Heart Surgeries and Surgical Care

Surgery for coronary heart disease (CHD) such as Coronary Artery Bypass Grafting (CABG), is a fairly common procedure. Preparation for surgery should take into account individual circumstances. Although experiences may be similar, it is important to acknowledge that some patients will have been living with angina for a number of years and others may have recently suffered an Acute Myocardial Infarction (AMI) or severe unstable angina.

The heart is an emotive organ and the prospect of major surgery will increase anxiety for the patient, family and friends. It is vital that the patient and family understand the purpose of surgery, the risks and benefits of the operation and the impact surgery may have in the immediate recovery period and in the long term.

A full clinical assessment will be conducted before surgery. This will secure the diagnosis and give some indication of individual prognosis. Pre-operative preparation will include a range of investigations depending on the signs and symptoms reported by the patient.

Pre-operative information and support can be given to patients and their families before coming into hospital and on the day of admission. It is important that patients and their families understand the timing, format and content of pre-operative patient education. Examples of pre-surgery care includes:

• How to wash with an antibiotic soap the day before surgery
• Providing a list of all your medications, including vitamins, herbal medicines and over-the-counter medications
• Inform your doctor or nurse about any allergies and bad reactions to anaesthesia

Given the above, other measurement of a hospital’s quality includes:

• The ability of the hospital to offer a wide a range of specialty within heart surgeries.
• The percentage of the patients who undergo heart surgery who received the recommended care
• Clinical outcomes of the patient population who underwent heart surgery

Wound infections after coronary artery bypass operations need to be diligently monitored. Therefore another good indicator of a quality hospital is the rate of wound surveillance for isolated CABG cases.

Institut Jantung Negara (IJN) rates compare favourably with that of other international healthcare institutions’ reports. In fact with each year, IJN has improved on its rating.