Heart valve replacement is the primary treatment for moderately advanced rheumatic heart disease. The procedure involves removing the patient’s own diseased valve and replacing it with an artificially created valve to achieve a cure. Thousands of patients around the world undergo this procedure every year. Is it true that after the surgery the patient is off guard and can rest easy? The author reminds people that although surgery can restore good cardiac function in most patients, it does not mean that the alarm can be lifted. For patients with longer disease duration and poor preoperative cardiac function, the maintenance of cardiac function after surgery has just begun. Note 1: Monitor anticoagulant dosing Most of the prosthetic heart valves currently used are both mechanical and biological valves. Biological valves are made from materials such as pericardium of pigs and cattle after treatment. The advantage is that they are less likely to induce thrombosis and can be treated with postoperative anticoagulation for 3 months. The disadvantage is that the life span is short, lasting only about 10 years. Mechanical flaps are durable and can last for decades. The disadvantage is that after valve replacement, patients need to take anticoagulants for life to prevent thrombosis in the heart. Mechanical valves are mostly used in China. There are two main types of anticoagulation accidents in patients with valve replacement: first, insufficient anticoagulant dosage causes cerebral embolism, myocardial infarction, and arterial embolism of the extremities. The second is excessive anticoagulation causing cerebral hemorrhage, blood in the urine, blood in the stool, and subcutaneous bleeding of the extremities. To prevent these accidents, it is necessary to follow medical advice, check the prothrombin time every 2 to 4 weeks within six months after discharge (every 1 to 3 months after six months), and always keep the inr (international normalized ratio of prothrombin time) at 2.5 to 3.5. If symptoms such as syncope, weakness of one limb or subcutaneous bleeding occur during the medication period, the inr should be checked promptly and the amount of anticoagulant should be adjusted. It should also be noted in life that some drugs and foods can affect the efficacy of anticoagulants. For example, aspirin, anti-inflammatory pain, fenbid, pansentin, antibiotics and purgative herbs can enhance the effect of anticoagulants. Animal liver and green leafy vegetables such as spinach, as well as vitamin K, hemostatic minerals and other drugs can weaken the efficacy of anticoagulants. So, eat less animal offal when using medication and don’t overdo it by eating green leafy vegetables. Note 2: Maintenance of heart function Within 3 months after surgery, it is the main stage of patient’s recovery. During the bed rest period, the patient should turn over on time and spit more often. When sputum is being released, the patient can press the wound with his hand and take a deep breath to release the sputum deep in the trachea at once. After getting out of bed, the patient can take a slow walk according to the doctor’s suggestion, from indoor to outdoor, gradually. 3 months later, the amount of activity will be increased appropriately according to the heart function, but slow exercises such as walking and tai chi should still be the main focus. Six months after surgery, you can resume general work, and stop if you feel strained or short of breath. Women of childbearing age should avoid pregnancy for 3 years and wait until the heart function is fully recovered. Maintaining good heart function is highly related to the appropriate amount of activity of the patient. The following formula can be used to calculate the optimal heart rate of the patient during postoperative exercise: (170 – age) × 80% to the extent that the patient does not experience fatigue and panic symptoms, and should not be forced. If there are symptoms of cardiac insufficiency, it is also necessary to reduce the amount of activity on this basis and to ensure sufficient sleep. Sleep is the best rest for the heart. Patients should take digoxin for six months to one year after discharge from the hospital according to medical advice, usually one tablet (25 mg) daily. It should also be reviewed at the hospital once in six months to one year after surgery. In addition, patients after heart valve replacement should pay attention to self-monitoring of heart function throughout their lives. The early symptoms of cardiac insufficiency are chest tightness, panic, shortness of breath and weakness after activity, while the late symptoms are paroxysmal dyspnea at night and swelling of lower limbs. It should be noted that early symptoms of cardiac insufficiency are often confused with the symptoms of myocardial ischemia that are easily seen in menopausal female patients, which can be easily missed and misdiagnosed. The next thing to note is the presence of severe arrhythmias. If the patient feels palpitations, dizziness or syncope after the operation, he/she should go to the hospital promptly.