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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can swelling in the legs cause any complications based on the attached reports?

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Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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Posted on Tue, 8 May 2018 in Valvular Heart Disease
Question: Hi Doctor,

My dad recently underwent CABG 4 graft bypass. I wanted to understand the following things.

1. Breif information about the reports and discharge summary attached.
2. Post operation care.
3. Currently he has swelling on the legs from where they took grafts. Does it indicate any complication and how to take care of it.
4. Is there any chance of diabetes post surgery. My dad currently has only bp controlled with medication.

Please do reply inline to queries.

Thanks
doctor
Answered by Dr. Rishu Saxena 1 hour later
Brief Answer:
Stable patient.

Detailed Answer:
Good morning,
Thanks for asking query on this forum.
Have seen your father reports.
All reports are normal.
There were 4 blockages in heart which were bypassed succesfully by using graft from leg vein.
Best thing is that there is no motion abnormality in 2 d echo which means that pumping action of heart is perfect.
Above 60% ejection fraction is normal in humans.
Post op 4 th day patient is ambulated in his hospital room.
After 10 days patient is discharged.
If possible chest physiotherapy should be done initially for first 10-14 days.
Once discharged patient should move inside house 20-30 minutes a day for next 7 days after that for next week patient should start to walk in garden area.Fourth week post op patient should start walking 300 metres a day.
1month post operation patient is allowed to do all activities except lifting too heavy weight or running too fast.
Any thing can be done by patient in which body is comfortable.
1month post op 2d echo and stress test would be done again to see the condition of graft.
Grafts are taken from veins.Work of these veins is to drain back blood to major vessels.Now as the vein has been taken out small amount of fluid starts accumulating in that area causing edema in legs.It would take few weeks for body to develop parallel drainage channels.
Its not a complication its just a normal healing process.Just ambulate the patient thats it.

There is no relation of diabetes to bypass surgery.
If he was a nondiabetic he would be a non diabetic.

Hope i answered your queries well.
Please feel free to ask any other doubt.
Thanks!
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Rishu Saxena 3 hours later
Thanks for the brief reply doctor.

Few more things related to care which we need to take.

1. What activities he shouldnt do apart from weightlifting.
2. What diet plan should he follow - do's and dont's.

doctor
Answered by Dr. Rishu Saxena 4 hours later
Brief Answer:
follow up.

Detailed Answer:
Hi thre-
He can do any activity he is comfortable with after 4 weeks.
Just don’t over do things or try to push limitis.

Diet plans-
Healthy diet whatever every one in house eat he can eat the same.
Use saffola oil or olive oil for cooking.
carbohydrate should be 50%
Protein should be 30%
fats should be 15-20% preferrable polyunsaturated and monounsaturated fats.
Best diet is whatever every one is taking at home just try to cook it in bit less oil.
No smoking!

Thats it.
Regards!
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rishu Saxena 2 days later
Hi Doctor,

Can we massage the swollen leg with ice or hot water to reduce/overcome swelling?

Thanks!
doctor
Answered by Dr. Rishu Saxena 2 minutes later
Brief Answer:
Yes you can.

Detailed Answer:
Hello,
Yes you can give hot fomentation to that area.
Give her massage.
If possible a low dose diuretic like lasilactone can be given to reduce edema.
Regards!
Above answer was peer-reviewed by : Dr. Prasad
doctor
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