What to expect after coronary artery bypass grafting

  Coronary artery bypass grafting (bypass grafting) is a procedure in which one’s own vessels (internal mammary artery, radial artery or and saphenous vein) are transplanted to the heart to replace some of the narrowed coronary arteries. However, patients with coronary artery disease have sclerosis and varying degrees of stenosis in blood vessels throughout the body, including those distal to the coronary arteries of the heart that cannot be surgically resolved. Therefore, coronary bypass grafting can prevent large myocardial infarction caused by blockage of larger coronary arteries and alleviate angina attacks to some extent, but cannot remove continued sclerotic stenosis of the coronary arteries.  Therefore, the post-bypass grafting conditioning includes three aspects: 1, try to keep the grafted vessels open after coronary artery bypass grafting.  2.Maintain cardiac function and reduce oxygen consumption of the heart after coronary artery bypass grafting.  3.After coronary artery bypass grafting, develop healthy habits to eliminate the risk factors that lead to atherosclerosis and avoid continued narrowing of coronary arteries.  First of all, doctors should try to choose arteries to be grafted to more important vessels (such as anterior descending branch) during surgery; grafted vessels should be handled carefully: improve surgical suturing skills; and enhance perioperative myocardial protection and maintenance of cardiac function.  After coronary artery bypass surgery, anti-platelet coagulation drugs should be applied for a long time to prevent the formation of blood clots in the transplanted vessels, reduce blood viscosity and improve microcirculation. In the past, aspirin was generally used, the price is low, but aspirin is more likely to cause gastric discomfort or even gastric bleeding, now it is more often applied Polivy, 75mg once a day, but the price is slightly expensive.  Heart rate should be controlled after coronary artery bypass grafting, heart rate at 60-80 beats/min is ideal, fast heart rate will increase oxygen consumption, easily induce myocardial hypoxia and ischemia, leading to angina pectoris. The heart rate is generally controlled with beta hysteresis agents (atenolol). Beta hysteresis agents also have the effect of lowering blood pressure, and if the heart function is poor, it should be changed or added with digitalis drugs (digoxin).  Hypertension, hyperlipidemia, hyperglycemia, and smoking are risk factors for atherosclerosis.  A healthy diet after coronary artery bypass grafting includes: 1. Low sodium diet. Low sodium diet should eat less salt or smoked food; canned food are to eat less.  2, low-fat diet. Dietary intake of animal fat should be limited, cooking, more vegetable oil, cholesterol is limited to less than 300 mg per day. Fat-lowering foods are preferred to soy products. Black fungus has the effect of anti-platelet coagulation, lowering blood lipids and stopping blood cholesterol deposition. Capsicum, oats and barley are good for lowering blood lipids and can lower blood cholesterol and reverse fatty liver.  3, moderate intake of protein. Unless combined with chronic renal insufficiency, there is generally no need to strictly limit the intake of protein. Eat fish protein 23 times a week, can improve vascular elasticity and permeability, increase urine, sodium discharge, thereby reducing blood pressure.  4, eat more green vegetables and fresh fruit, is conducive to myocardial metabolism, improve myocardial function and blood circulation, to promote the excretion of cholesterol, to prevent the development of hypertensive disease.  5, avoid eating foods that excite the nervous system, such as wine, strong tea, coffee, etc. Smoking is extremely harmful to the heart because (1) cigarettes contain tar, nicotine and carbon monoxide, which are extremely harmful to the human body.  (2) When the blood concentration of carbon monoxide hemoglobin is too high, it can cause a decrease in blood oxygen concentration, insufficient oxygen supply to the tissues, edema of the inner walls of the arteries, endothelial damage, lipid infiltration into the walls of blood vessels, and accelerate the formation of atherosclerosis.  (3) patients with coronary heart disease, smoking can accelerate its progress and cause heart attacks. Heavy smoking can induce serious arrhythmias such as ventricular fibrillation, which becomes one of the causes of sudden death.  After coronary artery bypass grafting, exercise appropriately according to your tolerance, pay attention to the combination of work and rest, and avoid overexertion.