Triple Bypass Surgery: How to Prepare

If triple bypass surgery, also known as coronary artery bypass graft (CABG) surgery, is suggested by your surgeon and other healthcare providers to address coronary artery disease or angina, it is essential to be as prepared as possible prior to the procedure. You will need to take steps before the procedure and expect a hospital stay of about a week.

Location

A triple bypass surgery is one of the more common open-heart procedures. This procedure is always done as an inpatient surgery because of the serious complications and lengthy recovery after the surgery. You can expect to be in the hospital for at least a week after the procedure.

You will be admitted to the hospital on the day of surgery and transferred to the ICU/CICU immediately following the procedure. After the initial recovery period, if you are stable, you will move to a medical-surgical telemetry floor for the rest of the hospitalization.

What to Wear

The most important thing to remember for this procedure is to dress comfortably. Medical professionals recommend loose-fitting clothing to wear to and from the hospital.

Most patients wear hospital gowns after the procedure due to the medical equipment, including IVs, catheters, and drains, as well as from the mid-sternal incision. You can expect to wear non-skid footwear at all times when out of bed.

Food and Drink

You will be required to stop eating and drinking prior to surgery. This is called being NPO, which means nothing by mouth.

Instructions on a specific time will vary for all patients and are determined by the surgical team. You will be given this information at a pre-operative appointment and then a follow-up reminder call is done the day before the procedure.

Take only the medications your healthcare provider tells you to take on the morning of your surgery. Take them with just enough water to swallow comfortably. Make sure to confirm the medications with your surgeon and only take with water.

Medications

The surgeon will discuss all medications with you before the surgery. Make sure to bring a list of the medications to pre-operative appointments including the dosage, how often the medication is taken, and when it was last taken.

Also include all vitamins and supplements in the list of medications. These are just as important as prescribed medications as they may have side effects with the anesthesia and medications used during and after the procedure.

Providers may start patients on medications prior to surgery to manage symptoms. These medications might include:

• Stool softener: These medications relieve constipation to avoid straining which can cause additional strain on the heart. An example of this medication is Colace.
• Beta blocker: This class of medications helps lower blood pressure by blocking the effects of the hormone epinephrine, also known as adrenaline. They cause the heart to beat slower and with less force which in turn lowers blood pressure. An example of this medication is propranolol.
• ACE inhibitor: This class of medications helps lower blood pressure by decreasing chemicals that tighten blood vessels and allows the blood to flow more freely. An example of this medication is enalapril.
• Calcium channel blocker: This class of medications can be used in combination with other medications to treat high blood pressure. It is also used to treat angina and coronary artery disease. An example of this medication is amlodipine.
• Nitrate: This class of drugs is used to control chest pain associated with angina by vasodilating the blood vessels. An example of this medication is sildenafil.
• Aspirin: This medication is used to prevent blood clots.
• Alpha 2 agonists: This class of medications used to treat high blood pressure by decreasing your heart rate and relaxing the blood vessels so that blood can flow more easily through the body. An example of this medication is guanabenz.
• Oral anticoagulants: This medication is used to prevent blood clots from forming or growing larger in blood and blood vessels. An example of this medication is warfarin.
• Diuretics: These medications are used alone or in combination with other medications to treat high blood pressure. An example of this medication is furosemide.
• Digoxin: This medication is used to treat heart failure and arrhythmias.
• Antiarrhythmics: This class of medication used to treat abnormal heart rhythms making the heart more resistant to abnormal activity. An example of this medication is procainamide.
• Statins: This class of medication is used to reduce the risk of heart attack. It also decreases the amount of fatty substances such as low-density lipoprotein cholesterol (bad cholesterol) and triglycerides in the blood and increases the amount of high-density lipoprotein cholesterol (good cholesterol) in the blood . This can help prevent plaque buildup in the arteries. An example of this medication is atorvastatin.
• Insulin: These medications are used to treat abnormal blood sugar.

Specific medications will vary based on the patient and be determined by the provider. This is dependent on the patient's comorbidities, severity of angina and/or coronary artery disease, and blockages.

What to Bring

Here is a list of some of the most important items to bring with you on the day of your schedule triple bypass surgery:

• Comfortable loose-fitting clothing, robe, and rubber-backed, non-skid slippers
• Personal care products such as toothbrush and toothpaste
• Storage containers for glasses, contact lenses, and/or dentures if you wear them
• Insurance card and personal ID card
• Emergency contact information
• A copy of your legal paperwork pertaining to your health (such as your healthcare proxy or living will)
• A complete list of all the medications you currently take including the dosages, how often you take them and when they were last taken
• Any adaptive equipment for mobility including cane, walker, or wheelchair
• Earplugs and eye mask
• Reading material
• Cell phone charger
• Pillow or blanket

You should not bring:

• Valuables
• Jewelry
• Watches
• Credit cards
• Cash
• Laptop

Patients' belongings will be taken to their room by hospital staff and may be moved when a patient is transferred after surgery from the ICU/CICU to a general medical surgical floor. It's important to leave all the non-essentials at home and only bring what will make you the most comfortable during the recovery.

Pre-Op Lifestyle Changes

Lifestyle changes are essential to the success of a patient having triple bypass surgery. This procedure only fixes the current blockages around the heart but does not prevent new ones from forming.

It is important to start taking the proper steps prior to the surgery to make important lifestyle changes in order to prevent postoperative complications and worsening coronary artery disease. Important changes include:

• Quit smoking.
• Stop drinking alcohol.
• Get plenty of rest.
• Increase physical activity (as tolerated)
• Use an incentive spirometer.
• Make diet changes.

A Word From Verywell

Triple bypass surgery is a serious surgery that should not be taken lightly. Often this surgery is one that can not be delayed due to the possibility of worsening coronary artery disease and angina.

It's important to speak to your healthcare provider regarding all of the risk, potential complications and let them know if you have any questions or concerns.