Navigating MyCare
for coronary artery bypass surgery (CABG)
The information in this care pathway will help prepare you for your coronary artery bypass surgery. It also has information about what will happen on the day of surgery and your care after the operation, including when you go home.
Below we will take you through the general pathway patients go through when receiving coronary artery bypass surgery.
Your care pathway
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Before surgery
Preparing for your CABG surgery.
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Your surgery
What to expect during your CABG surgery.
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Care during your stay
What to expect during your post-surgery stay at Sunnybrook.
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Leaving Sunnybrook
Information about your transition plan for when it’s time to leave Sunnybrook.
Before surgery
Cardiac pre-operation education class
This class will help you and your family members or caregivers learn about what to expect and how to manage your care after your coronary artery bypass surgery (CABG). You will meet some of the team members involved in your care, as well as a volunteer who had heart surgery at Sunnybrook.
Your surgeon’s office will provide you with a date to attend the class.
Pre-anesthesia assessment
At your pre-anesthesia assessment, our team will make sure you are fit and safe for surgery. During the assessment, a nurse will ask you about your medical history, the medications you take, and will talk to you about any special needs you might have after your surgery. You may also meet with a pharmacist and the anesthesiologist who will be putting you to sleep in the operating room when you have surgery.
Your surgeon’s office will provide you with a date and time of your appointment. Check-in for your assessment at B-wing, 1st floor, room 11 (B1 11). Please eat and take all your regular medications before you come to this appointment.
Stay connected to your health records
Register for MyChart
Preparing for your surgery and recovery
You should begin preparing your body about 14 days before your surgery. Stop taking any herbal remedies or over-the-counter medication unless instructed by your surgeon. Speak with your doctor, nurse or pharmacist about when to stop taking any prescription medication.
Visit Sunnybrook's ambulatory pharmacy on the first floor of M-Wing to pick up your cardiac surgery package. The package contains a suppository and antibacterial soap that you are required to use in preparation for your surgery.
During your recovery, you will not be allowed to lift over 2.3 kg (5 lbs) for at least 6 weeks. Arrange for someone to help you with daily tasks for the first several weeks after your surgery.
View more detailed instructions on preparing your body and home for surgery
Your surgery
Arrival
When you get to the hospital, check-in at the surgical services registration desk in the M-Wing, ground floor, room MG 502. You will be asked to put on a hospital gown and all of your personal clothing will be given to your family. A nurse will then bring you to a room to prepare you for surgery.
Please do not bring any valuables – including (but not limited to) cash, jewellery, keys, electronics, and expensive clothing.
The Surgery
Surgery usually takes between four to six hours. In some cases, surgery may take longer than six hours. Following your surgery, you will be taken to the Cardiovascular Intensive Care Unit (CVICU) on the second floor of the M-Wing for your recovery.
View more detailed information about your surgery
For information about our critical and intensive care units, visit sunnybrook.ca/navigatingtheicu
During your stay
Care closer to home
If you have been transferred to Sunnybrook for specialized care that you could not have received locally, you will be transferred back to the hospital closer to home when your specialized care is complete.
Getting moving
Getting moving after surgery can help prevent some common complications such as pneumonia, blood clots, and muscle weakness or stiffness. Your nurse will help you sit over the edge of the bed and dangle your feet within the first eight hours after your surgery. They will also help you sit in a chair for all your meals.
On the first day after surgery, a physiotherapist will assess you and assist you with deep breathing, coughing, exercises and general mobility. You will be expected to continue your exercise program throughout your stay.
Delirium
After surgery, you may experience temporary changes to your thinking and behaviour. You may become disoriented, forgetful or have difficulty thinking clearly. This may be a result of your medication. Your health-care team will ask you questions to assess for signs of delirium and determine the best ways to help prevent or manage your condition.
Swelling
It is common for your legs to swell after heart surgery. Here are ways you can help decrease swelling and improve circulation:
- Do ankle pumping, lower leg exercises, and walk frequently. Avoid standing or sitting for long periods of time.
- When resting in bed, use pillows to raise your legs higher than your heart. When sitting in a chair, raise your feet by using a footstool.
- You may be instructed to wear compression stockings.
- Do not cross your legs – this limits blood flow.
Swelling should decrease within a few months. If you notice persistent swelling in both ankles, tell your doctor.
Leaving Sunnybrook
Discharge education class
We recommend that you and your caregiver(s) attend one of our discharge classes to help you prepare for your transition home. Discharge classes are scheduled every Monday, Wednesday and Friday at 10:30 a.m. in the patient lounge on our cardiac inpatient unit, D-Wing, third floor (D3).
Medication
Changes will be made to your medications after your surgery. New medications may be added for long-term heart protection, and you may be prescribed some temporary medications to help with pain or constipation after surgery. Some of your previous medication such as blood pressure medications, diabetes medications, or blood thinners may be adjusted or discontinued.
A new prescription will be given to you on the day that you are discharged – this prescription will be a complete list of all the medications you are to take when you go home. Consider filling your discharge prescription before leaving the hospital to avoid missing any medications. Our pharmacy is located in M1101 – M-wing, first floor – at our main entrance.On the day of your discharge
Typically, a patient will stay four days in hospital after coronary artery bypass surgery.
Some patients may have a longer stay in hospital. While this is rare, it may happen. Your health-care team will keep you informed about the predicted amount of time you may be on D3, or the ICU. If you have questions about the potential for a long stay in hospital after your CABG, please talk to your CABG team.
Before being discharged, please arrange for someone to drive you home on the day of your discharge from the hospital. The planned discharge time is 11 a.m. (unless you’re told otherwise). There may be times when we need your bed for an incoming patient. On the day of discharge, when you are ready, you will wait in our patient lounge for your driver to pick you up.
When you are ready to leave, your driver can park in the driveway in front of the hospital. They should tell the security guard at the front desk that they’re here to take you home. Parking is only allowed for a few minutes in this area. If your travel time is greater than two hours, you should plan on frequent stops to get out of the car and stretch your legs.
Cardiac rehabilitation program
There are outpatient cardiac rehabilitation programs across Ontario that are designed for people who are recovering from heart attacks, heart surgery or who are living with various heart and circulation conditions. Six weeks after your surgery, we recommend you participate in an outpatient cardiac rehabilitation program close to home. Your physiotherapist will recommend and refer you to an appropriate program.
Getting back to daily activities
During the recovery period, your body sees any activity as work. It is normal to feel more tired than usual. The goal is progressive activity – doing a little more each day. It takes six weeks for your breastbone to heal from your surgery, so certain activities should be avoided during that time. Do not lift items greater than 2.3 kilograms (5 pounds) for six weeks, for example: laundry baskets, groceries, pets, children or infants.
Follow the home exercise program and progress tracker available in your Coronary Artery Bypass guide
Follow-up appointments
You will need to contact your doctors’ offices for follow-up appointments.
Family Doctor: Call your family doctor to schedule your follow-up appointment for one week after your discharge.
Cardiologist: Call your cardiologist to schedule an appointment for four weeks after your discharge.
Surgeon: Call your surgeon to schedule your follow-up appointment at their discretion. Typically, follow-up appointments with surgeons occur six to twelve weeks after discharge.
