A better bypass: using ultrasounds of thigh muscles to predict complications for patients after cardiac surgery

Patients who are admitted to Calvary Adelaide Hospital to undergo Coronary Artery Bypass Graft or Mitral Valve replacement or Atrial Valve replacement performed via sternotomy are invited to participate in the study. Once a patient consents to the study, they will have a pre-surgery assessment of their routine Physiotherapy pre-operative assessment and in addition an assessment of the quadriceps muscle using the Real Time Ultrasound Machine. The Pre-operative physiotherapy assessment involves a subjective examination asking about any cardiorespiratory symptoms, their exercise tolerance, falls history, social history and current goals for discharge. In addition patients undergo an objective assessment, assessing their lungs via auscultation and palpation, along with a mobility assessment and ability to transfer between positions in bed. Patients are also taught sternal precautions post operatively and how to mobilise in and out of bed following precautions. The real time ultrasound measure of the quadriceps muscle will occur daily until discharge. In addition medical records will be access to record details regarding demographics including sex, age, location, co-morbidities and current medications. In addition they will be asked questions on a likert scale to determine acceptability and feasibility of the study. All assessments will be done by Physiotherapists in the hospital who have been trained by a registered sonographer only once they have met an acceptable level of inter and intra rater reliability in the measurement of quadriceps muscles.