Pre-Op Prep for Coronary Artery Bypass Graft (CABG)

Helpful Highlights

• The first and most important thing for your loved one to do is stop smoking (all tobacco use).

• Medication and lifestyle management, and possibly other medical procedures, are implemented before bypass surgery and can sometimes prevent it.

• There are many tests performed before surgery to determine if your loved one is safe and physically suitable to have it.

# 1 is smoking cessation

Smoking makes the heart work harder and puts coronary arteries at further risk of damage. Smoking also increases the risk of developing pneumonia or other pulmonary complications after surgery. 

Pre-op prep

The cardiologist will provide individualized instructions on any lifestyle changes that need to be made, as well as activities that need to be added to your loved one's daily routine before surgery.

Medication and lifestyle management, and possibly other medical procedures (such as angioplasty*), are typically implemented before CABG. Sometimes these efforts even prevent bypass surgery. Your loved one will start medications that lower cholesterol levels and blood pressure, and improve blood flow through the coronary arteries if they aren't on them already. They will need to adhere to a heart-healthy diet and exercise recommendations, including those aimed at preventing complications following surgery.

*Angioplasty, also called balloon angioplasty, is a minimally invasive procedure wherein a balloon-tipped catheter is threaded into the blocked coronary arteries and inflated. Inflation pushes against the blockage and opens the artery, allowing increased blood flow. (The same procedure is used for stent placement.)

When deciding if your loved one is a candidate for CABG, the cardiologist will also consider the following:

• Thorough physical exam

• Health history and any past treatment of heart disease or other cardiac issues, including surgeries, procedures, and medications

• History of other diseases and conditions

• Age and general health and well-being

• Family history of coronary artery disease, heart attack, or other cardiac conditions

Testing

Several tests (see below) will be performed to confirm that it's safe for your loved one to have bypass surgery.  Likewise, blood and imaging will be collected to find out which arteries are clogged, how much they're clogged, with what, and whether there's any heart damage.

The potential tests include, but are not limited to:

• Electrocardiogram (ECG or EKG)

• Echocardiogram

• Exercise stress test

• Nuclear cardiac stress test

• Cardiac catheterization (angiogram)

• X-ray angiography or computed tomography (CT) scan angiography

• Coronary calcium scan

• Complete blood count (CBC), chemistry (CHEM-12, 14), and lipid panel that analyzes cholesterol, blood sugar, electrolytes, and multiple other factors 

• Possibly urine tests that analyze kidney function