Xiao Tu’s father had a mitral valve replacement surgery in the hospital for “rheumatic heart disease and mitral stenosis”. Under the careful treatment and care of medical staff, the old man recovered quickly, and can be discharged from the hospital in the near future. Xiaotu happy, but also a little worried: father did so big heart surgery, but also replaced with artificial heart valves, home after what need to pay attention to? What are the dietary precautions? What kind of medicine do I need to take? Doctor’s advice: for patients with heart valve disease, do “valve” surgery can effectively improve heart function, improve the quality of life. However, surgery is only the first step in the treatment, patients need to strictly follow the 6 precautions after the operation, in order to consolidate the effect of the operation, to avoid the occurrence of various complications. First, 3 months after the operation, adequate rest Normally, “valve” 1 week after the operation, the patient can be discharged from the hospital. After returning home, patients generally need to recuperate for 3 to 6 months. Within 3 months after surgery (“early postoperative period”) is an important stage to recover from the trauma of surgery and stabilize the function of various systems and organs, patients should have sufficient rest and avoid catching a cold during this period. Life should be regular and patients should not be overly tired or excited. Appropriate activities (e.g. walking, doing a little housework, etc.) can be done, but if there is any discomfort such as panic or shortness of breath, the patient should take a rest immediately and reduce the amount of activities appropriately. Generally speaking, the patient can take a shower 2 weeks after the operation. When taking a shower, care should be taken to avoid getting cold and do not rub the wound, and the wound should be cleaned with antiseptic solution after taking a shower. If abnormal symptoms such as oozing, redness and swelling are found in the incision, the patient should go to the hospital immediately. Since the healing time of the sternum is usually about 3 months, patients should avoid chest expansion exercises, lifting heavy objects or holding children in the early postoperative period. In addition, patients should not drive within 3 months after surgery. Second, 3~6 months after surgery, gradually return to normal If the recovery is smooth and no complication occurs, the patient can gradually increase the amount of activity (to the extent of “no panic, shortness of breath”) from 3 months after surgery, until gradually return to normal working and living conditions. During the recovery process, patients should always maintain a happy mood and optimistic, positive attitude, do not be impatient, do not worry too much. At the same time, do not because of a whim or eager to achieve, violently increase the amount of activity or workload, so as not to cause damage to cardiac function. Third, eat a light diet, quit smoking and drinking After discharge, the patient can gradually resume a normal diet according to personal eating habits, and strengthen nutrition to promote wound healing. Of course, “strengthen nutrition” does not mean that every day to eat delicacies or eat wild supplements, but to eat more nutritious, easy to digest food, such as lean meat, fish, eggs, fruits and seasonal vegetables. “Valve” patients generally have no special contraindications, but because some foods (such as spinach, tomatoes, fresh peas, liver, etc.) rich in vitamin K, may interfere with anticoagulant therapy, so should be avoided in large quantities. In addition, in order to avoid aggravating the burden on the heart, patients should not eat too salty food, and should never abuse alcohol or smoke. Patients with poor heart function should also limit the amount of water, do not eat a lot of rice and soup. Fourth, follow the doctor’s instructions to take medication, do not stop taking medication without authorization Because most of the “valve” patients have a certain degree of cardiac function damage, and the operation of its fragile heart, is undoubtedly a heavy “blow”. In order to protect and improve cardiac function, patients should not suddenly stop taking medication after surgery, and should strictly follow the doctor’s instructions to take digoxin, tachycardia, amphotericin, cardiac pain and other cardiac, diuretic, vasodilator drugs. At the same time, the patient should also pay close attention to the change of their own urine output, observe whether there is edema or limb heaviness, but also to monitor their own pulse, if the pulse is less than 60 beats per minute, should be suspended to take digoxin. Generally speaking, patients need to take the drug for 3 months after the operation, and then the dosage can be gradually reduced under the guidance of the doctor according to the review situation. Before stopping the medication, the patient must go to the hospital for review and must not stop the medication without authorization. Fifth, adhere to anticoagulation therapy, monitoring coagulation indexes, there are two kinds of prosthetic valves, one is a biological valve, and the other is a mechanical valve. As artificial valves are a kind of “foreign object” to the heart, blood is easy to coagulate on artificial valves, which may lead to thromboembolism (e.g. cerebral infarction) or artificial valve dysfunction. Therefore, all “valve replacement” patients require anticoagulation. In general, patients with biologic valves