Monday, January 23, 2023

Open Heart Valve Surgery

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How Long Does It Take To Recover From Heart Valve Surgery

Watch a Transcatheter Aortic Valve Replacement (TAVR) Procedure at St. Luke’s in Cedar Rapids, Iowa

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.

What Happens During Heart Valve Repair Or Replacement Surgery

Heart valve repair or replacement surgery requires a stay in a hospital.Procedures may vary depending on your condition and your healthcareproviders practice.

Generally, open-heart valve repair or replacement follows this process:

  • You will be asked to remove any jewelry or other objects that may interfere with the procedure.

  • You will change into a hospital gown and empty your bladder.

  • The surgical team will position you on the operating table, lying on your back.

  • A healthcare professional will start an intravenous line in your arm or hand for injection of medicine and to give IV fluids. More catheters will be put in blood vessels your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples.

  • The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.

  • Your doctor will put a breathing tube through your mouth into your lungs and connect you to a ventilator, a machine that will breathe for you during the surgery.

  • Your doctor will place a transesophageal echocardiogram probe into your esophagus so he or she can monitor the function of the valves.

  • A soft, flexible tube will be put into your bladder to drain urine.

  • A tube will be put through your mouth or nose into your stomach to drain stomach fluids.

  • Someone on the surgical team will clean the skin over your chest with an antiseptic solution. If there is a lot of hair at the surgical site, it may be shaved off.

  • Heart Surgeries At Nkch

    Access a range of cardiothoracic surgery and procedures, such as:

    • Aneurysm surgery
    • Aortic dissection repair and root replacement
    • Cardiac catheterization
    • Closure of an atrial septal defect
    • Congenital cardiac defect repair
    • Coronary artery bypass grafting
    • Off-pump coronary artery bypass
    • Open heart surgery
    • Ventricular assist device implantation

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    Transcatheter Aortic Valve Implantation

    Transcatheter aortic valve implantation is a relatively new procedure. It involves accessing the aortic valve through the femoral artery or vein , or through a small surgical incision in your chest.

    A balloon catheter is guided into the left ventricle chamber in your heart, and it is used to position the prosthetic valve over the old one.

    TAVI may be used if someone is too frail to cope with the stress of standard valve replacement surgery, for example due to their age or another illness.

    While it is not as effective as traditional open surgery, a TAVI does offer a marked improvement in survival for people with severe aortic valve diseases. One study found that this type of treatment could half a persons risk of death.

    However, there is around a 1 in 16 chance of having a stroke in the first year after a TAVI.

    How Long Will My Valve Last

    TAVR is a less invasive alternative to traditional open

    The amount of time your valve repair or replacement lasts depends on several things:

    • Whether you have heart valve repair or replacement.
    • The type of valve you have placed .

    Mechanical valves rarely wear out, but they may need replacement if a blood clot, infection or tissue growth keeps them from working right. Biological valves may need to be replaced, especially if youre younger.

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    What Happens During An Open Aortic Valve Replacement

    Check with your doctor about the details of your procedure. In general, during your open aortic valve replacement:

    • You will be given anesthesia before the surgery starts. This will cause you to sleep deeply and painlessly during the operation. Afterwards you wont remember it.
    • The operation will take several hours. Family and friends should stay in the waiting room, so the surgeon can update them.
    • Your doctor will make an incision down the middle of your chest. To access your heart, your doctor will separate your breastbone.
    • The surgery team will connect you to a heart-lung machine. This machine will act as your heart and lungs during the procedure.
    • Your surgeon will remove your current heart valve and replace it with a new valve.
    • The surgery team will remove the heart-lung machine.
    • The team will wire your breastbone back together.
    • The team will then sew or staple the incision in your skin back together.

    Youll Play A Key Role In Managing Your Pain

    Post-surgical pain is unavoidable but can be managed in a variety of ways. Because of recent national legislation changes, physicians can prescribe no more than a seven-day supply of opioids to patients at the time of their hospital discharge.

    Weaning yourself off opioids as soon as possible is important. You may need less than a seven-day supply, depending on your condition. Some patients do not require any opioids for pain management.

    Other options for pain management include:

    • Oral and topical analgesics such as acetaminophen and Salonpas patches

    • Applying a warm cloth to the area, using caution near the incision because nerve sensitivity may be decreased, causing the skin to burn

    • Relaxation techniques such as meditation and guided imagery

    If you are on long-term opioids, you should meet with your prescribing physician to begin to wean down to the lowest dose possible before surgery.

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    Alternatives To Aortic Valve Replacement

    Aortic valve replacement is currently the most effective treatment for aortic valve diseases. But having open-heart surgery can place tremendous strain on the body.

    Surgery may be too dangerous in people who are in very poor health. In this case, less invasive alternative methods may be required. Some alternative methods are described below.

