Post-hospital course and complications following coronary bypass surgery
James R. Hodgman, M.D.
Department of Cardiology
Delos M. Cosgrove, M.D.
Department of Thoracic and Cardiovascular Surgery
Intraoperative and early postoperative problems and complications following coronary bypass surgery have been well described. The team approach by the surgeon, anesthesiologist, cardiologist, nurse, and respiratory therapist can prevent most complications or they can be quickly corrected, and most patients discharged 10 days after surgery. At this point the average patient is improving rapidly, but 6 to 8 more weeks of recuperation are required for total recovery. During this time the care of the patient generally reverts to the referring physician. The unique problems and complications which may arise during this recovery phase are the subject of this review.
The clinical course of 100 consecutive patients was reviewed during the 6- to 8-week recovery phase after hospital discharge following coronary revascularization surgery at the Cleveland Clinic Hospital. The study group consisted of 94 men and 6 women aged 30 to 72 years. All received at least one saphenous vein coronary bypass graft between July 1969 and July 1974. Of the 100 patients, 40 received two vein grafts, 45 received three vein grafts, and eight received a left internal mammary artery bypass graft. Seven received mammary artery implants, and three had mitral valve replacement in addition to coronary artery surgery. One patient had ventricular aneurysmectomy in addition to a single bypass graft.
The average patient was discharged on or about the 10th postoperative day. The status at this time was generally one of rapid improvement, but with considerable weakness, moderate anemia, occasionally slight fever from hematomas, and lessening. . .