CABG PPT.

April 2, 2018 | Author: pnanees | Category: Coronary Artery Bypass Surgery, Surgery, Medical Specialties, Clinical Medicine, Medicine


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Description

CABGHeart bypass surgery creates a conduit or "bypass" around the blocked part of a coronary artery to restore the blood supply to the heart muscle. The surgery is commonly called Coronary Artery Bypass Graft, or CABG and have a chest xray. be weighed. have a blood sample taken. in which the arteries that deliver blood to your heart are evaluated.  You also may undergo several pre-operative imaging tests. Be sure to bring a list of any medications. . a surgeon uses a piece of an artery or vein from another part of your body to reroute blood around the blocked or narrowed portion of your coronary artery or arteries. In CABG. allergies any other problem with anesthesia or herbal supplements that you take with you to your doctor's appointment.  Your surgeon will perform a physical examination and review your medical history before your procedure.PRE-OPERATIVE  CABG is performed to restore blood flow to your heart by bypassing coronary (heart) arteries that have been narrowed or blocked by the build-up of plaque. Eg. You will be in fast for 8-10 hours. You have to undergo complete body preparation as body bath with antiseptic solution . full body shaving & hair to be shampooed. you will get admitted to complete paperwork. 2D Echo & CAG  The day before your procedure. dietary supplements.  You & your close relative have to give surgical & anesthesia consent for medico-legal aspects. you will change into a gown.  At the hospital. You will have drain tubes and catheter for  Minimum 2days .  Post operatively you will be kept in ICU and on fasting for 24 hrs & nutritional needs will be met by administration of IV fluids & medication. medications will be given to you as ordered. and when it’s time to go to the operating room. You will receive an IV.  As a part of your pre-operative preparation respiratory preparation & post operative exercises will be taught to you by physiotherapist. Take a shower or bath again on the day of surgery with the anti-septic solution we gave you.  Midline sternotomy incision will be taken on you .  In OT you will be received in pre-op area & your file will be verified for completion of documentation.  As soon as surgical team is ready you will be shifted to the specified OT & you will be on your supine position & you will be anaesthetized.INTRA-OPERATIVE  Half an hour back to your scheduled time you will be shifted to operation theatre along with nursing staff. Flexion. Circumduction) . . Extension.  Exercise: Deep Breathing exercises Chest Exercises Spirometry Limb Exercises( Active & Passive ROM .POST-OPERATIVE  ICU Stay: You will have to stay 12-24 hrs post operatively in ICU or as recommended by the Surgeon/Anaesthetist.  Early Ambulation: Sitting at the edge of the bed with feet dangling (12nd day) Bed side ambulation ( 2nd –3rd day) Pace walking . 15% of total calories should come from fat. Diet: Low Fat diet Not more than 12 . . Plenty of vegetables & fruits ( High Fibre). E. groundnut. batatawada etc. fruit juices. jam. egg yolk. til. shellfish. sweets.  Red meat. Whisky & Beer  Sodium and fluids are restricted as per the disease  A good amount of vitamins A. jaggery. samosa. honey. B-carotene as these anti-oxidants play a vital role against free 02 radicals which initiate atherosclerosis . coconut . DO NOT CONSUME……  Deep fried foods like bhajiyas. Manganese.  Wine. organ meat  Sugar. C. kachori. zinc. selenium.  Bakery products  Dry fruits . Nitroglycerine: S/E: Headache In case of angina at 5 min interval you can take 3 tablets SL If no pain relief for 15 min consult Dr immediately  Beta Blockers:  Ca Channel blockers:  Oral hypoglycemic agents / Insulin  Take prescribed medications at the same time  Do not self medication  Do not use over the counter drugs . Bleeding tendencies.Medication: Aspirin S/E : Gastritis. CBC/ ESR .X ray .Follow-up: 1st visit after 15 days : For staple removal Or as per protocol After 6 weeks with Ix : .Lipid profile .Electrolytes .FBS/ PPBS After Angioplasty : Stress Test .  Discharge Instruction: You may ……… Not have much appetite Have some swelling. creams or powder to the incision. Have difficulty sleeping at night Have problems with constipation Have mood swings and feel depressed. Notice an occasional "clicking noise" or sensation in your chest Experience muscle pain or tightness in your shoulders Care of the Incision: • Do not apply oils. ointments. lotions. . Care of the Surgical Leg / Radial graft site: Check your leg daily for swelling Elevate the leg Watch for oozing or redness Wear Stockings . Rest . Travel Driving: . Lifting: Use of Chest corset Bowel Movement: Avoid constipation/straining. . You alone are responsible. You must begin. .If you are to be.Exupery THANK YOU . For every moment of your life . For every one of your acts.Antoine de Saint. By assuming responsibility.
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