    Icipants And Setting And Recruitment

    Transcatheter Aortic Valve Replacement (TAVR) – A Less-Invasive Alternative to Open Heart Surgery

    Patients undergoing open heart valve surgery at a high volume tertiary centre, Odense University Hospital, Denmark, from August 2013 to November 2017 were consecutively included in the cohort study . Open heart valve surgery was defined as one of the following surgical procedures : Aortic , Mitral and Tricuspid .

    Excluded were: patients 64 years , patients who died during index admission or within 180-days after discharge , patients who required endocarditis treatment during the index admission due to prolonged hospitalisation and patients who developed perioperative stroke and received neurological rehabilitation and patients who did not have a Danish civil registration number due to lack of data on work status . Thus, the current study was restricted to patients at the working age at inclusion time to ensure full follow-up before the patients were offered state pension .

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    When Surgery Is Required

    If your symptoms are mild, you will be invited to come in for an echocardiogram every year or two to check whether the problem is getting worse.

    If your symptoms are severe, it is highly likely that surgery to replace the valve will be recommended. Without treatment, stenosis or regurgitation of your aortic valve is likely to get worse and will eventually lead to heart failure, which is a long-term and sometimes debilitating condition.

    There is also a small risk that the heart will suddenly stop beating , which can also be fatal.

    Research has found that people with severe aortic stenosis who are not treated with surgery have a 25% chance of dying in the first year after the symptoms start. The risk is 50% in the second year.

    People with severe aortic regurgitation who are not treated with surgery have a 25% chance of dying after 5 years following the start of symptoms. The risk is 50% after 10 years.

    A Chest Pillow Is A Must

    Having a pillow to stabilize your chest is a must. Most hospitals will send you home with one, but if they dont, make sure to get one. Chest pillows can help you when you sleep, sneeze, and cough they have has many uses. I had a pillow with me for almost a year after my last surgery and I still usee one during long trips in the car.

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    What To Expect From Your Doctor

    The health care provider who sees you for possible mitral valve stenosis may ask:

    • What are your symptoms?
    • When did your symptoms begin?
    • Do you always have symptoms, or do they come and go?
    • Do you have rapid, fluttering or pounding heartbeats?
    • Have you coughed up blood?
    • Does exercise or physical activity make your symptoms worse?
    • Do you have any family members with heart valve disease?
    • Have you had rheumatic fever?
    • Are you being treated or have you recently been treated for any other health conditions?
    • Do you or did you smoke? How much? When did you quit?
    • Do you use alcohol or caffeine? How much?
    • Are you planning to become pregnant in the future?

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    How Surgery Is Performed

    Mitral Valve Replacement Open Heart Surgery

    An aortic valve replacement is carried out under general anaesthetic. This means you will be asleep during the operation and will feel no pain.

    The surgeon will begin the operation by making a large incision down the centre of your breastbone . The incision will be around 25cm long. This is known as a sternotomy and it allows the surgeon access to your heart.

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    What Happens During Open

    Heart surgery is complex. Some surgeries may take six hours or longer. You will receive anesthesia and be asleep during the procedure.

    Surgery steps vary depending on the heart condition and procedure. In general, your surgeon:

    • Makes a 6- to 8-inch long incision down the middle of your chest.
    • Cuts the breastbone and spreads your ribcage apart to reach your heart.
    • Connects the heart to a heart-lung bypass machine, if youll have an on-pump surgery. An anesthesiologist gives IV medication to stop your heart from beating and monitors you during the surgery.
    • Repairs your heart.
    • Restores blood flow to your heart. Usually, your heart starts beating on its own. Sometimes, the heart needs a mild electrical shock to restart it.
    • Disconnects the heart-lung bypass machine.
    • Closes the breastbone or other incision with wires or sutures that remain in your body.
    • Uses stitches to close the skin incision.

    Are There Any Alternatives To Surgery

    Medication is the main alternative to surgery.

    • Diuretics to lessen the strain on your heart.
    • ACE-inhibitors to make your heartbeat stronger.
    • Digoxin to stabilise your heart rhythm.

    Instead of open heart surgery, a leaking mitral valve may be treated by applying a clip to the valve. Certain health conditions can increase the risk of complications for people who have open heart surgery. This procedure may be more suitable in such cases.

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    Why The Procedure Is Performed

    You may need surgery if your aortic valve does not work properly. You may need open-heart valve surgery for these reasons:

    • Changes in your aortic valve are causing major heart symptoms, such as chest pain, shortness of breath, fainting spells, or heart failure.
    • Tests show that changes in your aortic valve are beginning to seriously harm how well your heart works.
    • Your heart valve has been damaged by infection of the heart valve .
    • You have received a new heart valve in the past and it is not working well.
    • You have other problems such as blood clots, infection, or bleeding.

