What To Expect Afterward
After open-heart surgery, a person will wake up in the ICU and remain there for observation for up to 2 days. They will then go to the regular surgical unit for up to 5 days.
Recovery generally takes several months. The speed of a persons recovery may depend on several factors, including their general health and age.
While it is usually safe to resume typical activities not long after surgery, a doctor will likely advise a person to avoid high intensity activities and take several weeks off from work.
It is typical to experience weakness and fatigue after this invasive surgical procedure. Most people will find that they regain their strength as they resume daily physical activities.
Most valve replacement procedures are successful. However, people may need to have valves replaced again in the future.
According to a 2021 Swedish study involving 33,018 people who underwent aortic valve replacement surgery, people who had this type of surgical procedure had a lower life expectancy than the general population. However, not all those who died within the follow-up period died as a result of heart problems.
In 2019, published in the Journal of Cardiothoracic Surgery, involving 324 people who underwent mitral valve replacement, found that:
- 1.9% of people died during the procedure
- 9% of people died after 30 days
- people who received a biological valve had a survival rate of 62.4% at 10 years
- people who received a mechanical valve had a survival rate of 77.1% at 10 years
What Are The Four Types Of Heart Valves
The heart is made up of four pumping chambers:
- Two atria: Upper chambers of the heart
- Two ventricles: Lower chambers of the heart
There are valves between each of the hearts pumping chambers that open and close in coordination with each other. Their action keeps blood flowing forward through the heart. There are four valves in the heart:
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Outcomes After Avr In Patients Aged 80 And More
There are studies reporting good outcomes after AVR in the elderly. Gehlot et al. studied 322 patients with a mean age of 82.2 years who underwent AVR. On multivariate analysis, the most important independent predictors of mortality included female gender, renal impairment, EF 35%, bypass grafting and chronic obstructive pulmonary disease. Age and year of operation did not influence mortality. Five-year survival rates for all patients and for operative survivors were 60.2 ± 3.2% and 70.3 ± 3.4%. Asimakopoulos et al. reported on data collected from 1100 patients > 80 years undergoing AVR from the UK Heart Valve Registry. Actuarial survival rates were 89, 79, 69% and 46% at 1, 3, 5 and 8 years, respectively. Survival in the operated patients in our series was practically identical to this. Sundt et al. retrospectively evaluated 133 patients between the age of 80 and 91 years undergoing AVR. Actuarial survival rates at 1 and 5 years were 80 and 55%, respectively. Urgent or emergent surgery, aortic insufficiency, perioperative stroke or renal dysfunction were significant risk factors for operative death by multivariate analysis.
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How Soon Will You Be Able To Get Back To Routine Life After Your Surgery
- A respirator may be required for the first few hours or days after surgery. After a day, the patient should be able to sit up in bed.
- After two days, the patient may be taken out of the intensive care unit. Patients are usually discharged after about seven to ten days.
- If the mitral valve replacement is successful, patients can expect to return to their regular condition or even better.
What To Expect Afterwards
After your operation, you may be taken to the hospitals intensive care unit or high dependency unit . When you wake up, youll be connected to machines that record the activity of your heart, lungs and other body systems. You may need a ventilator to help you breathe. When your medical team are happy that youre recovering safely, theyll move you to a surgical ward.
Youll need pain relief as the anaesthetic wears off. You may be given patient-controlled analgesia once you wake up. A PCA pump is connected to a drip in your arm you use it to control how much pain-relief medicine you have.
Youll be encouraged to get out of bed and move around as soon as possible. This will help to prevent chest infections and blood clots in your legs. A physiotherapist will visit you regularly after the operation to advise you on exercises to help your recovery.
Youll be able to go home when you and your surgeon feel youre ready. Many people are in hospital for around a week after heart valve surgery. Make sure someone can take you home and stay with you for a day or so.
Before you go home, your nurse will give you advice about caring for your healing wounds. You may be given a date for a follow-up appointment.
If you have wires in your breastbone from the operation, these will be permanent, but may be taken out six months after surgery if needed. The dissolvable stitches your surgeon used to close your skin wound dont need to be removed. They will slowly dissolve over several weeks.
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Reasons For Heart Valve Replacement Surgery
In many cases, heart valve disease can develop before your birth or be acquired during the span of your life. Further in many cases the causes remain unknown. There are some common causes
There are many other conditions that can affect the valves. They have papillary muscles or chordae tendinea that can tear or simply stretch. Another case can be the dilating of annulus of the valve. Then there are also chances of stiffness of the leaflets and they an also calcify.
