Surgery is an effective way to treat aortic disease, but successful surgery is not the end of the disease treatment, but only the beginning. After discharge from the hospital, patients still need a long time or even a lifetime of drug therapy, doctors can only give guidance in the clinic, most of the treatment needs to be mastered by the patient, which requires patients to have a clear understanding of their disease, do not think that everything is fine after discharge, negligence can be fatal!!!
The following is a compilation of common patient questions and answers in clinical work, I hope it will be helpful to all patients (statement: different hospitals, different doctors will have some different views, listed here is only the personal views of Dr. Yu, for your reference)
First of all, please read the “discharge summary” given to you by your doctor after discharge, which contains the main information about your hospitalization, including the diagnosis of the disease, the time and name of the surgery, the type of valve used, any accidents before and after the surgery, the dosage and time of the medications you need to take after discharge, the time and frequency of postoperative review, and the things you need to pay attention to after discharge, etc. The following are some of the things that need to be taken care of after discharge.
After Bentall surgery, patients with simple equine syndrome (also known as Marfan syndrome) should have their blood pressure controlled, be reviewed annually, and be aware of any possible lesions in other blood vessels. Watch for possible lesions in the eyes and bones.
The patient’s immediate family also needs to be examined by the cardiology department to clarify the presence of the disease and for early diagnosis and treatment.
For patients with aortic coarctation, after discharge from the hospital, it is recommended to avoid heavy physical work, eat a healthy diet, control blood pressure, and have regular follow-up examinations.
1.Blood pressure: It is recommended to buy an electronic blood pressure monitor, which requires frequent or even daily self-measurement of blood pressure, generally requiring control below 120/80 mmHg, and outpatient follow-up at the cardiology department to adjust blood pressure-lowering drugs at any time.
2, low salt, low fat diet, moderate exercise, weight control.
3.Keep bowel movements smooth, eat more fiber-rich diet.
4.At least once a year, come back to our hospital or cardiology hospital to review the whole aorta CT to clarify any changes and progress of the disease.
Q: I can’t understand the name of the operation written in the “discharge summary”, it’s all in English letters?
A: Because the Chinese names of heart disease are very long and inconvenient to read, many doctors like to use these international abbreviations to record the diagnosis of the disease, the name of the surgery and so on, so that it is concise and clear, the translation is as follows.
MVP — mitral valvuloplasty
MVR — mitral valve replacement
AVP — aortic valvuloplasty
AVR — aortic valve replacement
DVR — mitral + aortic valvuloplasty (equivalent to MVR + AVR)
TVP — tricuspid valvuloplasty
TVR — tricuspid valve replacement
LATH removal — left atrial thrombus removal
LAATH removal — left auricular thrombus removal
LAA ligation — left auricular ligation
LA folding — left atrial folding
LA decompensation — left atrial decompensation
IRF (or Mini-Maze) — radiofrequency ablation of atrial fibrillation
Bentall — valve prosthetic replacement of the ascending aorta
Wheat — aortic valve replacement + ascending aortic replacement
Carbrol — ascending aortic valve prosthesis (similar to Bentall procedure, but slightly different)
TAR — Total Aortic Arch Replacement
RAR — right hemiarthroplasty of the aorta
CABG — coronary artery bypass grafting
Q: I was discharged from the hospital with my wound still intact, which stitches need to be removed, when and where?
A: Because it takes about 10-14 days for the chest incision to heal, some patients will be discharged without waiting for the stitches to be removed. The stitches can be removed at the local hospital by the doctor, or at the time of stitch removal at our hospital (you need to arrive at the ward at 8:00 am).
1. The absorbable suture of each incision (a thin white or blue thread, generally visible only at the two ends of the incision with two knots exposed, the middle thread is inside the skin, so it is not visible. This line can not be removed, about 1 month after the absorption of the suture under the skin, the two ends of the two knots exposed on the outside will fall off on their own, if a month has not fallen off, you can find a doctor to remove).
2, after the drainage tube is pulled out, the original sutures (black silk threads, which must be removed, one thread for each tube mouth. The removal time is calculated from the extraction of the tube, it takes 8-10 days, can be delayed a few days, but it is best not to advance. It will lead to poor healing of the incision).
3, each incision exposed interrupted sutures, (black silk, must be removed, the removal time from the time of suture, 8-10 days, can be delayed a few days, but it is best not to advance. It will lead to poor healing of the incision).
4. Pacemaker wires (blue or red wires with a thin needle-like end, are used for temporary pacemakers and are often removed before discharge, unless under special circumstances)
Q: How long do I need to take the medication prescribed by my doctor?
A: We generally prescribe one month of oral medication for patients discharged from the hospital after surgery. However, various medical insurance, public health care, rural cooperative medical care, etc. can only prescribe one week’s worth of medication due to policy restrictions. Therefore, patients should return to our outpatient clinic when they run out of medication and decide whether they need to continue to be prescribed (those who travel far can also find a qualified hospital in their local area to review and prescribe medication).