Last updated: 11/24/2009

Diagnosis

The diagnosis of coronary artery disease is made after the patient's medical history is carefully reviewed, a physical exam is performed, and the patient's symptoms are evaluated. Tests used to diagnose coronary artery disease...

include:

• electrocardiogram
• stress tests
• cardiac catheterization
• imaging tests such as a chest x ray, echocardiography, or computed tomography (CT)
• blood tests to measure blood cholesterol, triglycerides, and other substances

Preparation

The individual should quit smoking or using tobacco products before the surgery. The individual needs to make the commitment to be a nonsmoker after the surgery. There are several smoking cessation programs available in the community. The individual can ask a health care provider for more information about quitting smoking.

Coronary artery bypass graft surgery should ideally be postponed for three months after a heart attack. Patients should be medically stable before the surgery, if possible.

During a preoperative appointment, usually scheduled within one to two weeks before surgery, the patient will receive information about what to expect during the surgery and the recovery period. The patient will usually meet the cardiologist, anesthesiologist, nurse clinicians, and surgeon during this appointment or just before the procedure.

If the patient develops a cold, fever, or sore throat within a few days before the surgery, he or she should notify the surgeon's office.

The evening before the surgery, the patient showers with antiseptic soap provided by the surgeon's office. After midnight, the patient should not eat or drink anything.

The patient is usually admitted to the hospital the same day the surgery is scheduled. The patient should bring a list of current medications, allergies, and appropriate medical records upon admission to the hospital.

Before the surgery, the patient is given a blood-thinning drug—usually heparin—that helps to prevent blood clots. A sedative is given the morning of surgery. The chest and the area from where the graft will be taken are shaved.

Coronary angiography will have been previously performed to show the surgeon where the arteries are blocked and where the grafts might best be positioned. Heart monitoring is initiated. The patient is given general anesthesia before the procedure.

The length of the procedure depends upon the number of arteries being bypassed, but it generally takes from three to five hours—sometimes longer.