Heart Valve Repair/Replacement Surgery

Discharge Instructions

Medications

Before your discharge, your nurse will bring you a list of your medications, as ordered by your physician. You will be given instructions regarding the dosage, schedule, and possible side effects. If you received a mechanical valve, you will be on blood-thinning medication for as long as you have this valve. Your physician will monitor the dosage of the medication by means of periodic blood tests.

Diet

Your physician may recommend that you follow a low-salt, low-cholesterol, low-fat diet. Ask to see a dietitian before your discharge if you have questions. Otherwise, you will be provided with some recommendations for decreasing fat and cholesterol intake. If you are now taking a blood-thinning medication, you will receive additional diet instructions about certain foods that may affect the action of the medication.

Activity

Your physician will give you specific instructions regarding your activity level. It is important to follow these instructions, even if you are feeling well enough that you think you can do more. If you over-exert yourself too soon, you may bring on complications that may delay your recuperation. The following schedule may be recommended:

• Walk for 5 minutes, four times a day.
  
  
• As tolerated, increase your walking time to 10 minutes, four times a day.
  
  
• As tolerated, increase your walking time to 15 minutes, two times a day.
  
  
• As tolerated, increase to walking 30 minutes every day.

In addition, you should not do any lifting until your physician advises you to do so.

It is not unusual for patients to feel sad, blue, or depressed at some point after heart surgery. Heart surgery can be quite stressful on your body and your emotions. If you become more emotional than usual and seem to cry easily, do not become alarmed, as this is a normal reaction. However, these feelings should go away within a few days. Any prolonged depression, lasting more than a couple of weeks, should be reported to your physician.

Sexual Activity

Your physician will give you specific instructions regarding sexual activity. Ask your physician if you need additional information, or have questions or concerns.

Bath Care

Showers are usually allowed by the time you go home, if not sooner. Wash normally with soap and water, but do not apply unusual pressure at the incision sites on your chest and legs. Pat dry instead of rubbing the skin around the site. Avoid tub baths (for a period of time determined by your physician), as they may increase your chance of infection at the incision site.

Site Care

Clean your incisions every day with soap and water only. After taking a shower, gently pat dry the area of the incisions. Do not use any powders, lotions, or oils on your incisions until they are well healed. Generally, healing takes several weeks.

Driving a Vehicle

You will not be allowed to drive for approximately four to six weeks. Your physician will give you specific information regarding your ability to resume driving.

Returning to Work

Ask your physician when you will be able to return to work. The nature of your occupation, your overall health status, and your progress will determine how soon you may return to work. In general, you will be out of work for six to eight weeks.

Office Visit

Your physician will advise you when you need to schedule a follow-up appointment.

Daily Weight

You will need to weigh yourself every day, at the same time of day, and in the same kind of clothes. If you gain 2 to 3 pounds or more over a 24-hour period, notify your physician. Also, note if you have swelling in your hands, feet, or ankles.

Warning Signs/Symptoms to Monitor

Notify your physician if you develop any of the following symptoms:

• any changes in your incisions, such as redness, swelling, drainage, increased tenderness, or opening of your incisions
  
  
• temperature higher than 100 degrees F
  
  
• changes in the sensation, movement, or circulation in your arms or legs
  
  
• changes in the location, type, or severity of pain
  
  
• chest pain, pressure, or your previous heart pain
  
  
• pain that is unrelieved
  
  
• fast or irregular heart rate

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