Care after heart valve surgery

The article is professionally consulted by Dr. Tran Van Hung - Cardiologist - Cardiovascular Center - Vinmec Central Park International General Hospital

Heart valve surgery aims to repair or replace a heart valve that has been significantly damaged, affecting the heart's pumping or blood-sucking function. Valve repair or valve replacement is necessary to prevent heart failure or reduce heart failure and other serious complications later.
Just because the valve has been repaired or replaced does not mean that the heart disease is completely cured. Surgery only helps the patient move from a severe or potentially unstable medical condition to a more stable one. Therefore, patients after heart valve surgery need to continue to be monitored and regularly take medication, periodically re-examined as directed by the doctor.

2.1. Immediately after surgery Immediately after surgery, the patient will be transferred to the recovery room to be closely monitored for postoperative developments. Usually, patients after surgery will start to wake up gradually after about 2 hours from the end of surgery, but there are also cases where they wake up later.
After a few hours of surgery, when the patient is in the recovery room, the family can be visited for a short time, but usually must be limited to avoid the risk of infection.
After surgery, the patient will find on his body many drains, wires and monitoring and support devices. These devices help monitor to ensure a safe and effective postoperative process. These devices will be removed when you are stable and can be moved to the postoperative care room. This process usually lasts about 24 hours after surgery. On average, the hospital stay after surgery is about 7 to 10 days. If you have laparoscopic surgery, the recovery time will be faster, it may only take 3-5 days.
Care of patients after heart valve replacement surgery should pay attention:
● Most patients often feel pain at the incision site with varying degrees but usually not much. Comfortable lying position, gentle hand movement will help the patient feel less pain. If the pain is too much, the nurse will give you pain medicine. Usually this feeling rarely lasts more than 3 days.
● Immediately after surgery, the incision will be covered with a moderate, breathable bandage. This makes it easier for the incision to dry and heal. After a few days, bathing with soap is also very good. Sutures can be cut 1 week after surgery
● Deep breathing and coughing exercises will help the patient recover faster. Cough reduces stagnation in the lungs, so it reduces the risk of pneumonia and fever, does not affect the incision as well as the sutures in the heart. Most patients are afraid of pain, so they do not dare to cough after surgery. Coughing is easier if you put a pillow under your back. Changing your lying position regularly, constantly turning over also helps the recovery process better.
● During sleep, the patient should be placed on one side and turned frequently during sleep, changing positions every few hours if possible. Lying on your back for a long time is not good for your lungs.
● Once the endotracheal tube is removed, the patient will be able to eat liquid foods such as soup or porridge. Depending on the digestive system, the transition from liquid food to normal eating is sooner or later.
● Usually 2 days after surgery, the patient can sit up or walk around the room. The patient may then be given short walks in the hallway, even up the stairs, for longer walks to prepare to go home.
● Body hygiene: Patients can be cleaned immediately after surgery. A few days later you can take a shower or shower and wash your hair.

2.2. Caring for a Patient After Recovering From Heart Valve Surgery Once you've recovered from a valvular surgery, are discharged from the hospital, and resume your daily activities, there are a few important things to keep in mind:
Rehabilitation Regular regular check-ups: Within the first 3 months after surgery, patients need to have regular check-ups so that doctors can check the appropriate medication regimen and dose and make necessary adjustments accordingly. After that, when the condition is stable, the patient only needs to have regular check-ups at least twice a year.
Monitor your weight: Unusual weight changes can be a bad sign. Patients after heart valve surgery, if possible, should weigh themselves daily to monitor their health status.
For about 3 weeks after surgery, the patient may lose some weight. If you gain weight more than 2.5 kg/week, you may have edema.
Post-surgery diet: A nutrient-rich diet is important for your post-surgery recovery.
2.3 Diet after heart valve surgery What to eat after heart valve replacement?
Patients after heart valve surgery do not need too special abstinence.
However, you should limit your intake of salt and foods containing a lot of salt (melon, salted eggplant, dried fish, canned foods, fast food,...). For patients with heart valve replacement, some dark green vegetables can also affect the effect of anticoagulants that the patient is taking.

What should I eat after heart valve surgery?
Ideally, try to build a menu with a balanced ratio of meats, fish, green vegetables, vegetables for each meal. Patients can consult more nutritionists to have a more suitable diet for their current health status.
2.4 Physical activity after heart valve replacement Appropriate physical activity mode will help patients recover as well as improve health.
Since you are still in the hospital, you should regularly exercise gently such as walking in the room or in the hallway, taking care to make sure that you do not force your heart to work too hard.
By gradually increasing physical activity each day, only a few weeks after surgery, most people can walk 3-4 km a day.
With normal surgery, it takes about 4-6 weeks for the patient to return to normal. Then your sternum is completely healed. Some people are able to return to desk jobs about 4 weeks after surgery. For workers with higher intensity, they need to rest for at least 6 weeks before they start working again. If it is laparoscopic surgery, the patient can recover faster.
In some cases, patients are no longer suitable for their old jobs because they are too heavy and stressed, they need support from people around them to find a job that is more suitable for their health status.
2.6 Sexual activity The patient may initiate sexual activities when ready. However, it is necessary to avoid strong impacts on the chest while the sternum is healing, as well as avoid excessive exertion.
2.7 Medicine It is necessary to follow the doctor's prescription. Absolutely do not take more medicine, increase or decrease the dose without the consent of the doctor.
After heart valve replacement surgery, patients need to take anticoagulants regularly to prevent thrombosis due to artificial heart valves. Anticoagulants should be monitored regularly with a prothrombin time test (often abbreviated PT and standard INR).

For 6 to 8 weeks after surgery, do not lift or pull anything heavier than 50 kg. That will help the patient avoid putting pressure on the healing incision and ensure enough time for the sternum to heal.
Only light housework should be done. People who have heart surgery in the first few weeks after surgery often get tired easily, so it is not recommended to do anything that causes prolonged fatigue. After 3 to 6 weeks, your health will improve and you will be able to move more easily and quickly.

After surgery, most patients have a marked improvement. However, if the patient needs to be taken to the emergency room immediately if there are some unusual symptoms such as:
Chest discomfort: Most angina attacks are manifested by discomfort in the chest area. mid-chest, severe, squeezing, squeezing, or pain that lasts for several minutes, is repetitive, and increases with continued movement.
Shortness of breath
Cold sweat, nausea, dizziness, loss of balance.
● Sudden onset of numbness and weakness in the face, arms or legs, especially in one half of the body
● Sudden loss of consciousness or confusion, apathy, inability to understand or answer questions correctly.
● Sudden appearance of vision problems in one or both eyes.
Severe, sudden headache for no apparent reason.
Fever, severe shortness of breath unrelated to exertion.
● Unusually fast weight gain, ankle swelling.
● Tired, irregular heartbeat.

Cardiovascular Center - Vinmec Times City International General Hospital is one of the leading centers of Vinmec Times City International General Hospital, the heart center's experts include Professors, Doctor, Doctor of Specialist 2, Master of experience, has great reputation in the field of medical treatment, surgery, interventional cardiac catheterization and application of advanced techniques in the diagnosis and treatment of diseases. cardiovascular theory.
In particular, the Center has modern equipment, on par with the most prestigious hospitals in the world, including the Hybrid operating room equipped with advanced equipment such as DSA angiography machine, induction machine. Anesthesiology integrates the most closely integrated patient hemodynamic monitoring software (PiCCO system, entropy,...).
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