Frequently asked questions

Coronary Artery Bypass Graft (CABG) or Valve Surgery

What you should know about having a coronary artery bypass graft (CABG) or valve surgery at Yale-New Haven Hospital.

What should I do to prepare?
Knowing what your hospital experience will be like is one way to reduce the natural anxiety you may be feeling when you're scheduled for surgery. Talk with you doctor and other members of your healthcare team to learn more about how to prepare for your surgery.

It's never too soon to think about what support you'll need after you're released from the hospital. Talk with your physician and learn about what options are best for you and your family. Ask your doctor any questions you may have about your condition and your surgery. Check with your insurance company about preauthorization requirements and arrange to have a friend or family member transport you to the hospital.

What tests are taken before I'm admitted?
You will be notified when you may check in at the Express Admission Service before your scheduled surgery date. During the preadmit process, you will have a blood test, urine test, chest X-ray and EKG.

What about my medications?
Ten days before surgery, stop taking aspirin and any nonsteroidal medications such as Motrin^®, Advil^®, ibuprofen, etc. Your physician will instruct you about which medications to take on the morning of your test. You do not need to bring any with you to the hospital unless you are specifically instructed to do so, but do bring a list of the medications and the dosages you take. If you have diabetes, ask your doctor for specific directions on taking your medication.

May I eat and drink as usual?
Do not eat anything after midnight the night before your surgery, unless otherwise instructed. You may take water with your usual medication if your doctor has instructed you to take it the morning of the procedure.

What should I bring with me?
If you like, you may bring pajamas and a robe, although a hospital gown will be provided for you. You may bring material to read, your glasses and any toiletries you plan to use. Leave valuables at home.

Will my family be allowed to stay with me?
Your family is welcome to stay with you until you go to the operating room. While you're in surgery, they may wait nearby in the cardiothoracic intensive care unit (CTICU) waiting room on the third floor of the West Pavilion where they can receive updates and your surgeon can brief them after the surgery.

Where should I check in for my surgery?
You will be instructed to check in at the Admitting Office on the first floor of the East Pavilion.

What happens before the operation?
Your nurse will tell you about the CTICU where you will be taken after surgery. Your nurse will also tell you what to expect during surgery, give you instructions on coughing and explain how you might feel when you wake up. You will be given a brief physical, and your medical history will be taken. You will also be given preoperative medication to help you relax. Your chest area and possibly your leg area will be prepared. You may also have a urinary or foley catheter to relieve your bladder during surgery and for a few hours after surgery.

How long will the surgery take?
After you go to the operating room and are asleep, you are prepared for surgery with the insertion of monitoring catheters and a breathing tube. This preparation phase takes one to one and a half hours. Cardiac surgery takes about five hours, but it may range between three and six hours. Your surgeon will be able to give you an estimate of how long you'll be in the operating room.

Will my family be able to check on how my surgery is progressing?
Whenever possible, an operating room nurse will let your family members know how the surgery is progressing. When the surgery has been completed, the surgeon will call or meet with your family in the CTICU waiting room. Family and friends may also call the hospital's Patient Information number (203) 688-4177 24 hours a day for a general report on your condition. Immediate family members may call the CTICU directly for more detailed information about your condition.

Can I wear my glasses and/or dentures during surgery?
No. We strongly recommend families hold these items for safekeeping during the surgery.

Who will be in the operating room with me?
Your surgeon, a surgical nurse, cardiac anesthesiologist and a perfusionist, whose responsibility is monitoring the heart-lung machine that may be used in your surgery.

Will I be asleep during the surgery?
Yes. You will be completely unconscious during surgery and will awaken in the CTICU after your surgery has been completed.

How will I feel when I wake up?
When you wake up, you will have a breathing tube in your throat, chest drainage tubes, IV lines in your arm(s) and/or neck as well as a urinary catheter to drain urine. You will not be able to speak until the breathing tube is removed, which is generally later that evening. CTICU nurses are skilled in communicating with patients who have breathing tubes. Pain medication will be given as needed. While in the CTICU, you may hear unusual sounds such as buzzing, beeping and bubbling. These are normal sounds for this environment, and there's no reason for you to be alarmed.

What is the CTICU like?
The CTICU has 18 private rooms specifically designed for patients who have just had heart and/or lung surgery. You will be connected to a device that monitors your heart, blood pressure, respiratory rate and oxygen level. This monitor is connected to a central monitor at the nurses' station so nurses can watch you even if they are not at your bedside. Your IVs may also be attached to IV pumps that deliver medications at a set rate as well as a chest drainage device at the side or foot of your bed that monitors drainage from your surgical site.

