Before you have surgery to replace a heart valve due to a condition such
mitral valve stenosis or
mitral valve regurgitation, you will need to prepare
for your hospital stay.
You will have to visit the
hospital or your doctor's office several days in advance of your surgery for a
hospital preadmission session. During this session, your medical team will
educate you about your upcoming surgery. They will also teach you how to
prepare for your operation, explain what the procedure will be like, and give
you instructions for a successful recovery. Some institutions even show a
patient-education video about having valve replacement surgery.
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You should use this time to ask questions. It is natural for you to be
anxious before your operation, so be sure to address issues that may be causing
you particular anxiety.
One of the issues that your
doctor or nurse will discuss with you during the preadmission session is
informed consent. Your doctor or nurse will describe the risks associated with
a valve replacement surgery. These include:
You will then be asked to sign a consent form (waiver)
that you should read carefully. You should feel free to ask questions about the
form if there is anything that you do not understand.
During your preadmission
session, you will undergo a range of preparatory procedures. Your hospital
staff will give you a few preliminary tests, such as an
EKG and a blood test, to make sure that your bodily
functions are normal. You will also be asked to bathe or shower with an
antiseptic soap, while a technician will shave any hair from your chest and
abdomen, so that your body can be as clean as possible during surgery.
One of the most important discussions
you have prior to surgery will be with your anesthesiologist, who will
administer anesthesia during your operation. Because general anesthesia carries
significant risks, you will need to describe your past medical history,
including other operations you have had and any allergies to food or medicines.
Mention any history, either personal or within your family, of adverse
reactions to anesthesia. Bring a list of the medicines you are currently
Because valve replacement surgery is
a serious surgical procedure, you should begin preparing for it several days
ahead of time. Try to get into good condition by eating healthfully, getting
plenty of rest, and limiting vigorous physical activity. Ask your doctor if
there are any medicines you should take or should not take before your
Your doctor will give you instructions for the night before your surgery. For example, you doctor will tell you when you must not eat or drink anything
(including water) before surgery. Follow the instructions exactly,
or your surgery may be canceled. If
your doctor has instructed you to take your medicines on the day of surgery,
do so using only a sip of water.
During the operation
Before surgery begins, you
will be put under general anesthesia, which will be administered both through
an IV line and through a mask placed over your mouth and nose. When you are
given general anesthesia, you will be unconscious during the entire operation
and will not feel anything.
While you are unconscious, your
surgeon will make an incision along the length of the breastbone and expose
your heart. Your heart will be hooked up to a heart-lung machine. After blood
flow is directed to this machine, the surgeon will remove your damaged mitral
valve and replace it with an artificial valve. Most surgeries will take an
average of 3 to 5 hours.
Immediately after the operation
When you first wake
up after your operation, you will be in an intensive care unit (ICU) so that
your doctor can monitor your heart function to make sure that there are no
complications. You will also find many wires and tubes inserted into different
body parts. Most of these wires and tubes were inserted while you were in
surgery, but were kept to help your body perform vital functions and to provide
you intravenously with medicine (primarily painkillers) and nutrients. See the
chart at the end of this section for detailed information on these wires and
At first, you will feel drowsy and disoriented while the
anesthesia wears off. You may also experience some pain, though you will be
given painkillers. For the first few hours after surgery, you will be kept on a
respirator or ventilating machine to help you breathe.
length of stay in the ICU is 1 day. But your doctor may keep you there longer
if any complications develop.
Wires and tubes after heart valve surgery
Wire or tube
Where it attaches to body
What it does
Heart monitor (EKG) wires
Chest, arm, and legs
Small, round sticky pads connected to an EKG
machine to monitor the electrical activity of your heart
Chest drainage tubes (usually 2)
Just below your surgical incision
Remove extra fluid, blood, and air that may
collect in your chest
Arterial line tube
In an artery
Used to continuously monitor your blood pressure
and to obtain blood samples. This tube can leave long-lasting bruising at the
Generally in arms and neck
Provide nutrients and medicines intravenously
(through your vein into your bloodstream)
Drains waste that may be in your stomach. May be
used to give medicines directly into the stomach
Helps you breathe and is left in until your doctor
is sure that you can breathe on your own. You will not be able to speak while
this tube is in your mouth. After this tube is removed, you will receive oxygen
through a mask or nasal prongs for a few days.
Recovery after you leave the ICU
When your condition
stabilizes and you have been moved to a regular hospital room, you will
continue to rest and recuperate while your doctor monitors your recovery. Your
care will also include physical and respiratory therapy, emphasizing breathing
exercises and simple exercise such as walking. You will also receive counseling
about a heart-healthy diet and exercises that you should maintain after leaving
The average length of stay in the hospital after
valve replacement is 7 to 12 days, though different hospitals have different
policies in this regard. Basically, before you are discharged and sent home,
your doctor needs to make sure that you are mending well and that there are no
Primary Medical Reviewer
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
George Philippides, MD - Cardiology
February 12, 2010
WebMD Medical Reference from Healthwise
February 12, 2010
This information is not intended to replace the advice of a doctor.
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