take oral aspirin and clopidogrel for 6 months, after which the drugs can be gradually discontinued. Patients with mechanical valves, as well as those with atrial fibrillation, require lifelong anticoagulation (warfarin). Anticoagulation after “valve replacement” is crucial and is a long-term and delicate task. Inadequate anticoagulation can lead to thromboembolism (insufficient anticoagulation) or bleeding tendency (excessive anticoagulation), which can be life-threatening. Patients taking Warfarin should go to the hospital regularly to check the coagulation index. If the internationalized ratio (INR) of prothrombin time is between 2 and 3, it means that the dosage is appropriate; if the INR is less than 2, it means that the dosage is insufficient and needs to be increased; if the INR is more than 3, it means that the dosage is too large and needs to be reduced. Normally, anticoagulation therapy should be started the day after surgery. The doctor will give the patient a certain dose of Warfarin according to the results of the prothrombin time measured every day. Upon discharge from the hospital, the doctor will tell the patient exactly how much Warfarin he or she needs to take each day. After discharge from the hospital, the prothrombin time will continue to change as the patient’s dietary intake and dietary structure change. Therefore, patients should have their prothrombin time rechecked regularly after discharge. During the first two months, patients should be rechecked every 1 to 2 weeks. If the INR is stable, this can be extended to monthly. If the INR is stable for one consecutive year, the interval between reviews can be further extended, but not longer than 2 months. During the medication period, patients should also pay attention to whether they have bleeding gums, nosebleeds, skin ecchymosis, increased menstruation, etc. If so, they should also consult a doctor promptly. It should be reminded that some drugs will affect the efficacy of anticoagulant drugs, and should be avoided at the same time. If they must be used, the dosage of anticoagulants should be adjusted promptly. For example, anti-inflammatory pain, aspirin, methotrexate, sulfonamides will enhance the anticoagulant effect, vitamin K, phenobarbital, sleeper, birth control pills and hormonal drugs will reduce the anticoagulant effect. In addition, if the patient is combined with liver and gallbladder diseases and heart failure, the production and secretion of vitamin K in the body will be reduced, and the effect of anticoagulants will be enhanced, and the dosage of anticoagulants should also be reduced as appropriate. Sixth, pay attention to the recovery status, regular follow-up in the hospital, “valve” after surgery, the patient should go to the hospital on a regular basis to review, so that the doctor timely understanding of the recovery situation, adjust the treatment program. It should be reminded that patients must keep the discharge summary after discharge. When reviewing, patients should bring along the discharge summary and various examination reports, such as X-ray chest radiographs, electrocardiograms, laboratory tests and so on. At the same time, the patient should also give the doctor a detailed introduction of their own recovery, such as the current level of activity (such as can go up a few floors, can walk a few kilometers, etc.), can engage in what kind of work and physical activities, usually have any discomfort symptoms, how to eat and drink, how much urine per day, whether they have gone to the hospital for examination recently, the results of the examination, what kind of medication they are taking, how to take the dosage and how to take it, etc., in order to enable the doctor to This will allow the doctor to fully assess the current stage of the disease and guide the next step of treatment. Generally speaking, half a year, one year and every year after the operation, the patient needs to review the echocardiogram, in order to understand the degree of recovery of cardiac function and the functional status of the prosthetic valve. Special reminder: 8 signs of exacerbation 1. Infection in any part of the body. 2. Unexplained fever; 3. Sudden onset of shortness of breath, or obvious panic, shortness of breath, or frothy bloody sputum. 4, Sudden weight gain, edema, or swollen ankles. 5, Bleeding symptoms such as subcutaneous bleeding and hematuria. 6.Yellow staining of the sclera and peripheral skin. 7, Occurrence of new cardiac arrhythmia. 8, Sudden numbness of the face, temporary blindness or loss of vision in one eye, numbness and dyskinesia of one side of the limb, sudden fainting, limb pain, cyanosis and pallor. It should also be noted that our country is one of the countries with a high incidence of rheumatic heart disease, with many new patients every year. This disease often involves the heart valves and impairs the heart function, and as the disease progresses, the condition will gradually worsen, and eventually and inevitably make the patient incapable of labor or even endanger his life. Therefore, once it is clear that there is a problem with a heart valve, surgery should be performed as soon as possible before the heart’s function is seriously harmed, and medication alone cannot solve the fundamental problem. Currently, valve replacement surgery has become very mature, with a success rate of more than 98%, so it is a safe surgery. Of course, it is better to go to a major hospital or heart center that has extensive experience in cardiac surgery.