Heart Valve Replacement
- Mechanical, made of metal and plastic, such as a St. Jude valve
- Made of tissue—most commonly from a pig or a cow, but they may also be supplied by a human donor or even made from your own tissue
|Aortic Valve Replacements: Mechanical vs. Tissue|
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Reasons for Procedure
- Congenital defects
- Narrowed, stiff valves that obstruct the free flow of blood
- Loose, leaky valves that allow blood to flow the wrong way through the heart
- Infected heart valves
- Blood clots forming around the valve, which can cause a stroke, , myocardial infarction, kidney damage, or damage to the extremities
- New valve does not work properly
- Anesthesia-related problems
- Pre-existing heart or lung condition
- Increased age
- Recent or long-term illness
- Recent infection
What to Expect
Prior to Procedure
- Physical exam
- Echocardiogram —a test that uses sound waves to visualize functioning of the heart, including the valves
- X-ray —a test that uses radiation to take a picture of structures inside the body
- Electrocardiogram (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
- Cardiac catheterization —the insertion of a tube-like instrument into the heart through an artery to detect problems with the heart and its blood supply. It can also accurately define the valve problem.
If you had to stop medicines before the procedure, ask your doctor when you can start again. Medicines often stopped include:
- Anti-inflammatory drugs
- Blood thinners
- Arrange for a ride to and from the hospital.
- Arrange for help at home after the surgery.
- Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
Description of the Procedure
Immediately After Procedure
- A heart monitor
- A breathing tube—until you can breathe on your own
- Chest tubes—to drain accumulated fluids from the chest
- A line into an artery in your arm or leg—to measure pressure
- A tube through your nose and into the stomach—to keep the stomach drained of accumulated fluids and gas
- An IV to deliver fluids and medications
- A bladder catheter
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Breathe deeply and cough 10-20 times every hour to help keep your lungs working well.
- Walk with assistance. You may be encouraged to walk 2-3 days after surgery.
- Take blood thinners to prevent blood clots from forming around the valve. If you have a tissue valve, you will not need a blood thinner. If you have a mechanical valve, you will have to take the medicine for the rest of your life.
- Gradually resume your regular diet.
- Work with a physical therapist.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Be sure to follow your doctor’s instructions .
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
- Pain that you cannot control with the medicines you have been given
- Cough, shortness of breath, or chest pain
- Coughing up blood
- Rapid heart rate
- Sudden headache or feeling faint
- Problems with vision or speaking
- Numbness or weakness on one side of your body
- Inability to urinate
- Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine
- Pain and/or swelling in your feet, calves, or legs
American Heart Association http://www.heart.org
National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov
Health Canada http://www.hc-sc.gc.ca
Heart and Stroke Foundation of Canada http://www.heartandstroke.ca
Cardiac catheterization. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/heart/services/tests/invasive/ccath.aspx . Updated February 2011. Accessed May 8, 2013.
Cecil RL, Goldman L, Bennett J. Cecil Textbook of Medicine . 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
6/2/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.