When will I be able to eat?
After your breathing tube is removed, you may have ice chips or clear liquids. You may eat solid food the day after your surgery.

How long will I have to stay in bed?
After your breathing tube is removed, you may sit on the side of your bed. The next day you may sit in a chair or walk to the bathroom.

When can my family and friends visit?
The CTICU visiting policy allows five to 10-minute visits each hour immediately after surgery for immediate family members.

How long will I be in the CTICU?
Although it varies, most patients stay in the CTICU for less than 24 hours before transfer to the hospital's cardiac step-down unit. Most patients are in the hospital a total of six days from admitting through discharge.

What happens the next day?
Your care team will continue to monitor your heart and check your blood pressure and pulse every two to four hours, as needed. You will also cough and deep breathe at least every two hours. Your urinary catheter, chest tubes and IVs may be removed, but you will continue to receive pain medication, as needed. You may also have a chest X-ray, EKG and lab work. Your physician may order aspirin for you if you have had bypass surgery or blood thinning medication if you have had valve replacement surgery. You will transfer via wheelchair to 4-7 or 4-8, the cardiac step-down unit, located on the fourth floor of the East Pavilion.

Will I be on a special diet?
You will need to be on a heart healthy diet (low fat, low cholesterol and low sodium). While in the hospital, you can learn about changing your diet to help reduce your chance of developing more severe heart disease. To encourage wound healing after surgery, you may be advised to follow the "no added salt" portion of the heart healthy diet, but otherwise encouraged to eat enough to promote wound healing. Once your wounds are fully healed, you should follow the full heart healthy diet. If you have questions about diet, ask to see your dietitian. You will receive a free pass to the nutrition clinic at Yale-New Haven in your discharge packet in case you have additional questions after you return home.

When will I be able to walk around?
Your activity will increase each day. You may sit in a chair and walk short distances in the hall. The length of your walks will increase each day.

When will I be able to use the bathroom?
While you're in intensive care, if your condition permits, you'll be able to get out of bed to a bedside commode. As soon as you're transferred to the step-down unit, you will be able to use the bathroom in your room. You may still need help walking to the bathroom, so remember to use your call light and wait for help before attempting to walk unassisted.

Will I continue to take medications?
You will be on pain medication and laxatives, as needed, and aspirin or blood thinners, if ordered, as well as any special medications prescribed by your doctor. Your doctor will determine if you should resume the medications you were taking prior to your hospitalization.

When can I go home?
Most patients stay in the hospital for five days after their surgery. Your doctor will tell you when you are ready to be discharged. In some cases, you may decide to transfer to a rehabilitation facility to continue your recuperation before returning home or, if your doctor recommends, you may receive visits from home care professionals. Your social worker and care coordinator will be able to help you and your family make the right decisions for your individual situation.

How can I help my family adjust to living with someone with heart disease?
YNHH offers a Family Support Group for family members of patients led by the cardiac services social workers. The meetings are held Mondays and Wednesdays, 5-6 p.m., in the East Pavilion solarium adjacent to unit 4-7. The meeting is an open forum to address family members' questions and concerns. Call (203) 688-7452 for more information.

When can I drive?
Your physician will tell you when you can safely start driving again. Usually people recovering from surgery need to wait at least four to six weeks from the day of surgery. It is fine to be a passenger in the front or back seat, and remember to wear your seat belt. When you drive for the first time, take someone with you and stay out for a short time, about a half hour. Keep in mind challenges that await you at your final destination. Will there be stairs you have to climb? How far is the parking lot from where you're going?

When will I be able to get back to work?
Your ability to get back to work is a very personal decision made by you and your cardiologist or surgeon. This decision is based upon the kind of work you do, your medical condition and how stressful your job is.

When can I have sex?
The amount of energy expended during sexual activity is equal to climbing two flights of stairs or walking a city block. Most patients find they are ready to resume their sexual activity the second week after discharge from the hospital. Specific guidelines are included in your postoperative materials. Avoid sexual activity right after eating, drinking alcohol or when feeling tired.

• YNHH Health Library: Coronary Artery Bypass Graft Surgery

Next page: Cardiac rehabilitation-Getting back to normal

Cardiac Services home page

Last revised: May 23, 2007 (dh)

Home page URL: http://www.ynhh.org

By accessing this Website, you agree to be bound by the terms and conditions set forth in our Privacy Policy, Usage Policy and other disclaimer pages and any other terms concerning use and operation of this site. All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen. Copyright © 2008, Yale-New Haven Hospital. All rights reserved. Comments or suggestions to the site editor.