Coronary Artery Bypass Grafting (CABG)

Generally, there will be a midline incision on the chest, with forearm and leg incisions, though this might vary depending on the extent of the surgery. Newer techniques such as the ‘key hole’ surgery are available for selected patients.

Once the wounds are dry, they can be cleansed with mild soap and will not be covered with dressing. 

No, your breast-bone will be securely closed with surgical steel wire and the incision will be closed with sutures. Coughing and deep breathing will not affect the closure or healing process of your chest wound.

You may notice an occasional “clicking noise” or sensation in your chest in the first few days after surgery. This should occur less often with time and go away completely within the first few weeks. If it gets worse, consult your doctor.

During the healing process, you may feel sore due to the incisions and muscle spasms. It can be relieved by good posture and frequent movements of the arms and shoulders. The wound is also exposed to air, which allows it to become dry. After a few days, the wound can be cleansed with a mild soap. Do not apply any talcum powder, lotion or ointment onto your wound.

If an artery in your chest, called the mammary artery, was used during your surgery, you may experience numbness to the left of your incision. This is normal.      

External stitches or staples are removed from the chest about a week after the operation and a few days later from the legs, if the stitches or staples are present. It takes about six weeks for complete healing of these wounds. It is advisable to avoid lifting heavy objects for 3 months while the wound is healing.

Leg incisions will first be cleansed with an antiseptic solution, and then with mild soap and water. There may be some tendency for the ankles to swell or the presence of a burning sensation felt when standing up. Elastic support stockings and walking will help to improve blood circulation and reduce the swelling. Avoid crossing your legs.

The doctor, dietician and nursing staff will advise you on your diet. It is wise to reduce the risk factors of heart disease as much as possible by cutting down on salt, cholesterol and saturated fats in your diet. Increase your vegetables and fruits intake to prevent constipation. It is also important to keep your weight under control as extra weight will place strain on your heart. 

Moderation and wise judgement are usually the best guides in maintaining a healthy diet. Refrain from drinking alcohol. Refer to diet instructions given.

Depending on the surgery and how well you have recovered, the average length of stay for patients undergoing CABG Surgery is six to eight days. However, the length of stay may vary with each individual. Patients with multiple pre-existing medical conditions may require a longer stay.

An uncomplicated hospital stay may last a week, whilst your surgical wounds will completely heal between six weeks to two months.

Deep breathing and coughing exercises will help clear your secretions. You should use the incentive spirometer diligently and perform deep breathing exercises. The physiotherapist will assist you in coughing techniques. Taking pain medication and holding a small pillow against your chest to splint the incision will make you more comfortable when you cough. Changing positions in your bed also helps in the recovery process. Lying on your back for a long period of time causes secretions to collect in the lungs.

It depends on the nature of your work. An office worker can return to his/her desk-job after four to six weeks. Those performing manual labour, especially work that requires upper body strength, could return to work after three months. Some may not be able to return to their former jobs.

CABG is well-established in Singapore and worldwide. It is undoubtedly the most well studied operation in the realm of surgery, and has an excellent track record of over 50 years. Furthermore, the effects of CABG last an average of 10 years which is much longer than the alternative, coronary angioplasty (also known as percutaneous coronary intervention, or PCI). However, the procedure has a higher risk for complications than coronary angioplasty. It also requires a longer hospital stay (one week) and longer recovery (one to two months).