After Mitral valve replacement

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After Mitral valve replacement

Patients will be moved to a postoperative care or Intensive care unit to be carefully monitored. Each patient recovers differently. Anxiety and pain medications will be given along with the regular medications.

Ventilator will be removed usually after a day when the patient is awake and breathes on his/her own without difficulty.

Chest tubes also will be removed once the fluid/blood drainage stops.

IV lines will be connected for medications. Chest leads and a blood pressure cuff will help monitor the hemodynamic stability and this will be regularly recorded in the notes. Transfer from ICU will happen usually in one to two days when the doctor determines the patient is stable.

Rehabilitation process helps speedy recovery. The total hospital stay usually lasts less than two weeks.

The total time for full recovery can vary and can be as much as 6-8 weeks. Once the wound heals, there will be no restrictions to daily activities. Patients with physically demanding jobs should check with their doctors before returning to work.

As far as possible direct injury to the chest should be avoided. Scarring process may cause some itching, numbness and redness. Proper wound care is necessary. Signs of infection like fever or pus needs immediate medical attention. Application of any lotions or creams on the incision site should be avoided to prevent infection.

Involvement in an exercise program is recommended. The amount of exercise should be increased progressively to improve strength. Lifting weights is restricted until the breastbone is healed completely.

Signs of fluid retention like swollen ankles/legs, shortness of breath and weight gain should be reported to the doctor immediately.

Antibiotics as prophylaxis are required before any other surgeries or dental procedure. This prevents infection to the heart valve, which is called prosthetic valve endocarditis.

Patients with bioprosthetic valves are required to be on anticoagulation therapy like Coumadin for 2-3months. Patients with mechanical valves need to be on an anticoagulant throughout their lifetime. This keeps the blood thin and prevents clot formation in the heart. Initially, patients on Coumadin will be required to have blood draw every week to optimize the dose. Later on they will have these tests every 3 weeks to maintain the dosage. This test is called INR or International Normalized Ratio. It assesses clotting and bleeding factors in blood. INR is maintained at a specific range to avoid clotting or excessive bleeding. Patients on Coumadin have certain dietary restrictions. Foods rich in Vitamin K, can alter the INR results. Some of these foods are

► Green leafy vegetables,

► Green tea,

► Beef

Medications such as aspirin can increase the INR. Dietician and doctor can guide the patients about these restrictions.

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Methods for Mitral Valve Repair: Annuloplasty:In annuloplasty an artificial ring is placed around the annulus of the valve.This ring reinforces the annulus and restores the valve to its normal shape and size. Balloon Valvuloplasty:Balloon valvuloplasty is performed using a catheter, i.e. a very thin flexible tube which can be inserted into the body, with a balloon at the end. The balloon is put inside the valve and is expanded thus stretching the valve and bringing it back to its normal size. For more info:

Patients with a biological valve may need replacement valve of 10-15 years. Mechanical valves may also fail, so patients should inform their doctor if they have symptoms of valve insufficiency. Patients with mechanical valves must take blood-thinning medication at the end of their lives. Because these medicines increase the risk of bleeding in the body, you should always be used in medical notification bracelet and the doctor or dentist that you are taking anticoagulant medicine. Even if you take anticoagulant medication, you should always inform your doctor and dentist to have had valve surgery. If you have any surgery or dentistry, you should take antibiotics before the procedure. The bacteria can enter the bloodstream during these procedures. If bacteria enter the repair or artificial heart valves, can lead to a serious condition called bacterial endocarditis. Antibiotics can prevent bacterial endocarditis.

Mitral Regurgitation also known as mitral insufficiency or mitral incompetence is a disorder affecting the mitral valve of the heart. The cusps or flaps of the mitral valve do not seal tightly in this condition and causes a backflow of blood through the mitral valve from the left ventricle to the let atrium of the heart. The heart valve in this state is referred to as a leaky valve.

Various symptoms are
* Shortness of breath.
* Pulmonary edema or fluid accumulation in the lungs.
* Orthopnea or shortness of breath while lying flat.
* Paroxysmal nocturnal dyspnea or Cardiac Asthma
* Decreased exercise tolerance.
* Swollen feet or ankles.


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