Triple Bypass Surgery: Recovery

Triple bypass surgery, also known as coronary artery bypass grafting (CABG), is a surgical procedure done to increase blood flow to the heart. This is done by bypassing blood vessels that are blocked due to plaque build-up resulting in coronary artery disease.

This procedure is done as an inpatient procedure and requires immediate postoperative hospitalization. Find out how to recover from triple bypass surgery, including recovery time and postoperative incision care.

Surgery Follow-Up

Upon discharge from the hospital you will have several follow up appointments with your healthcare providers. This will include with the surgeon and a cardiologist.

Appointments will be regular during the first year after the surgery and it is very important to keep all schedule appointments. If for any reason you are unable to make an appointment, call your healthcare provider to have it rescheduled as soon as possible. These are expected:

• First postoperative appointment: This appointment will be three to seven days after discharge from the hospital and will be focused on the immediate postoperative care including pain management, stooling, incision care, and overall health.
• Second appointment: Six to eight weeks after surgery, the surgeon will do an in-depth examination to determine if you are cleared to resume physical activity, driving, and working.

Expect to have follow-up appointments yearly after the initial appointments. Some providers will want to see patients every six months but that will be dependent on your condition and recovery. Appointments may be more frequent during the first year after surgery especially if there are any postoperative complications.

During these appointments, your healthcare provider will provide you with instructions including:

• Guidelines on reducing risk factors
• Exercise including cardiac rehabilitation
• When to resume sexual activity
• Monitoring your weight
• Medication schedule
• When to resume driving
• Work clearance

Following the instructions and appointments provided by your healthcare team will help ensure the success of the surgery, reduce possible surgical complications, and prevent future issues.

Recovery Timeline

Recovering from triple bypass surgery can be a long process even without potential complications. You will want to speak to your healthcare provider for specifics regarding your own timeline as every patient is different. This is a rough guideline of the recovery timeline for patients after triple bypass surgery.

Day After Surgery

You can expect to remain in the ICU or CICU the day after surgery. If you had an endotracheal breathing tube, that will be removed and you will be taken off the ventilator. Patients can also expect to:

• Start on a clear liquid diet, but transitioning to solid foods as tolerated
• Perform breathing and coughing exercises
• Be transferred to a telemetry medical-surgical unit

Second Day After Surgery

On the second day after your heart bypass surgery, you may:

• Walk two or three times with physical therapist and nursing staff.
• Begin to eat solid foods and resume normal eating patterns.
• Limit the amount of fluids you can drink (no more than 6 to 8 cups over a 24-hour period).
• Sit upright in a chair for all meals.

First Six Weeks

By six weeks you will start to resume some activities around the home and participate in your self care. You may resume the following activities:

• Light housekeeping
• Light gardening
• Needlework
• Reading
• Cooking meals
• Climbing stairs
• Shopping
• Passenger in car
• Walking
• Stationary bike
• Shampooing hair
• Playing cards/games
• Attending sporting events

After Six Weeks

After six weeks you will still be limited in your activities but will have more freedom including being able to drive. You may also resume the following activities:

• Continue activities from the previous six weeks
• Return to work part-time
• Heavy housework (laundry, vacuuming, sweeping)
• Heavy gardening (mowing, raking leaves)
• Ironing
• Fishing
• Boating
• Light aerobics (no weights)
• Driving a small car or truck
• Walking dog on leash

After Three Months

By three months most patients are able to resume all normal activities and are encouraged to do so. Other specific activities that may resume include:

• Heavy gardening (shoveling snow, digging)
• Return to work full time
• Sports
• Jogging
• Wight lifting
• Motorcycle riding
• Bicycling
• Heavy housework (scrubbing floors)

Cardiac Rehabilitation

Cardiac rehabilitation (CR) is a very specialized and comprehensive program for all patients after triple bypass surgery. According to the American Heart Association (AHA), cardiac rehabilitation serves two purposes:

• CR promotes a faster and better recovery from heart surgery in the first weeks after the procedure, which is particularly important for the typical CABG patient, an elderly individual with several comorbidities and limitations.
• It provides healthy routines, tools, and the knowledge necessary to manage coronary artery disease to be successful in the long term

CR reduces postoperative complications and hospital readmissions. Cardiac rehab is not only physical training but also mental, and social conditions to help slow down the progression of coronary artery disease while identifying unhealthy behaviors and risk factors that increase the patient's overall risk.

The goals for CR include:

• Movement
• Independence
• Good mental performance
• Avoiding stress
• Maintaining a healthy social compatibility
• Regaining abilities

There are several stages to cardiac rehabilitation and goals are set with the therapist and patient. At times rehab will be hard but the goal is for you to resume your life as safely and normally as possible.

Cardiac rehab requires a prescription from your healthcare provider and may or may not be started in the hospital during the initial postoperative period.

Coping With Recovery

Triple bypass surgery can be difficult emotionally on a patient and their family. You might have feelings of anger, depression, anxiety, stress, pain, and fatigue. While most focus on the physical recovery, the emotional and mental is just as important.

Postoperative Depression

The AHA states that roughly 25% of triple bypass patients suffer from depression after the procedure. Often, depression is associated with progress after the surgery and if there are any setbacks of complications; however, that is not always the case.

The Cleveland Clinic says that up to 20% of patients who have undergone bypass surgery experience major depression after surgery.

Multiple studies have shown that mental stress directly affects a patient's heart health. Specific issues are:

• High blood pressure, arterial damage, irregular heart rhythms, and a weakened immune system
• Increased platelet reactivity, decreased heart variability, and increased proinflammatory markers
• Intensifies pain, worsens fatigue and sluggishness, or causes a person to withdraw into social isolation
• Increased morbidity and mortality

Some tips to help your overall health include:

• Practicing habits for emotional health
• Setting positive goals
• Maintaining realistic expectations
• Celebrating progress

Wound Care

You will have a midsternal surgical incision following the procedure. Initially, the primary dressing will stay in place and be care for by the surgeon and nurses. Upon discharge, you will receive written instructions on how to care for the incision.

General incisional care includes lightly washing the wound with mild soap and warm water daily and patting dry. Avoid scrubbing the area with a washcloth or loofah sponge. Scrubbing vigorously can open the incision.

The incision will have tape or steri strips covering it. This dressing will peel back on its own. Do not scratch or pick the incision area. It's important to remember to:

• Remove the tape from your incisions (it will come off by itself)
• Avoid swimming
• Take baths
• Scrub or rub your incisions
• Use lotion or powder on your incisions
• Overexpose your incisions to sunlight

Patients may also have a surgical dressing on a leg from a vessel grafting. Care will need to be done for this incision as well.

If your surgery involved taking a bypass graft from your leg, follow these guidelines:

• Care for your leg incision as described above.
• Avoid crossing your legs because this impairs circulation.
• Avoid sitting in one position or standing for prolonged periods of time.
• Elevate your leg on a stool or coffee table when sitting.
• You can also lie on a couch and elevate your leg on the arm of the couch.
• Check your leg daily for swelling. The swelling should decrease when you elevate your leg, but it might recur when you stand.
• If compression stockings (TED hose) were prescribed for you, wear the elastic stockings while you are up for at least two weeks after discharge.

A Word From Verywell

Recovering from triple bypass surgery may seem daunting at first, but with the proper support and care it is manageable. It's important to remember to follow the discharge instructions provided by your healthcare team and feel comfortable asking questions or bringing up your concerns with the surgeon.