Journal of Perioperative & Critical Intensive Care Nursing
Open Access

Post-Surgical Patient Education after Coronary Artery Bypass Graft Surgery: Recovery Treatments

Banu Aydem^{* *}Correspondence: Banu Aydem, School of Nursing, Hacettepe University, Turkey, Email:

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Introduction

Coronary artery bypass graft surgery, often known as CABG or bypass surgery, is a procedure that can assist restore blood flow to a part of the heart. Surgery, on the other hand, does not halt the progression of atherosclerosis (coronary heart disease), which deposits fatty material in artery walls, narrowing them and eventually reducing blood flow at other places in the bypassed arteries or previously normal coronary arteries. Following surgery, patients and healthcare providers must collaborate to treat the underlying atherosclerosis as well as the variables that can accelerate the progression of heart disease. After bypass surgery, patients and their families are given techniques to help them quit smoking, control high blood pressure, improve cholesterol levels, start exercising regularly, lose weight if necessary, and reduce stress. Some of these modifications can be accomplished by altering one's lifestyle choices, such as food and exercise. However, lifestyle improvements may not be enough, and drugs are frequently required. Patients who have had a straightforward CABG are usually discharged after about five days in the hospital. The hospital stay may be extended in some circumstances. If difficulties arise, discharge is postponed until the patient's condition has stabilised. It is critical for the patient and family to participate in and understand the discharge plan before leaving the hospital. Ensure that all of your questions are answered, and that you have written instructions on how to take all of your prescriptions (new and old). It is usual to begin new medications after bypass surgery and to cease or change the doses of old medications [1].

Most patients who have had bypass surgery are given prescriptions for a number of medications, the majority of which must be taken on a daily basis. Some of these medications increase survival, reduce the risk of complications, and aid in the prevention or treatment of recurrent chest pain. Aspirin is an antiplatelet drug that is used to prevent blood clots from forming in the coronary arteries or the coronary bypass graft. It is usually given on an indefinite basis. Beta blockers reduce the heart's demand for oxygen via slowing the heart rate, lowering blood pressure, and lowering blood pressure. They are given to some individuals with high blood pressure, heart failure, certain rhythm alterations, or a heart attack, as well as to some people for whom bypass surgery is unlikely to treat all angina symptoms. If a beta blocker is not tolerated, a calcium channel blocker may be used instead. A nitrate, either as nitroglycerin, a short-acting nitroglycerin, or as a long-acting nitroglycerin (isosorbide mononitrate or dinitrate). These medications widen coronary arteries, allowing more blood to flow to the heart muscle. Nitrates also limit the amount of blood returning to the heart, lowering the heart's oxygen requirement. Nitrates are frequently prescribed to alleviate or prevent chest discomfort. If any of the coronary blood arteries could not be bypassed, patients may be administered nitrates after bypass surgery. Even if the patient's lipid readings are in the "normal" range, lipid treatments are indicated. Less than 70 mg/dL (1.8 mmol/L) is the target level for "bad" cholesterol (also known as LDL or low density lipoprotein). The most frequent drugs used to decrease cholesterol levels are statins. Heavy lifting and severe shoulder movement (as in tennis, baseball,and golf) should be avoided for six to eight weeks after surgery to allow the breast bone to heal completely (sternum) A healthcare professional should be notified right away if the patient develops any of the following signs or symptoms of wound infection. The majority of wound infections appear within 14 days of surgery [2].

A planned, thorough cardiac rehabilitation programme is beneficial to the majority of persons who have had bypass surgery. Cardiac rehabilitation patients typically have appointments several times a week in a hospital or clinic, allowing them to live and sleep at home. Improved heart function, a lower heart rate at rest and during activity, and a lower chance of dying or developing complications from heart disease are all potential benefits of rehabilitation. Exercise, lowering risk factors, and coping with stress, worry, and depression are all components of cardiac rehabilitation. Only when this multimodal strategy is implemented can the benefits of cardiac rehabilitation be demonstrated. To put it another way, one component is insufficient. Exercise has been demonstrated to benefit cardiovascular health over and over again. Importantly, determining the potential risk of heart and/or blood vessel issues from exercise is the first step in beginning to exercise. This is normally accomplished by completing a treadmill exercise test under supervision. Although almost everyone may exercise safely after discharge, the intensity and duration of exercise should be adjusted based on the degree of the patient's cardiac disease. Risk categories describe a person's risk of cardiovascular (heart-related) issues as a result of physical activity. Each category has its own set of monitoring and workout limitations. People in risk group a are generally healthy, do not need medical supervision when exercising, and have no restrictions on exercise time or intensity [3].

A variety of variables raise the chance of getting heart disease or hastening its course. Even if a person currently has heart disease or has had a heart attack, reducing or eliminating these risk factors can be beneficial. Below are some risk-reduction strategies.

Diet counseling is helpful for people who need to lose weight or reduce cholesterol levels. A heart healthy diet involves substituting veal, lean meat, poultry, whole grain pasta, lentils, corn, rice, beans, nuts, or vegetarian dishes for fatty meats, cream, cheese, and high sugar.

Cigarette smoking significantly increases the risk of coronary heart disease and heart attack. Stopping smoking can rapidly reduce these risks. Cardiac rehabilitation programs can recommend a treatment to help stop smoking. Other options include nicotine patches, gum, or nasal spray; or prescription medication.

People with diabetes are at an increased risk of complications after bypass surgery. Good control of blood glucose levels can help to reduce the risk of these and other types of complications. Tight control can be achieved by losing weight and managing the diet, exercising and monitoring blood sugar levels.

Feelings of depression, anxiety and denial are common after bypass surgery. Depression can reduce a person's ability to exercise, decrease energy levels and cause more fatigue. Women are at an especially high risk for depression in the wake of heart bypass surgery - especially younger women [4].

Conclusion

The best strategies to recover following bypass surgery are to stick to the discharge plan and enroll in a cardiac rehabilitation programme. It's also crucial to arrange and attend regular appointments with an internal medicine physician and/or a heart specialist (cardiologist). People who have had bypass surgery have a greatly higher chance of further cardiac events, such as recurring chest discomfort, heart attack, heart failure, and an increased risk of dying. Follow-up care is critical. Following a clinician's suggestions for rehabilitation, follow-up visits, and therapies closely reduces the likelihood of these issues.

References

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2. Theobald K, McMurray A. Coronary artery bypass graft surgery: Discharge planning for successful recovery. J Adv Nurs. 2004;47(5):483- 491.
3. Lopez V, Ying CS, Poon CY, Wai Y. Physical, psychological and social recovery patterns after coronary artery bypass graft surgery: A prospective repeated measures questionnaire survey. Int J Nurs Stud. 2007;44(8):1304-1315.
4. Milano CA, Kesler K, Archibald N, Sexton DJ, Jones RH. Mediastinitis after coronary artery bypass graft surgery: Risk factors and long-term survival. Circulation. 1995;92(8):2245-2251.