Aortic Valve Replacement

What is an Aortic Valve Replacement

Aortic valve replacement is surgical replacement of an aortic valve that cannot be repaired. This procedure may be done to replace:

• A narrow aortic valve (aortic valve stenosis).
• A deformed aortic valve (bicuspid aortic valve).
• An aortic valve that does not close all the way (aortic insufficiency).

The aortic valve is replaced with artificial (prosthetic) valve. Three types of prosthetic valves are available:

• Mechanical valves made entirely from man-made materials.
• Donor valves from human donors. These are only used in special situations.
• Biological valves made from animal tissues.

The type of prosthetic valve used will be determined based on various factors, including your age, your lifestyle, and other medical conditions you have. This procedure is done using an open surgical technique, meaning that a large incision will be made in your chest over your heart.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Blood clotting caused by the prosthetic valve.
• Failure of the prosthetic valve.

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
• Follow instructions from your health care provider about eating or drinking restrictions.
• You may be given antibiotic medicine to help prevent infection.
• You may have tests, such as:
  • Echocardiogram.
  • Electrocardiogram (ECG).
  • Blood tests.
  • Urine tests.
• Plan to have someone take you home when you leave the hospital.
• Plan to have someone with you for at least 24 hours after you leave the hospital.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
• You will be placed on a heart-lung bypass machine. This machine provides oxygen to your blood while your heart is undergoing surgery.
• An incision will be made in your chest, over your heart.
• Your damaged aortic valve will be removed.
• A prosthetic valve will be sewn into your heart.
• Your incision will be closed with stitches (sutures), skin glue, or adhesive tape.
• A bandage (dressing) will be placed over your incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• Do notdrive until your health care provider approves.

Aortic Valve Replacement, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain around your incision area.
• A small amount of blood or clear fluid coming from your incision.

Follow these instructions at home:

Eating and drinking

• Follow instructions from your health care provider about eating or drinking restrictions.
  • Limit alcohol intake to no more than 1 drink per day for nonpregnant women and 2 drinks per day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
  • Limit how much caffeine you drink. Caffeine can affect your heart’s rate and rhythm.
• Drink enough fluid to keep your urine clear or pale yellow.

Eat a heart-healthy diet. This should include plenty of fresh fruits and vegetables. If you eat meat, it should be lean cuts. Avoid foods that are:

• High in salt, saturated fat, or sugar.
• Canned or highly processed.
• Fried.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Exercise regularly once you have recovered, as told by your health care provider.
• Avoid sitting for more than 2 hours at a time without moving. Get up and move around at least once every 1–2 hours. This helps to prevent blood clots in the legs.
• Do notlift anything that is heavier than 10 lb (4.5 kg) until your health care provider approves.
• Avoid pushing or pulling things with your arms until your health care provider approves. This includes pulling on handrails to help you climb stairs.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.

Check your incision area every day for signs of infection. Check for:

• More redness, swelling, or pain.
• More fluid or blood.
• Warmth.
• Pus or a bad smell.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider.Do notstop taking the antibiotic even if you start to feel better.

Travel

• Avoid airplane travel for as long as told by your health care provider.
• When you travel, bring a list of your medicines and a record of your medical history with you. Carry your medicines with you.

Driving

• Ask your health care provider when it is safe for you to drive. Do not drive until your health care provider approves.
• Do notdrive or operate heavy machinery while taking prescription pain medicine.

Lifestyle

• Do notuse any tobacco products, such as cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• Resume sexual activity as told by your health care provider. Do notuse medicines for erectile dysfunction unless your health care provider approves, if this applies.
• Work with your health care provider to keep your blood pressure and cholesterol under control, and to manage any other heart conditions that you have.
• Maintain a healthy weight.

General instructions

• Do nottake baths, swim, or use a hot tub until your health care provider approves.
• Do notstrain to have a bowel movement.
• Avoid crossing your legs while sitting down.
• Check your temperature every day for a fever. A fever may be a sign of infection.
• If you are a woman and you plan to become pregnant, talk with your health care provider before you become pregnant.
• Wear compression stockings if your health care provider instructs you to do this. These stockings help to prevent blood clots and reduce swelling in your legs.
• Tell all health care providers who care for you that you have an artificial (prosthetic) aortic valve. If you have or have had heart disease or endocarditis, tell all health care providers about these conditions as well.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You develop a skin rash.
• You experience sudden, unexplained changes in your weight.
• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a fever.

Get help right away if:

• You develop chest pain that is different from the pain coming from your incision.
• You develop shortness of breath or difficulty breathing.
• You start to feel light-headed.