CORONARY ARTERY BYPASS GRAFTING (CABG). A patent blood vessel from another part of the body is grafted to the affected coronary artery distal the lesion. The new vessel bypasses the obstruction. Unfortunately, unless reduction of risks and modification of the lifestyle accompany this procedure, the grafted vessels will also eventually occlude. Vessels commonly used for grafting are the greater or lesser saphenous veins, basilic veins, and right and left internal mammary arteries. Managing the patient after heart surgery involve complex collaborative strategies among the nurse, surgeon, and respiratory therapist. Usually, a patient le the operating room with temic arterial and pulmonary artery catheter in place. Fluids and medications administered are according to the patient's hemodynamic response to the surgery. Monitoring for complications an essential role. Early complications from heart surgery include hypotension or hyper tension (lowered or raised blood pressure), hemorrhage, dysrhythmias, decreased cardiac put, fluid and electrolyte imbalance, pericardial bleeding, fever or hypothermia gas poor exchange, gastric distension, and changes in level of consciousness If the patient has a large amount of drainage from mediastinal tubes, the nurse ma initiate autotransfusion. In the immediate postoperative period, patients will need airway management with an endotracheal tube and breathing support with mechanical ventilation. will also require temporary cardiac pacing through Some patients the epicardial pacing wires that are inserted during lost surgery. Patients will often need fluid therapy with blood, colloids, or crystalloids to replace fluids or bleeding.