Aortic stenosis surgery recovery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Mohammed A. Sbeih, M.D. [2]; Usama Talib, BSc, MD [3]

Overview

The recovery of patient is divided into recovery at the hospital and recovery at home. Patient may spend 4 to 7 days in the hospital after surgery. Patient stays in ICU for one or two days. Recovery at home includes taking care for his or her healing incisions, recognizing signs of infection or other complications, coping with after-effects of surgery, followup appointments, medicines, and situations when he or she should call the doctor right away. Ongoing care after valve surgery may include periodic checkups with the doctor. During these visits, the patient may have blood tests, an EKG (electrocardiogram), echocardiography, or a stress test.[1]

Recovery

Recovery at Hospital

The patient may spend 4 to 7 days in the hospital after surgery (much less in Minimally invasive mitral valve surgery 3 to 5 days). Then patient will wake up in the intensive care unit (ICU) and recover there for 1 or 2 days. Two to three tubes will be in the patient's chest to drain fluid from around the heart. They are usually removed 1 to 3 days after surgery. Anticoagulation with aspirin is started to minimise risk of post operative clot formation, cerebral ischemic events, and it also improves survival.[1] The patient may have a catheter in the bladder to drain urine, and may also have intravenous lines to get fluids. Nurses will closely watch monitors that show information about the vital signs (pulse, temperature, and breathing).

The patient will be moved to a regular hospital room from the ICU. The nurses and doctors will continue to monitor the heart and vital signs until the patient is stable enough to go home. The patient will receive pain medicine to control pain around the surgical incision site.A nurse should help the patient to slowly resume some activity, and the patient should begin a physical therapy program to make the heart and body stronger. A temporary pacemaker may be placed in the patient's heart if the heart rate becomes too slow after surgery. The post operative recovery depends on the pre operative LVEF, showing an inverse relation.[2]

Recovery at Home

The patient should be informed about the following:

  • Taking care for his or her healing incisions.
  • Recognizing signs of infection or other complications.
  • Coping with after-effects of surgery.
  • Followup appointments, medicines, and situations when he or she should call the doctor right away.
  • When he or she can go back to daily routine, such as working, driving, and physical activity.

After-effects of heart surgery are normal. They may include muscle pain, chest pain, or swelling. Other after-effects may include loss of appetite, problems sleeping, constipation, and mood swings and depression. After-effects usually go away over time.

Less recovery time is needed for off-pump heart surgery and minimally invasive heart surgery.

Ongoing Care

Ongoing care after valve surgery may include periodic checkups with the doctor. During these visits, the patient may have blood tests, an EKG (electrocardiogram), echocardiography, or a stress test. These tests will show how the patient's heart is working after the surgery.

Routine tests should be done to make sure the patient is getting the right amount of the blood-thinning medicine in case of mechanical valve placement.

The patient may be advised to change his or her lifestyle, this includes: quitting smoking, making changes to diet, being physically active, and reducing and managing stress.

References

  1. 1.0 1.1 Owais T, Rouman M, Breuer M, Hüter L, Fuchs J, Lauer B; et al. (2016). "Anticoagulation After Biological Aortic Valve Replacement: Is There An Optimal Regimen?". J Heart Valve Dis. 25 (2): 139–144. PMID 27989055.
  2. Dauerman HL, Reardon MJ, Popma JJ, Little SH, Cavalcante JL, Adams DH; et al. (2016). "Early Recovery of Left Ventricular Systolic Function After CoreValve Transcatheter Aortic Valve Replacement". Circ Cardiovasc Interv. 9 (6). doi:10.1161/CIRCINTERVENTIONS.115.003425. PMID 27296201.

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