    You May Experience Collarbone And Sternum Pain After Open

    Wyatt’s Open Heart Surgery

    Sometimes you can have prolonged collarbone and sternum pain. Collarbone pain and sternum pain can be caused by the trauma of the surgery on your body or sternal wires. This pain can be sometimes helped with cardiac rehab or a resternotomy. However, make sure to communicate with your doctor about your pain to make sure its normal. After this past open heart surgery, Ive had a lot of pain and clicking in my shoulders and chest. Its caused a lot of chronic pain but working with physical therapy has helped me regain strength.

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    Wearing Certain Types Of Clothing Might Be Hard During Surgery Recovery

    Usually in discharge, they tell you to wear button-down clothing for a while, but what they dont tell you is that your skin is super sensitive and wearing tight clothing even a couple of months after might be hard. For women, wearing bras might be tough. Try to find comfortable sports bras you can unclasp or undershirts. I tend to wear bras now that dont have underwires and have a t-shirt cotton feel.

    How Much Times Does The Open Heart Surgery Take

    “Heart surgery is a complicated task that can take six hours or more to finish. The reason why patient is administered general anaesthesia, which keeps them asleep and pain-free throughout the procedure. The turnaround time depends on the medical operation, comorbidities, and the patients overall health prior to surgery,” says Dr Thakur.

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    What Is Recovery Like After Open

    Recovery time varies depending on the surgery type, complications and your overall health before surgery. It can take 6 to 12 weeks to recover from an open-heart procedure.

    Your surgeon will let you know when you can return to work and other activities. Typically, you shouldnt drive or lift anything heavy for the first six weeks.

    Some people need to take blood thinners after heart surgery to prevent blood clots. Your healthcare provider may also recommend cardiac rehabilitation. This medically supervised program can help you regain strength and stamina and improve overall heart health.

    Will I Need To Take Blood

    Is Valve Replacement Surgery Open Heart Surgery

    The need for anticoagulant medication after surgery depends on the type of surgery you have. The medication prevents blood clots from forming and causing problems with your heart valve. Currently, warfarin is the only approved blood thinner for mechanical heart valves.

    If you have a mechanical heart valve, youll need to take this medication for the rest of your life.

    If you have valve repair or a biological valve replacement, you may need to take this medication for several weeks after surgery, or maybe not at all.

    You may need to take an anticoagulant for a condition not related to your heart valves. This medication also treats:

    • An irregular heartbeat.

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    Recovery From Surgical Heart Valve Replacement

    In the ICU, the staff will keep a close watch on your heart rate, temperature, blood pressure, and other vital body signs. You may feel a little uncomfortable because of all the monitoring equipment attached to you. The nurses will try to keep you as comfortable as possible. Friends and family are usually welcome to visit you.

    When intensive care monitoring is no longer needed, you’ll be moved to a regular hospital room. Typically, you may be in the hospital for three to 10 days, depending on how quickly you recover.

    Risks Of Open Heart Surgery

    “Open-heart surgery is a major surgical procedure. Therefore, like all surgeries, there is risk of complications and death. It may be greater if the patient has other health conditions such as kidney or liver problems, diabetes or obesity, chronic obstructive pulmonary disease etc. People who smoke are more susceptible to surgical and postsurgical issues. Complications for open-heart surgery though rare are chest wound infection, most commonly seen in patients with obesity or diabetes, brain stroke, irregular heartbeat, lung or kidney failure, breathing difficulty and pneumonia etc,” says Dr Singh.

    “There are risks with any surgery. Complications are more likely if the patient has an existing health condition such as diabetes or obesity. Lung diseases such as chronic obstructive pulmonary disease also multiply the risk. Similarly, people who smoke a lot are more inclined to have surgical and post-surgical complications. The following risks are associated with surgery: allergic response to anaesthesia, arrhythmias , bleeding and damage to adjoining blood vessels or organs such as the lungs or kidneys, infections and strokes,” says Dr Thakur.

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    Preparing For The Operation

    To make sure youâre healthy enough for surgery, youâll get:

    • Drugs you buy âover the counterâ
    • Prescription medicines

    You may need to stop taking certain ones before surgery.

    Also tell your doctor about any illnesses you have, even a simple cold. It might seem minor, but it could affect your recovery.

    If you smoke, youâll need to stop 2 weeks before surgery to help prevent blood clots and problems breathing.

    The night before surgery, youâll likely need to wash with a special soap that your doctor provides to kill germs. And in most cases, you wonât be allowed to eat or drink anything after midnight.

    How Long Does It Take To Recover

    1 Year After Aortic Valve Replacement Open Heart Surgery – Tips for new patients.

    Open heart surgery requires 57 days of hospital stay, while home care continues for 710 days afterward. Minimally invasive procedures generally require less time in the hospital and have quicker recovery periods. However, recovery after a sternotomy, a surgical incision through the sternum, can take several weeks or months.

    A range of factors, such as age and other health conditions, can influence healing. A persons doctor will provide guidance on recovery time.

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