms. This includes vacuuming, lawn mowing, and even golfing.

Walk a little. When your doctor says it’s okay, try to walk a little each day. Then try increasing the amount you walk a little each day. Walking boosts blood flow and helps you recover. Pay attention to your fatigue level, and stop when you are tired. Do not go on walks alone. Stop and get help if you have chest pain, dizziness, a racing heart, or difficulty breathing.

Incision care

Brace yourself. Hold a pillow against your chest to support your incision when you’re moving and coughing.

Keep it clean. Follow your doctor’s directions, but generally, you should be able to wash the area gently with soap and water. Pat your incision dry with a soft, clean towel. If you have a bandage, change it at least once per day (or as directed).

Keep it dry. Do not take a bath or get into a pool or hot tub until your incisions are completely healed and your doctor says it’s okay.

Keep it elevated. If a vein was removed from your leg, keeping the leg elevated can help reduce swelling. Ask your doctor if you can wear compression socks to further reduce swelling.

Keep an eye on it. Watch for redness, drainage, swelling, or re-opening of your wound.

Diet

Hydrate. Drink plenty of water and other healthy fluids.

Eat heart-healthy. Your surgeon may recommend a diet high in protein to support healing after surgery. If you are not prescribed a specific diet, eat plenty of fresh vegetables, lean proteins, and whole grains to support a healthy heart. Avoid sugar, added salt, and processed and deep-fried foods. 

Constipation is common early in recovery. Do not strain when going to the bathroom. Eat plenty of fiber daily, and talk to your doctor about adding a fiber supplement or a mild laxative to your medications.

Medication

Look at your list. Your discharge instructions include a list of your medications and instructions for taking them. Follow your doctor’s instructions and take all of your medications exactly as prescribed.

Take your antibiotics. If your doctor prescribes antibiotics, take them until they are gone. Don’t stop taking them just because you feel better — this means the antibiotics are doing their job, not that their job is done. You must take the full course of antibiotics.

Breathing. Use your incentive spirometer throughout the day to help keep your lungs clear, or do breathing exercises as instructed by your doctor.

Cardiac rehabilitation. Following discharge, patients typically participate in cardiac rehabilitation. This includes exercise, lifestyle modifications, and other support to help you return to pre-surgical activity levels.