Aortic regurgitation surgery
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Aortic Regurgitation Microchapters |
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Diagnosis |
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Treatment |
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Acute Aortic regurgitation |
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Chronic Aortic regurgitation |
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Special Scenarios |
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Case Studies |
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Aortic regurgitation surgery On the Web |
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American Roentgen Ray Society Images of Aortic regurgitation surgery |
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Risk calculators and risk factors for Aortic regurgitation surgery |
For the WikiPatient page for this topic, click here; For the main page of aortic insufficiency, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Varun Kumar, M.B.B.S., Lakshmi Gopalakrishnan, M.B.B.S., Mohammed A. Sbeih, M.D.[3]
Related Key Words and Synonyms: Aortic valve replacement.
Overview
Indications
Preoperative Evaluation
Procedure
Recovery
Recovery
Recovery at Hospital
The patient may spend 4 to 7 days in the hospital after surgery (much less in Minimally invasive mitral valve surgery-3 to 5 days). Then patient will wake up in theintensive care unit (ICU) and recover there for 1 or 2 days. Two to three tubes will be in the patient's chest to drain fluid from around the heart. They are usually removed 1 to 3 days after surgery.
The patient may have a catheter in the bladder to drain urine, and may also have intravenous lines to get fluids. Nurses will closely watch monitors that show information about the vital signs (pulse, temperature, and breathing).
The patient will be moved to a regular hospital room from the ICU. The nurses and doctors will continue to monitor the heart and vital signs until the patient is stable enough to go home. The patient will receive pain medicine to control pain around the surgical incision site.
A nurse should help the patient to slowly resume some activity, and the patient should begin a physical therapy program to make the heart and body stronger. A temporary pacemaker may be placed in the patient's heart if the heart rate becomes too slow after surgery.
Recovery at Home
The patient should be informed about the following:
- Taking care for his or her healing incisions.
- Recognizing signs of infection or other complications.
- Coping with after-effects of surgery.
- Followup appointments, medicines, and situations when he or she should call the doctor right away.
- When he or she can go back to daily routine, such as working, driving, and physical activity.
After-effects of heart surgery are normal. They may include muscle pain, chest pain, or swelling. Other after-effects may include loss of appetite, problems sleeping, constipation, and mood swings and depression. After-effects usually go away over time.
Less recovery time is needed for off-pump heart surgery and minimally invasive heart surgery.
Ongoing Care
Ongoing care after valve surgery may include periodic checkups with the doctor. During these visits, the patient may have blood tests, an EKG (electrocardiogram),echocardiography, or a stress test. These tests will show how the patient's heart is working after the surgery.
Routine tests should be done to make sure the patient is getting the right amount of the blood-thinning medicine in case of mechanical valve placement.
The patient may be advised to change his or her lifestyle, this includes: quitting smoking, making changes to diet, being physically active, and reducing and managing stress.
Outcomes & Prognosis
Outcomes and Prognosis
Most valve surgery operations are successful. In some rare cases, a valve repair may fail and another operation may be needed. The risk of death or serious complications from isolated aortic valve replacement is typically quoted as being between 1-3% of cases, depending on the health and age of the patient, as well as the skill of the surgeon and the health care institute. The patient's past history of heart surgery affects the mortality rate as well. Patient with mechanical valve may hear a quiet clicking sound in his chest. This is just the sound of the new valve opening and closing, and a sign that the new valve is working.
Mechanical Versus Biological Valves
Mechanical heart valves do not fail often. They last from 12 to 20 years. However, blood clots develop on them. If a blood clot forms, the patient may have a stroke. Bleeding can occur, but this is rare. Biological valves tend to fail over time [1][2], but they have a lower risk of blood clots. Patients with a biological valve may need to have the valve replaced in 10 to 15 years. Patients with a mechanical valve will need to take a blood-thinning medicine for the rest of their lives.
Complications
Complications
Risks of any surgery
- Blood clots in the legs that may travel to the lungs.
- Blood loss.
- Breathing problems.
- Infection, including in the lungs, kidneys, bladder, chest, or heart valves.
- Reactions to medicines.
- Nausea and vomiting.
- Abnormal or painful scar formation.
- Allergic skin reaction
Possible risks from having open-heart surgery
- Heart attack or stroke.
- Heart rhythm problems; such as atrial fibrillation.
- Infection in the cut, which is more likely to happen in people who are obese, have diabetes, or have already had this surgery.
- Memory loss and loss of mental clarity, or "fuzzy thinking."
- Post-pericardiotomy syndrome, which is a low-grade fever and chest pain. This could last for up to 6 months.
Prosthetic heart valves are associated with a variety of complications
- Structural deterioration, particularly with bioprosthetic valves.
- Valve obstruction due to thrombosis or pannus formation.
- Systemic embolization.
- Bleeding.
- Endocarditis and other infections.
- Left ventricular systolic dysfunction, which may be preexisting (Heart failure).
- Hemolytic anemia.
Videos
Videos
Severe aortic insufficiency in patient after aortic valve replacement 1
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Severe aortic insufficiency in patient after aortic valve replacement 2
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Severe aortic insufficiency in patient after aortic valve replacement 3
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Severe aortic insufficiency in patient after aortic valve replacement 4
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Severe aortic insufficiency in patient after aortic valve replacement 5
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Severe aortic insufficiency in patient after aortic valve replacement 6
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Severe aortic insufficiency in patient after aortic valve replacement 7
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Severe aortic insufficiency in patient after aortic valve replacement 8
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References
- ↑ Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Rahimtoola S (1993). "A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease". N Engl J Med. 328 (18): 1289–96. doi:10.1056/NEJM199305063281801. PMID 8469251.
- ↑ Hammermeister K, Sethi GK, Henderson WG, Grover FL, Oprian C, Rahimtoola SH (2000). "Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial". J Am Coll Cardiol. 36 (4): 1152–8. PMID 11028464.