After cardiac bypass surgery, many patients are asking about post-discharge care, precautions, and what tests need to be done, etc. Here I would like to give some advice based on the latest version of the European Guidelines for the Revascularization Treatment of Coronary Artery Disease (2010), combined with many years of clinical experience. First of all, what are the follow-up treatment and care after bypass surgery? Cardiac bypass surgery is only the first step in the treatment of coronary heart disease, and although it is the most important step, its follow-up treatment and care is also crucial. This is not only necessary to maintain and improve the long-term patency rate of the grafted vessel bridge, to maintain good cardiac function after the operation, to prevent restenosis of coronary vessels, but also to improve long-term survival rate and reduce the occurrence of related diseases. Specifically speaking, the follow-up treatment and maintenance are mainly centered on three aspects: 1, rational drug treatment; 2, control of coronary heart disease related risk factors; 3, change of lifestyle habits. The above three points seem simple, but the majority of patients, including medical staff, to guide the main points of postoperative treatment and maintenance. Second, what medications do I need to take after surgery and for how long? Generally speaking, it is necessary to take antiplatelet drugs, β-blockers, angiotensin-converting enzyme inhibitors (ACE I), angiotensin receptor blockers, nitrate preparations, antihypertensive drugs, lipid-lowering drugs, and blood glucose-lowering drugs. The details are as follows: 1. Antiplatelet drugs, such as aspirin and poliovir. Antiplatelet therapy is essential to maintain and improve the long-term patency rate of the graft vascular bridge and needs to be taken for life. If the patient cannot take aspirin because of gastrointestinal problems, he can use Polivir instead. 2.Beta-blockers, such as bethanechol and atenolol, of which bethanechol 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, too fast heart rate is not only unnecessary for patients, but also increases myocardial oxygen consumption, induces myocardial hypoxia and ischemia, and leads to angina pectoris. Since beta-agonists are of great help in improving the long-term survival rate of patients, it is generally recommended that all patients take them for life, especially for patients who have had a history of acute myocardial infarction and acute coronary syndromes, as well as patients with left heart insufficiency, the application of the application is of greater significance. 3.Angiotensin converting enzyme inhibitors (ACE I), such as captopril or enalapril. Since ACEI agents have the effect of helping ventricular remodeling in addition to antihypertensive effect, it is recommended that all postoperative patients should take them routinely, especially for patients with LVEF less than 40%, or with hypertension, diabetes mellitus, chronic renal insufficiency. For patients who can not apply angiotensin-converting enzyme inhibitor (ACE I) agents, can be changed to angiotensin receptor blockers, i.e., sartans, especially for patients with chronic cardiac insufficiency or post-infarction left ventricular EF value of <40%< span="">. 4, Nitrate preparations, such as nitroglycerin, anticardiac pain, 5-mononitrosorbital, long-acting nitroglycerin preparations. For patients without angina pectoris 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 undergo interventional or surgical treatment after examination, need to take long-term. 5, other drugs, such as antihypertensive drugs, lipid-lowering drugs and blood sugar-lowering drugs, need to be selected according to the patient’s specific situation. The above medication should be adjusted every six months at the latest. Third, if the postoperative control of coronary heart disease risk factors? The main risk factors of coronary heart disease are: high blood pressure, high blood fat, excessive obesity, high blood sugar, bad life habits and psychosocial factors and family genetic factors. 1. Blood pressure: the ideal blood pressure of patients after bypass surgery should be within 130/80mmHg. Drug treatment is based on β-blockers, angiotensin-converting enzyme inhibitors (ACE I), angiotensin receptor blockers, calcium antagonists, and diuretics, and the specific medication should be taken by experts in the control of high blood pressure. 2. Lipids: The ideal lipid profile for postoperative bypass patients should be LDL cholesterol less than 100 mg/dL (2.5 mmol/L), and for high-risk patients, LDL cholesterol should be less than 70 mg/dL (2.0 mmol/L). Routine postoperative lipid-lowering therapy is recommended for all patients, even if the lipid profile is not high in the early postoperative period. Lipid-lowering drugs are mainly statins, but betulinic acid and folic acid, as well as omega-3 fatty acids are also recommended, especially for patients who cannot use statins. In the process of applying statin therapy, changes in muscle tissue and liver function should be observed. Specific drugs should be subject to the opinion of endocrinologists. 3. Blood Glucose: Diabetic patients should be treated with routine anti-diabetic therapy after surgery. The goal is to control glycated hemoglobin below 6.5% through dietary modification, appropriate exercise, and the addition of necessary medications. Specific treatment programs are developed with the help of diabetes care specialists. 4. Weight: For obese patients, the goal in the initial postoperative period is to reduce weight by about 10% through dietary adjustments and appropriate increase in exercise. The long-term goal is to keep the body mass index (BMI) below 25 kg/m2 , with a waist circumference of less than 94 cm for men and less than 80 cm for women. (BMI is a number obtained by dividing weight in kilograms by height in meters squared, with a normal range of 18 .5 C 24, and greater than 24 is considered to be the normal range. (BMI is a number obtained by dividing the weight in kilograms by the square of the height in meters. Postoperative maintenance 1, maintain a positive and proactive attitude towards rehabilitation Early postoperative physical exercise will help patients recover early, therefore, we require patients to get out of bed as soon as they are transferred to the general ward and start functional exercise. Similarly, even if the patient’s appetite is low, he should try to eat (not overeating) and even “take the food as medicine” in order to recover faster. If the patient does not have a proactive attitude towards recovery and just waits for the doctor to prescribe medication, various complications are likely to occur. Diet: In addition to rice and noodles, staple food should be accompanied by grains and beans. Lean meat (chicken, fish) 100-150 grams per day, do not eat fat meat, eat less animal offal. Use vegetable oil, not animal oil or less. Eat more green vegetables and fruits. Peanuts, walnuts can be eaten often, but should not be excessive. Salt should be controlled, adult daily intake of 5 to 6 grams of salt is enough, it is recommended to choose commercially available low-sodium salt. 3, control the consumption of alcohol Try to drink less alcohol, even wine, should also be moderated. The most beneficial beverages are plain water and green tea, do not drink sugary drinks. Appropriate activities should be carried out in the early postoperative period and the recovery period. When patients engage in sports for the first time after surgery, they must measure their pulse, and exercise should be carried out strictly according to the exercise prescription, which is neither “conservative” nor “radical”, and should be gradual and persistent. Preparatory activities should be done before exercise, if chest tightness, chest pain, breathlessness, dizziness, rapid heartbeat and other discomforts occur during exercise, the activity should be stopped immediately and go to the hospital in a timely manner. Patients can carry nitroglycerin and other first aid medicines with them in case of emergency. Do not exercise immediately before or after meals. When it is cloudy or rainy, hot or cold, you should reduce the amount of exercise or pause exercise. After exercise, you should rest for 20 minutes before bathing. It should be reminded that sports can not completely replace drug therapy, patients should not change the dosage and method of heart disease drugs without authorization. 5, adhere to the medication Drug therapy is an irreplaceable and important means of treatment for patients with coronary heart disease, including blood pressure, lipids, blood glucose, anticoagulation and coronary expansion of five kinds of drug therapy, should be developed by experienced doctors to formulate a reasonable drug therapy program, and timely adjustments. Regular monitoring Patients should go to the hospital regularly for review after surgery. Electrocardiogram, isotope or coronary angiography should be done to monitor whether the “bridge” is smooth.