Coronary bypass and nutritional care post surgery Coronary heart disease Coronary heart disease is characterized by a narrowing of the arteries that supply blood to the heart. Fatty deposits (rich in cholesterol) stick to the artery walls, causing thickened patches called plaques to develop (atherosclerosis). These plaques narrow the arteries and reduce the flow of blood to the heart muscle. Clots (thrombosis) may then occur, blocking the artery and causing a heart attack (coronary occlusion). The risk factors are mainly lifestyle related, and include:
• A diet high in saturated fats • Cigarette smoking • Obesity • Lack of physical activity • Uncontrolled diabetes • High blood pressure • Family history of heart disease.
Heart bypass operation Your chest, arms and legs are shaved and your skin washed with antiseptic solution. It is important not to eat or drink before the operation. You are given a pre-medication injection to make you feel drowsy and to dry up internal secretions. Heart bypass surgery is performed under general anaesthesia. The saphenous vein (from your leg) the internal mammary artery (from your chest wall) or the radial artery (from your wrist) can be used as grafts. Commonly, between two and four coronary arteries are grafted, depending on the location and severity of the blockages. The surgeon accesses your heart using one of two possible incisions: either cutting down the length of your breastbone (median sternotomy) or cutting beneath the left nipple (thoracotomy). A heart-lung machine maintains your blood circulation while your heart is deliberately stopped. The vein or artery is then grafted onto the narrowed segment of coronary artery, which allows the blood flow to bypass the blockage. Sometimes, the operation is performed while the heart is still beating (this is called 'beating heart' or 'off-pump' surgery). Complications of heart bypass surgery Some of the possible complications of heart bypass surgery include:
• Hemorrhage • Infection of the wound • Heartbeat irregularities (arrhythmia) • Kidney failure
• Fluid build-up in the lungs (pleural effusion) • Blood clots
Coronary Artery Bypass Graft: Nutrition After Surgery Diet after coronary artery bypass graft (CABG) surgery You will have a special diet after surgery. Cardiac liquid diet: You will most likely receive a cardiac liquid diet immediately following surgery. This is a diet that includes only low-fat liquids with no added salt and no caffeine. (different kinds of soups, low fat buttermilk, smooth liquid porridges) Diminished appetite: It is likely that you will have a diminished appetite following your surgery. Your doctor or registered dietitian many prescribe either oral supplements or tube feeding to ensure that you get enough nutrients to heal properly. Cardiac prudent diet: Once your diet has progressed to solid food, you will follow a cardiac prudent diet. This meal plan is very similar to the recommendation of what you should eat when you are at home. Nausea: You may feel nauseous for several days following surgery. If this is the case, ask if you can receive several small meals, instead of the standard three meals. Constipation: You may become constipated following the procedure. Make sure you drink good amount of fluid and increase your fiber intake slowly. Heart-healthy diet: For the first 2 weeks following surgery, do not worry too much about your diet (unless you are diabetic). After these 2 weeks, it is highly recommended that you follow a heart-healthy diet. Heart-healthy diet
The CABG procedure does not stop coronary artery disease progression. Following your
procedure, you sill will need to follow a heart-healthy diet to prevent further progression of your
coronary artery disease. This diet should include:
Reduced intake of saturated fatty acids (found in animal products and foods containing animal Avoid the following foods:
Fried foods ,Ice cream, Regular cheeses ,2% or whole milk ,Cream ,Regular sour cream
,Coconut oil ,Palm kernel oil, Palm oil ,Butter ,Hard margarines (stick) ,High-fat snack foods
,High-fat baked goods, Cream soups ,High-fat dips such as regular mayonnaise.
Trans fats are at least equally as detrimental to your heart health as saturated fatty acids.
You can avoid most trans fats by avoiding foods that list “partially hydrogenated fatty acids” as
an ingredient(generally seen in vanaspati ghee and other low quality loose deep fried and bakery
Increased intake of omega-3 fatty acids
Flaxseed, Canola oil, Olive oil, Peanut oil, Soy nuts, Walnuts, Butternuts (similar to
Many fresh fruits and vegetables
If you have diabetes, talk to a dietitian about how many servings of these foods you should
Plenty of whole grains
Look for the following words on food labels:
Whole (name of grain), such as whole wheat or whole oats, Wheat berries, Brown rice, such as
brown rice flour, Stone-ground whole (name of grain), such as stone-ground whole wheat, Oats
A few servings of low-fat or nonfat dairy products each day Limited sodiumand sugar
The less processed a food is, the less sodium that it will contain
Limited alcohol intake: preferably red wine not more than 30ml. Edema You must weigh yourself frequently once you are at home. Rapid weight gain is a sign that you are developing edema (collecting and retaining fluid). If you gain more than 2 pounds in 3 days, it is important that you contact your doctor.
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