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    Learning About Your Health

    Coronary Artery Bypass Graft (CABG) & Heart Valve Surgery:
    Preparing for Your Surgery

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    Please review this information to help you prepare for your surgery and hospital stay. We want you to be informed and involved in the decisions affecting your care. If you have family members, friends, or caregivers who will assist you, please have them read this information as well.

    This information provides general guidelines, but we know that each person’s condition is unique. If you have any questions or concerns, please discuss them with the doctors, nurses, and therapists who are caring for you.

    What is Coronary Artery Bypass Graft (CABG) Surgery?

    Your heart needs a constant supply of blood in order to work. Blockages in the blood vessels of the heart (coronary arteries) can cause chest pain (also called angina) or a heart attack. Coronary artery bypass graft (CABG) surgery is recommended for patients with severe blockages in the coronary arteries. During CABG surgery, your surgeon uses blood vessels from the chest, leg, and/or wrist and creates new pathways for blood to flow to your heart muscle. Restoring the blood supply to the heart relieves chest pain and returns your heart to better function.Figure A shows the location of the heart. Figure B shows how vein and artery bypass grafts are attached to the heart.

    Figure A shows the location of the heart. Figure B shows how vein and artery bypass grafts are attached to the heart.

    Source: National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services.
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    What is Heart Valve Surgery?

    Heart valves open and close to keep blood flowing through your heart and out to your body. When heart valves do not open (valve stenosis) or close (valve regurgitation) properly, the heart muscle cannot work normally. Symptoms of heart failure may occur, such as difficulty breathing, weakness, ankle swelling, or irregular heartbeats. During heart valve surgery, your surgeon repairs or replaces abnormal valves to restore better flow of blood through the heart and relieve heart failure.

    The illustration shows a cross-section of a healthy heart and its inside structures. The blue arrow shows the direction in which oxygen-poor blood flows from the body to the lungs. The red arrow shows the direction in which oxygen-rich blood flows from the lungs to the rest of the body.

    The illustration shows a cross-section of a healthy heart and its inside structures. The blue arrow shows the direction in which oxygen-poor blood flows from the body to the lungs. The red arrow shows the direction in which oxygen-rich blood flows from the lungs to the rest of the body.

    Source: National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services.
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    Preparing for Your Surgery

    • Your surgeon's office will schedule your surgical procedure and will notify you of the details and preparations.


    • You will need to be seen for a physical exam prior to surgery to make sure you are physically able to undergo the procedure. You should discuss this with your surgeon’s office, as they will coordinate these arrangements.


    • If you are being admitted on the morning of your surgery, you will need to pre-register via phone or on-line. This will be confirmed with your surgeon’s office in advance, and they will provide you with the contact information.


    Your Diet
    • Eat heart-healthy foods.
    • Avoid salt and salty foods.
    Your Activity
    • Follow your usual activities, as directed by your doctor.
    • Avoid strenuous activity before your surgery
    Quit Smoking
    • Talk with your doctor about quitting smoking.
    • Call 1-800-NO-BUTTS for more information.
    Advanced Directives
    • An advanced directive (living will, durable power of attorney for health care) tells your doctor what kind of care you would like if you are unable to make medical decisions for yourself. If you have any of these documents, please bring them with you to the hospital.
    What to Pack for Your Hospital Stay
    • Comfortable clothing that you can wear home, avoiding small buttons, hooks, etc. that may be difficult to open or close after your operation.
    • Pack lightly, as storage is limited. We advise you to bring:
      • Toiletries: dental, shaving, lip balm, hairbrush/comb
      • Change of underclothes, bathrobe
      • Dentures, glasses, hearing aids
      • Light reading material

    Note: Please leave jewelry, money, credit cards and other valuables at home. If you need to bring cell phones or laptops, leave with family or in our safe during surgery.

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    Your Medicines

    • Please discuss all current medicines and any herbal supplements or teas you take regularly with your surgeon, as some can prolong bleeding. We will advise you how to adjust or stop taking blood thinning medicines such as Coumadin (Warfarin), Plavix (Clopidogrel), Pradaxa (Dabigatran), or Effient (Prasugrel). Stop any over the counter non-steroidal anti-inflammatory medicines like Aleve (Naproxen), Advil (Ibuprofen), and Motrin (Ibuprofen). You do not need to stop Aspirin unless your surgeon tells you to.

    • If you are taking medicines for diabetes such as Glucophage (Metformin), Micronase (Glyburide), or Glucotrol (Glipizide), ask your surgeon/primary doctor when you should stop taking these before surgery. If you are taking insulin for diabetes, ask your surgeon/ primary doctor about the dosage (amount) and type of insulin you should take, or if you should skip a dose.

