After heart bypass surgery, many patients are asking questions about post-discharge care, precautions and what tests need to be done. Here, according to the latest version of the European Guidelines for Revascularization of Coronary Artery Disease (2010), combined with years of clinical experience, we would like to give some suggestions. First of all, what is the follow-up treatment and care after bypass surgery? Heart bypass surgery is only the first step in the treatment of coronary heart disease, although it is the most important step, but its follow-up treatment and maintenance is also crucial. This is not only necessary to maintain and improve the long-term patency of the graft, maintain good cardiac function after surgery, and prevent restenosis of the coronary vessels, but also to improve the long-term survival rate and reduce the occurrence of related diseases. Specifically, the follow-up treatment and maintenance mainly focus on the following three aspects: 1, reasonable drug treatment; 2, control of risk factors related to coronary heart disease; 3, change of lifestyle habits. The above three points seem to be simple, but they are the key points for the majority of patients, including medical personnel, to guide the post-operative treatment and maintenance. Second, what drugs do I need to take after surgery and how long do I need to take them? Generally speaking, anti-platelet drugs, beta-blockers, angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers, nitrate preparations, antihypertensive drugs, lipid-lowering drugs, and blood sugar-lowering drugs, etc. need to be taken. The details are as follows: 1. Anti-platelet drugs: such as aspirin and Poliovel. Anti-platelet therapy is essential to maintain and improve the long-term patency of the transplanted vascular bridge and needs to be taken for life. If a patient cannot take aspirin because of gastrointestinal problems, he or she can switch to Polivir. 2. Beta-blockers: such as betalactam and atenolol, among which betalactam favors lowering blood pressure and atenolol favors lowering heart rate. After bypass surgery, it is best to control the heart rate at 60-80 beats/min. An excessively fast heart rate is not only unnecessary for patients, but also increases myocardial oxygen consumption, inducing myocardial hypoxia and ischemia, leading to angina pectoris. Since beta-receptor lagging agents are of great help in improving the long-term survival of patients, they are generally recommended for all patients for life, especially for patients with a history of acute myocardial infarction and acute coronary syndrome, as well as left heart insufficiency, where their application is of greater significance. 3, angiotensin-converting enzyme inhibitors (ACEI): such as captopril or enalapril. Because ACEI agents have a hypotensive effect in addition to helping ventricular remodeling, it is recommended that all postoperative patients should take them routinely, especially for patients with a left ventricular EF of less than 40%, or with hypertension, diabetes mellitus, or chronic renal insufficiency. For patients who cannot apply angiotensin-converting enzyme inhibiting (ACEI) agents, angiotensin receptor blockers, i.e. sartans, can be used instead, especially for patients with chronic cardiac insufficiency or post-infarction left ventricular EF values <40%. 4, nitrate preparations: such as nitroglycerin, cardiac pain, sorbitol 5-mononitrate, long-acting nitroglycerin preparations, etc. For patients without angina pectoris they can be taken for 3-6 months after surgery and do not need to be taken for a long time. For symptomatic patients, patients who cannot be treated by intervention or surgery after examination, need to be taken for a long time. 5, other drugs: such as antihypertensive drugs, lipid-lowering drugs and blood sugar-lowering drugs, need to be selected according to the specific circumstances of the patient. The above drug therapy should be adjusted every six months at the latest. 3. What are the risk factors for coronary heart disease after surgery? The main risk factors of coronary heart disease are: high blood pressure, high blood fat, excessive obesity, high blood sugar, poor living habits and psychosocial factors and family genetic factors, etc. 1.Blood pressure: The ideal blood pressure of patients after bypass surgery should be within 130/80mmHg, and the drug treatment should be based on β-blockers, angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers, calcium antagonists and diuretics, and the specific medication should listen to the opinions of experts in hypertension control. 2. Lipids: The ideal lipid profile for post-bypass patients should be less than 100 mg/dL (2.5 mmol/L) for LDL cholesterol, and less than 70 mg/dL (2.0 mmol/L) for high-risk patients. Routine postoperative lipid-lowering therapy is recommended for all patients, even if lipid tests are not high in the early postoperative period. Lipid-lowering drugs are mainly statins, but also betulinic acid and folic acid, as well as Omega-3 fatty acids are recommended, especially for patients who cannot apply statins. During the application of statin therapy, changes in muscle tissue and liver function should be observed. Specific drugs should be listened to endocrinologist's opinion. 3. Blood glucose: Postoperative diabetic patients should be routinely treated with anti-diabetic therapy, and the goal is to control glycated hemoglobin below 6.5% by adjusting diet, appropriate exercise, and adding necessary medication. The specific treatment plan is formulated with the help of diabetes treatment experts. 4.Weight: For obese patients, the goal of the initial postoperative period is to reduce body weight by about 10% by adjusting diet and increasing exercise appropriately. The long-term treatment goal is to control the body mass index (BMI) below 25kg/m2, while the waist circumference of men should be less than 94cm and women less than 80cm. (BMI is the number derived by dividing the weight in kilograms by the square of height in meters, the normal range is 18, 5C24, when greater than 24 that is overweight, when greater than 27 that is obese). Fourth, which habits need to be adjusted? 1, the first is to stop active and passive smoking. 2, adjust the diet: low sodium, low-fat diet, appropriate intake of protein, more green vegetables and fresh fruit. The way food is cooked is also important. In cooking animal foods, absolutely avoid deep-frying. The more appropriate methods are steaming and baking, so that the fat in the food drips out. 3, appropriate to increase activity: mild patients can start activity exercise during the postoperative hospitalization, serious patients should wait for the clinical manifestations to stabilize and start. It is recommended to do 30-60 minutes of moderate intensity aerobic exercise every day, or at least 2 days a week. 4. Avoid foods that excite the nervous system, such as alcohol, strong tea, coffee, etc. Caffeine will increase the cholesterol in the body. 5.Adjust your mind, positive and optimistic life is also very important. 6.Annual influenza vaccination is recommended. V. What are the regular checkups needed after bypass surgery? 1.For patients without angina, routine physical examination (such as: heart rate, heart rhythm, blood pressure, heart auscultation, etc.), electrocardiogram, blood biochemical examination (including: blood lipids, blood sugar, liver and kidney function, cardiac enzymes and other indicators), glycosylated hemoglobin, color ultrasound examination of the heart, etc. 2. For patients with angina pectoris, cardiac spiral CT, cardiac stress ultrasound, myocardial nuclear scan, and coronary angiography are required.