Often, cardiac bypass surgery is done in an emergency situation, giving no time before the surgery to make modifications or adjustments in the patient's diet. Other times, you're scheduled for bypass surgery, and can make lifestyle and dietary changes before the surgery.
Heart-Healthy Diet
Most cardiologists will suggest a heart healthy diet. This is a low-sodium, low-cholesterol diet with a caloric intake adequate to meet the body's nutritional requirements. If there is advanced notice of the surgery, you may be asked to lose weight. This will make it less stressful on the body during surgery, as well as in the recovery and rehabilitation process. The majority of bypass surgeries consist of making a large incision in the chest wall, as well as smaller incisions in the legs. The physical limitations and discomfort are easier to deal with if there is less excess body mass to maneuver.
Special Diets
Some patients are on special diets and should maintain these diets unless instructed otherwise. Examples of these would be diabetic patients or those with chronic kidney failure. Both of these diseases have special dietary requirements and cannot be grouped into a generalized pre-bypass diet. If you have a specialty doctor managing a certain disease, for example, an endocrinologist for diabetes or a nephrologist for kidney disease, consider having the doctors coordinate a plan of care specific to your needs.
Fluid Considerations
Maintaining a low-sodium diet should be a consideration in almost any pre-bypass diet to assist in excess fluid removal. High sodium levels in the bloodstream contribute to fluid retention and high blood pressure, causing the heart to work harder than necessary. Too much sodium can cause fluid to back up into the cardiopulmonary system. Signs of this might be exhibited in difficulty breathing, as well as swelling in the feet, ankles, legs and hands. If you feel that you are retaining fluid, inform your heart doctor as soon as possible.
Alcohol and Cigarettes
Alcohol should be stopped at least two days before surgery. During the preoperative interview, inform the surgeon and the anesthesiologist if you are a regular drinker. It is imperative you are completely honest in the amount and frequency you drink alcohol, because this may affect the plan of care during and after surgery. The body can react violently if a regular drinker stops drinking suddenly, so considerations should be made in advance to recognize and treat symptoms of alcohol withdrawal.
If you smoke, stop. Tobacco is a toxin and contains many substances, the most potent being nicotine. Nicotine is a vasoconstrictor, meaning it tightens the blood vessels, increasing blood pressure, making it harder for the heart to pump blood throughout the body. Smoking also increases your chance of lung-related complications, making it more difficult to get you breathing on your own after surgery is over, as well as increasing your chances for post-operative pneumonia.
Medications
Aspirin, non-steroidal anti-inflammatory drugs and other drugs can increase the risk of bleeding during and after surgery. Most often, these drugs are stopped at least a week before surgery. This can also include herbal remedies, so include these in the list of current medications to your doctor. Consult your cardiothoracic surgeon for specific instructions on these and other medications. Do not stop taking medications that help control blood pressure, diabetes or any other disease process without an order from your doctor.
The Night Before Surgery
Do not have anything to eat or drink after midnight the night before your surgery. In certain situations, your doctor may suggest you take your morning medication with a sip of water on the day of surgery, but ask about this in advance. In some cases, even a small amount of water, a piece of chewing gum or a mint may delay or cancel surgery due to the risk of complications for the anesthesiologist. The general rule is: Nothing by mouth a minimum of eight hours before surgery.
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