    • Bring a list of your current medicines to the hospital, including name of medicine, dosage, frequency, and when the medicine was last taken. These medicines should be reviewed with the nurse facilitator.


    Note: Make sure you understand your medicines and any changes that will be needed before surgery. For questions, ask your surgeon’s office.

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    The Day Before Surgery

    • Call your surgeon immediately with any changes in your health such as a fever or cold. Be sure to tell your surgeon if you are pregnant.

    • You may eat your regular diet until the evening before your surgery. You should drink plenty of fluids until midnight to make sure that you are hydrated.


    • Do not eat or drink anything after midnight the night before your surgery, including coffee, water, hard candy or gum, unless otherwise indicated by your surgeon. If you have had something to eat or drink, notify your surgeon.


    • You are strongly encouraged not to smoke or drink alcohol 24 hours before your surgery.


    • You may shower normally and wash your hair the night before your surgery.


    • After you shower and dry off, use chlorhexidine gluconate (CHG) bath wipes to cleanse your skin, as directed on the next page. These are special wipes that help reduce the amount of bacteria on your skin and prevent infection. These will be provided at your pre-registration appointment.

    Use CHG Skin Prep Wipes at the Following Times:
    • Prep the evening before surgery (around 6:00 or 7:00 pm)
    • Prep again the morning of surgery before you come to the hospital
      If you wish to shower, bathe, or wash your hair, do so several hours before your first skin prep.


    Directions for Using CHG Wipes:
    • Remove cellophane film and discard.
    • Use scissors to open all 3 packages (each has 2 wipes)
    • Do not allow this product to come in contact with your eyes, ears, mouth, or mucus membranes.
    • Use one clean cloth to prep each area of the body in the order shown below, using a new cloth for each of the 6 areas shown.
    • Wipe each area thoroughly with a back-and-forth motion. Assistance may be required.
    • Use all the cloths in the packages.
    • Do not rinse after using cloths.
    • Do not apply lotions, perfumes, or makeup after using cloths.
    • Discard cloths in trash can.
    • Allow skin to air dry. Dress in clean clothes/pajamas.
    • In the morning, open a new package and repeat these instructions.

    diagram of a body front and back that show areas that need to be wiped using CHG Wipes in order from 1 through 6.
    1. Wipe your neck and chest.
    2. Wipe both arms, starting at the shoulder and ending at the fingertips. Be sure to thoroughly wipe the arm pit areas.
    3. Wipe your right and left hip followed by your groin. Be sure to wipe folds in the abdominal and groin areas.
    4. Wipe both legs, starting at the thigh and ending at the toes. Be sure to thoroughly wipe behind the knees.
    5. Wipe your back, starting at the base of the neck and ending at the waist line. Cover as much area as possible. Assistance may be required.
    6. Wipe the buttocks.

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    The Morning of Surgery

    • Cleanse with a new pack of CHG wipes, as directed above.


    • If your surgeon or nurse facilitator instructed you to take heart and/or blood pressure medicines on the day of your surgery, take them before coming to the hospital with a small sip of water only.


    • Please arrive at least 2 hours before your scheduled surgery, to allow for adequate preparation time. If you are scheduled for surgery at 6:30, 7:00, or 7:30 a.m., please arrive at 5:30 a.m.


    • Most surgeries are performed on time, but emergencies do happen. Our staff will keep you informed of any delays in starting your procedure.


    • Your family can wait with you until you proceed to the operating room.


    • Most surgeries last 3-4 hours. Once the operation is finished, our surgeons will look for your family or friends in the lobby area, located on the first floor of the main hospital.


    • Once the surgeon has spoken to your family, they can take the hospital elevators upstairs to either waiting room on the 3rd floor. Our staff will need additional time before they can visit you in the medical-surgical intensive care unit (MSICU).

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    Where Do I Go for My Surgery?

    On the day of your surgery, go to:
    Ambulatory Care Unit (ACU)
    2351 Clay Street
    Stanford Building, 6th Floor
    Telephone: (415) 600-3480

    View a map of the Pacific Campus

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    Produced by the staff and physicians at California Pacific Medical Center in association with the Center for Patient and Community Education. Last updated: 12/11. © 2011 California Pacific Medical Center

    Funded by: A generous donation from the Mr. and Mrs. Arthur A. Ciocca Foundation.

    Note: This information is not meant to replace any information or personal medical advice which you get directly from your doctor(s). If you have any questions about this information, such as the risks or benefits of the treatment listed, please ask your doctor(s).
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