Life after a coronary bypass
Posted on 11 March 2015
Dr Marius Swart is a specialist cardiocthoracic surgeon at Mediclinic Bloemfontein. Here he describes life after coronary bypass surgery and what a patient can expect during the healing process…
After the coronary bypass operation, how long can a patient expect to stay in hospital?
The patient is not woken up immediately after surgery but will proceed to the intensive care unit, asleep on a breathing machine. Thereafter, patients stay on average five days after surgery. Only two percent might stay longer than 14 days. As a rule of thumb, we tell patients that the number of days they spend in hospital post-operatively correlates with their decade of life. Patients under 50 years old can go home after four days, patients in their 50s stay five days, those in their 60s and 70s can expect to be in hospital for six or seven days. Patients in their 80s stay somewhat longer. We discharge a patient once they are independent in terms of feeding, dressing and using the bathroom. Patients who live far from the hospital will stay a day longer. We seldom transfer patients to step-down facilities, but at times it is helpful.
Can patients experience any post-op complications?
A number of complications can occur after surgery and discharge – such as lung, wound and bladder infections. The patient’s heart rate can change from a regular rhythm to a fast and irregular rhythm, and that needs to be addressed. Fluid in the chest cavities may impair the patient’s breathing. Peptic ulcer is a complication we sometimes see, although patients are given medication to prevent this. Non-union of the chest bone is seen in probably two percent of patients. The closure of a graft or the coronary artery is also a possibility, though we hardly ever encounter this.
What lifestyle changes will need to be made?
Lifestyle changes include the cessation of smoking – this is one of the most potent preventions of further coronary artery incidents. Weight and diet control with a basic fitness programme is also very important, as is stress management. It’s also vital to remember that surgery (and stents) is not a curative procedure – the likelihood that some form of intervention like stents and further surgery might be necessary in future is always there. The younger the patient, the higher the chance is that this will happen. Regular follow-ups by the cardiologist is thus very important.