Coronary artery bypass grafting (CABG) surgery is frequently the preferred choice of therapy for individuals with multi-vessel coronary heart disease, narrowing of the proximal left main coronary artery, and extensive atherosclerosis in the presence of left ventricular dysfunction or debilitating angina.
Following CABG surgery, individuals are at less risk of sudden death than those who retreated medically. Most drivers who undergo CABG surgery are able to return to work. A longer waiting period is recommended to allow sternal incision healing.The sternum should be completely healed before certifying a driver.
A significant risk associated with CABG surgery is the high long-term reclusion rate of the bypass graft.
Certification/Recertification— Post-CABG Surgery
Minimum — 3 months regardless of type of CABG surgery performed
NOTE: If more than one waiting period applies (because of multiple cardiac conditions brother co morbid diseases); examine the driver for certification after the completion of the longest waiting period.
Maximum certification period — 1 year
Recommend to certify if:
Tolerates cardiovascular medications with no orthostatic symptoms.
Has a left ventricular ejection fraction (LVEF) greater than or equal to 40%.
Is examined and approved by a cardiologist for medical fitness to drive.
Has a healed sternum.
Recommend notto certify if:
Haveorthostatic symptom side effects from cardiovascular medication.
Has an LVEFless than 40%.
Is examined and is not approved by a cardiologist for medical fitness to drive.
Has a sternum that has not healed.
Because of the risk of reclusion over time, 5 years post-CABG surgery, the driver should obtain:
Annual exercise tolerance test.
Imaging stress test, if indicated.
Follow-up- The driver should have an annual medical examination