There is another condition called Mitral valve prolapse that can lead to flopping back of the mitral valve leaflets to the hearts contraction. This also impacts the tissues and they become abnormal thereby causing a leakage.
Further other causes include heart attack, coronary artery disease, syphilis, coronary artery disease, connective tissue diseases and high blood pressure. Other lesser reasons include radiation, tumour or some type of drug abuse.
What The Total Doesnt Include:
- Insurance premiums. This is the monthly fee you have to pay just to keep your insurance active. You may also be responsible for your annual deductible and will have to pay any applicable co-payments until you reach your out-of-pocket maximum. Those charges are on top of your monthly insurance premiums.
- Physical therapy after the operation. After bypass surgery, most patients need physical therapy to learn how to move properly without harming the incision. They also must learn exercises that will assist in recovery. Physical therapy can cost between $50 and $350 an hour and might not be covered by insurance.
- Additional medications you might need. These could include blood-thinning medication to prevent blood clots , beta-blocker medication to slow your heart rate , statins to lower your cholesterol , and an ACE inhibitor to control your blood pressure and prevent heart failure .
- Additional miscellaneous expenses like caregiving, travel and anything else you might have to pay as a result of having bypass surgery.
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What Is The Procedure For A Heart Valve Replacement
A traditional heart valve replacement surgery is a type of open surgery and involves general anesthesia. Once the anesthesia has been administered, the cardiac surgeon cleans the surgical site. Then, an incision is made down the center of your chest to expose the heart. Before beginning the procedure, the surgeon will insert tubes in your heart. These will allow the blood to be pumped across the body with the help of a bypass machine. Once the blood has been diverted to the machine, the surgeon will stop the heart by injecting a cold solution. Then, the surgeon will replace the malfunctioning or diseased valve with a biological or mechanical valve.
After the surgery has been completed, the surgeon will remove the tubes and the blood circulating via the bypass is allowed to return to the heart. Once the heart starts pumping blood again, the cardiac surgeon will observe how well the valve is functioning.
The heart valve replacement surgery may last for about 2 hours. However, the duration can vary depending on the number of heart valves that have to be replaced.
Since this procedure is technically intricate, it is essential that you receive it from a highly experienced and skilled cardiac surgeon at a reputed hospital to minimize the risks of any surgical error.
Medicare And Heart Surgery
Although it is a common procedure used to treat coronary heart disease, angioplasty has its limitations. The procedure is ideal when few blood vessels are affected, but in the case of more extensive disease, a more invasive approach may provide better long-term results.
In this case, you might be considered as a candidate for coronary artery bypass surgery , more commonly known as open heart surgery.
Every year the Centers for Medicare and Medicaid Services releases a list of surgical procedures that, regardless of the number of days you are hospitalized, will be automatically approved for inpatient care. In this case, Part A covers your procedure irrespective of the 2-Midnight Rule. CABG is covered on the inpatient-only list.
Many surgeries are not on the inpatient only list and are categorized as outpatient procedures, even if you stay in the hospital overnight or longer. In those cases, Part B will be billed. As an example, many pacemaker placement surgeries are considered outpatient procedures.
Being admitted as an inpatient is important not only because it keeps your out of pocket costs down but because it determines whether Medicare will pay for your care in a rehabilitation facility after you leave the hospital.
You need to be admitted as an inpatient for three consecutive days if you want Part A to pick up the costs for your stay in a rehabilitation facility.
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Positive Reviews On Heart Valve Replacement
We successfully operated on our daughter Nika Popova at the San Donato clinic . Thank you so much for the Bookimed service for the excellent organization of the trip. Our manager Aleksey Karaganov was always in touch and helped with all issues . The clinic, staff, ward are all at the highest level and the main thing is that real masters of their craft work there. Our attending physicians were delighted with the results of the most complicated heart surgery, the Ross operation. It is unfortunate that politics affects not only ordinary citizens, but also their children. I wish you patience, kindness and health to you and your loved ones, so that as many children from all over the world as possible can receive help. Thank you very much to Alexei and your entire team. San Donato Bookimed . , , – . – . , . , , . .
