Doctor insights on:
Sterum Separation Post Cabgs
If a patient come Hosp with sternum infection after his CABG 2 weeks before How we exclude for nosocomial infection?
Complicated : Since it happened within the 30 days after an operation it's by definition a nosocomial infection. Infectious disease doctor initially treat this with the antibiotics with presumption of antibiotic resistant nosocomial bacteria. If specific bacteria is isolated in a culture, the antibiotic sensitivity test can allow a more targeted approach with narrow spectrum antibiotic. ...Read more
If you had CABG and sternum infection 2 weeks later what would healing time be? It's been 11 months for me and still sore.
Depends: Telmisartin or Micardis (telmisartan) is a blood pressure (BP) medicine. It is classified as an arb (angiotension receptor blocker), and is a very effective treatment for high blood pressure. BP control is an important step in managing heart disease including blocakages. Most patients after CABG need to be on long term blood pressure meds. An arb is often a good choice. It's up to you and your doctor. ...Read more
No: No age limit. It depends on your other health issues and your activity level. I've seen 90 year old women get bypasses. ...Read more
Take care of wound: Hopefully the surgeon gave you some instructions on how to care for the wound. Since this is a break in the skin that goes through the bone, you have to be careful for it to remain clean until it heals. You should have a follow up arranged with the doctor to assess for wound healing. I assume you have access to fresh clean bandage? Do you have a visiting nurse? They can show you proper wound care. ...Read more
Probably not: This is a complex question. Graft occlusion occurs at about 10% the first year then 2-4% per year after that. Vein grafts occlude much more frequently than arterial grafts. Most factors that affect graft patency are related to the vein (i.e. Varicose) and grafted target vessel. However, patient factors such as very high cholesterol and ongoing smoking have been associated with early graft failure. ...Read more
A bit: A bit higher than I'd like to see under most circumstances post CABG but not worrisome. ...Read more
Diuretics: While the bypass surgery helps improve blood flow to the heart muscle, there could have been damage to that muscle before the surgery that has not or cannot recover. Medications(such as diuretics) can help to get rid of excess fluid. This should be directed by your cardiologist. ...Read more
I had a quadruple CABG 2 years ago and recently had a positive nuclear stress test? What are my options?
Cardiac cath. : Since the nuclear test is positive, this has to be confirmed with coronary arteriography for full evaluation and rx. Especially, in your case with previous cabg, you want to make sure that the grafts are still open. If not, angioplasty/stent or redo-cabg may be options to be considered after angiogram. Medical rx for all you know, maybe be the better recourse, depending upon angiographic findings. ...Read more
I've AF & CAD 70% at LM. my EF is 68%, which one better, do the CABG alone or do the CABG with the maze procedure??
It depends.: It depends upon the echocardiographic data and the experience of the cardiac surgery team. One would want the surgery to be done by a team with experience doing a very large number of each procedure planned. The echo data can determine how large the atria are as well as the function of the heart; this will give a hint as to the likelihood for permanency of maze achievement of a normal rhythm. ...Read more
If pt had CABG surgery, what should we look for afterward for any signs that there may be a complication, need to see doc, etc? Thank you.
Simple Enough: For the most part, your big worries are just complications of wound healing. Generally speaking, things should get slowly better every day. New redness or pus at the sternotomy, opening of previously closed surgical wounds, or fevers and shaking chills are a problem and your md should be notified. Grafts sometimes don't take and new onset, severe chest pain (not mild) may need eval. ...Read more
How often should a pt see cardiologist following a 4x cabg? Dad has only been to cardiologist 1 or 2x in over 17 months post cabg. Thank you.
Cad: Depending on condition. I will follow post CABG patients between 4-6m. ...Read more
I read "grafts last 8 15 yrs, then need to be replaced" for CABG pts. Does this mean pts need another surgery in 8-15 yrs? How long do grafts last?
Father had cabg 4 yrs bfr his age now 60 yrs. Al test normal lvef 67% tmt result TMT borderline positive for induced ischemia, serious or wat to do?
Cardiology eval: Need to go to a cardiologist and possibly get a cardiac cath done under fluoro to see patency of coronary arteries, flow and blood distribution, etc. to get all the answers you seek... ...Read more
Excellent: Once patient leaves the hospital after bypass surgery, the recovery is almost always unevenful! Pts need to start cardiac rehab asap for quicker recovery. Most of my pts are back to work in 6-8 wks. ...Read more
Same as CAD: CABG failure either means the grafts clotted off or else the grafts were not placed in the best area to bypass all the blockages, especially in patients with diffuse blockages where there may not have been a good place no matter what ... Symptoms are return of the angina, decreased exercise tolerance, fatigue, shortness of breath, lightheadedness, nausea, sweating, etc. ...Read more
Ask around: Ask patients in the area who was good and ask your doctor where he would have his operation. ...Read more