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All about Cardiac Valve Surgery

WHAT TYPE OF VALVE?
The heart has four valves. The two valves on the left side of the heart are the most
likely to get diseased. One or both may need to be repaired or replaced. They are
called the Aortic and the Mitral valve.

If the valve in your heart is leaking or becomes stiff, it may not open or close properly
and you may be advised to have valve surgery. There are two types of valve surgery:
valve replacement and valve repair.

Valve replacement is when the diseased valve is replaced with a new valve. The
most common types of replacement valves are manufactured valves (mechanical
valves) or tissue valves (animal valves)

Your surgeon will discuss the best type

with you. Each has certain advantages.
Mechanical valves will last a long time
but you will need blood-thinning tablets
(warfarin), usually for life. Tissue valves
may last for a slightly shorter time but
warfarin is only needed for the first few
weeks.

Valve repair is usually performed for mitral valves which leak but are not seriously
damaged.

WHAT WILL I FEEL

In most heart operations the surgeon has to open the chest as well as the sac in which
the heart lies, because of this it is common enough after the operation to complain of
chest pain or a "stabbing" sensation, worse on movement or deep breathing. Some
patients notice a “grating” sensation on movement or numbness along the scar. Most
of this soreness goes away after a few weeks. A small number of patients will
complain of this soreness for a longer time. Ask the nurse at the rehab course if you
are worried about any of these things

The risk of the operation is usually small about 1-2%. Overall risk is assessed on an
individual basis and depends on your general health. Your consultant will discuss
your individual risk with you.

AFTER THE OPERATION

Most patients are sitting out of bed a day or two after the operation and return home in
about 1 week. Gradually begin the exercise program that was started in hospital.
Walking slowly and increasing physical activity as you feel able to. Get plenty of rest
at night. You may even feel a little "down" or gloomy for a few days. Some people
have difficulty in concentrating for example, reading the newspaper. Other people
have difficulty remembering names of things or people and it causes them a lot of
worry and anxiety. These problems are usually temporary but discuss it with your
doctor or rehab nurse if you have concerns.
Depending on your level of fitness before the operation, most people are back to
normal in about 8 to 12 weeks. Follow the exercise guidelines given to you in hospital
to help you get out and about again. It is important to contact your GP on discharge
from hospital and follow their advice.

WHAT ABOUT SEX?

People are often worried about this. We suggest that you wait a week
or two. Then, as with other forms of exercise, start gently at first
whenever you feel right. If you can climb up 2 flights of stairs
comfortably without getting chest pain or breathless then you are
physically ready.

TO PREVENT INFECTION
Taking care of your teeth is very important for your heart
valves. Germs from your gums like nothing more than a
damaged valve or a new artificial valve. If your gums bleed
when you brush them, they are not healthy. Germs can enter
the blood stream and travel to the heart. Once there, they can
"seed" themselves on the valve. Some people have bad teeth
and may need to have them removed before having heart surgery.

You must tell your dentist if you have a damaged valve or a new valve in place. This
is very important if you are having cleaning, filling or extraction. An antibiotic can be
given to protect your valve before any dental procedures. If you have any allergies,
tell your dentist before taking an antibiotic.
An antibiotic is usually necessary before any invasive procedure for example a
gastroscopy. Please inform your doctor (GP) or any doctor if admitted to a hospital
that you have a damaged or replaced valve.
You can purchase an identity bracelet in your local pharmacy to identify that you have
had a valve replacement and /or are taking Warfarin.

CARDIAC REHABILITATION
A cardiac rehabilitation programme of exercise and education will help with your
recovery and restore your confidence. Education through Cardiac Rehab is also
available for your partner, spouse or significant other. Contact the Cardiac rehab co-
ordinator two weeks after you leave the hospital.