What Are The Additional Costs The Patient Has To Be Aware Of In Case Of Heart Valve Replacement Surgery
The patient may have to keep in mind, certain additional costs which may be required-
Dentist Fee: In case of a risk of oral bacteria to cause on the replaced valve, the patient may have to go to the dentist for thorough checkup.
Physical Therapy : After the surgery is done, the doctor may recommend the patient to go for physical therapy in order to get back to normal life. The patient is taught various exercises which help in recovering better. Such therapies may cost around $50 to$350 per sitting, depending on the general health of the patient.
Medicines: In case the new replaced heart valve is a mechanical one, the patient may have to take blood thinners for the rest of his life to avoid blood clots. Depending on the brand and the dosage of such medications, it may cost anywhere around $50-$200 every month.
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What Are The Types Of Valve Used For Heart Valve Replacement Surgery In Indian Hospitals
There are primarily two types of replacement valves: mechanical, tissue/bioprosthetic. Another type of valve replacement that can be used, although less often, is donor valve from a human, also called homograft. This type is mostly considered for patients with a medical condition that affects their valve, for example infective endocarditis .
Human valve replacements have a risk of developing severe calcification in the donor aortic wall over time, which in turn increases the likelihood of needing a subsequent surgery.
Both types of heart valve replacements have their own pros and cons. The choice of valve type recommended by the surgeon depends on certain patient related factors, such as:
- Presence of any other medical conditions
- Personal preference
Can A Heart Valve Repair Itself
No, a heart valve cant repair itself. Valve disease doesnt go away. It gets worse with time. As the disease gets worse, youll have more symptoms and your overall health will suffer. These changes often happen slowly, but they can also occur very quickly.
Depending on the type and extent of valve disease you have, you may be able to take medication for the short term. Surgery is the only effective long-term solution, and your healthcare provider will help determine when its time to pursue that option.
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Life Expectancy After Surgical Aortic Valve Replacement
Original Investigation
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia
Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
University of Oslo, Oslo, Norway
Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland
Faculty of Medicine, University of Iceland, Reykjavik, Iceland
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
Other Frequently Asked Questions
- Is there such a thing as too old? What about aortic valve replacement in a 90-year-old? Ultimately, theres two people who matter when making this decision: the senior and their doctor. There are risks associated with any medical procedure, but you may decide that the cost of inaction outweighs the risks.
- If I had heart valve replacement at 65, will I need another later? Possibly, depending on a number of factors, including the health of your other valves at the time. Its not uncommon for those with heart valve issues to live long lives with the help of modern medicine, nutrition and fitness.
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Survival Time In Relation To Surgical Risk
The 30-day mortality for the entire cohort was 2.0% , 1.2% for low-risk, 4.1% for intermediate-risk, and 8.3% for high-risk patients .
Low-risk patients had a median survival time of 10.9 years , intermediate-risk patients of 7.3 years , and high-risk patients of 5.8 years . The continuous survival time for the 3 risk groups is illustrated in . The cumulative 5-year mortality of patients classified as low risk was 16.5% , for those classified as intermediate-risk, 30.7% , and for patients classified as high-risk, 43.0% . The 10-year cumulative mortality is depicted in . The sensitivity analysis, with imputed EuroSCORE values for patients with missing risk assessment, confirmed the results of the primary analysis .
Figure 2
Smoothed Line Plot of Survival Time Based on Age at Operation
The median survival time as a function of age for low-, intermediate-, and high-risk patients. As is illustrated, older age had a substantial impact on median survival for patients in the low-risk group but the impact was attenuated for intermediate- and high-risk patients.
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How Long Does It Take To Recover From Heart Valve Surgery
It takes about four to eight weeks to recover from heart valve surgery. But your recovery may be shorter if you had minimally invasive surgery or surgery through a vein.
The way you feel after surgery depends on:
- Which valve was repaired or replaced.
- Your overall health before the surgery.
- Which method your provider used to get to your heart .
- How the surgery went.
- How well you take care of yourself after surgery.
You can expect to get tired easily for the first three weeks after surgery.
Dont drive for a few weeks after surgery.
Dont handle anything that weighs more than 15 pounds for the first six to eight weeks after surgery.
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The Technology Used During Surgery
Traditional cataract surgery involves making a very small incision on the cornea to remove the cataract. A laser then breaks up the cataract so it can be suctioned out and removed.
Laser cataract surgery, which is typically more expensive, uses a laser to create the initial incision instead, reducing certain risks and improving the visual outcome of cataract surgery.