Preoperative and postoperative management of patients undergoing coronary artery bypass grafts

In the preoperative care of patients for coronary artery bypass grafting, emphasis is given to the need for good coronary arteriograms and left ventricular cineangiograms, and the proper timing of operation after these investigations. The special measures needed for dealing with unstable and variant angina are discussed, and it is recommended that betaadrenergic blocking drugs should not be discontinued before operation . Good postoperative care is easiest when the operation habeen correctly performed. The management of postoperative hypertension, arrhythmias, low output syndrome, and myocardial infarction is discussed. Following discharge from the hospital, it is important to minimize known risk indicators for coronary artery disease and to encourage the patient to achieve as complete functional rehabilitation as possible. Excellent relief of angina is obtained in about 80% of patients initially, but in those who have recurrence of chest pain postoperatively, the possibility of a second coronary artery bypass grafting operation may be considered. The need for long‐term follow‐up and aftercare of coronary artery surgical patients is stressed, so that the true benefit to the patient in terms of improved quality and quantity of life may be established .