In Hospital After Aortic Valve Replacement Care
The patient will have continuous cardiac monitoring performed in the intensive care unit (ICU) postoperatively. Medications or mechanical circulatory assist may be instituted during the surgery or postoperatively to help the heart provide the necessary cardiac output to sustain the pulmonary and systemic circulations.
These will be discontinued as cardiac function improves. As the patient is able to breathe without assistance, ventilatory support will be discontinued. Drainage tubes allow blood to be collected from the chest cavity during healing and are removed as blood flow decreases. Prophylactic antibiotics are given. Anticoagulation (warfarin, aspirin, or a combination) therapy is instituted and continued for patients who have received a mechanical valve. The ICU stay is approximately three days with a final hospital discharge occurring within a week after the procedure.
The patient receive wound care instructions prior to leaving the hospital. The instructions include how to recognize such adverse conditions as infection or valve malfunction, contact information for the surgeon, and guidelines on when to return to the emergency room.
Risks After Aortic Valve Replacement surgery
There are unassociated risks with general anesthetic and cardiopulmonary bypass. Risks associated with aortic valve replacement include embolism, bleeding, and operative valvular endocarditis. Hemolysis is associated with certain types of mechanical valves, but is not a contraindication for implantation.
Normal results After Aortic Valve Replacement
Myocardial function typically improves rapidly, with decrease in left ventricle enlargement and size of the inner chamber over several months, allowing the heart to return to normal dimensions. Anticoagulation therapy will be continued, depending on the type of mechanical valve implanted. Implantation of biological tissue valves are associated with the formation of blood clots. If non-cardiac surgery or dental care is needed, the anticoagulant medication will be adjusted to prevent bleeding complications.
Mortality After Aortic Valve Replacement
There is a 3–5% hospital mortality associated with aortic valve replacement. The average survival rate after five years is 85% for patients suffering from aortic stenosis who undergo aortic valve replacement.