Adequate rest for 3 months after surgery In general, the patient can be discharged from the hospital 1 week after the “flap replacement” surgery. After returning home, patients generally need to recuperate for 3-6 months. The 3 months after surgery is an important stage to recover from the surgical trauma and stabilize the function of the systems and organs, so the patient should get enough rest and avoid catching a cold during this period. The patient should have a regular life and should not be overworked or overexcited. Appropriate activities (such as walking, doing a little housework, etc.) are allowed, but if there is discomfort such as panic and shortness of breath during the activities, the patient should rest immediately and reduce the amount of activities appropriately. Generally speaking, the patient can take a shower 2 weeks after the operation when the incision is healing well. When bathing, care should be taken to avoid getting cold and not to rub the wound, and the wound should be cleaned with disinfectant after bathing. If abnormal symptoms such as oozing, redness and swelling of the incision are found, 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 for 3 months after surgery. 3~6 months after surgery Gradually return to normal If the recovery is smooth and no complications occur, the patient can gradually increase the amount of activities (to the extent of “no panic and shortness of breath”) from 3 months after surgery until gradually return to normal work and life. During the rehabilitation process, patients should always maintain a happy mood and optimistic, positive attitude, do not be impatient, and do not worry too much. At the same time, do not increase the activity or workload violently on the spur of the moment or in a hurry, so as not to cause damage to cardiac function. After discharge from the hospital, patients can gradually resume a normal diet according to their personal dietary habits and enhance nutrition appropriately to promote wound healing. Of course, “strengthening nutrition” does not mean eating delicious food or tonic every day, but eating more nutritious and easily digestible food, such as lean meat, fish, eggs, fruits and seasonal vegetables. Patients with “valve replacement” generally have no special contraindications, but because some foods (such as spinach, tomatoes, pork liver, etc.) are rich in vitamin K, which may interfere with anticoagulation therapy, should be avoided in large quantities. In addition, to avoid increasing the burden on the heart, patients should not eat foods that are too salty and should never abuse alcohol or smoke. Patients with poor heart function should also limit the amount of water they drink and not eat large amounts of thin rice and soups. Take the medication as prescribed by the doctor and do not stop taking it without permission. Since most patients with “valve replacement” have some degree of cardiac impairment, surgery is undoubtedly a heavy “blow” to their fragile hearts. To protect and improve cardiac function, patients should not stop taking their medications suddenly after surgery, but should take them strictly according to medical advice. Patients should also pay close attention to changes in their urine output, observe whether they have edema or a feeling of heaviness in their limbs, and monitor their pulse. Generally speaking, the patient should take the medication for 3 months after surgery, after which the dosage can be gradually reduced under the guidance of the doctor according to the review. Before stopping the medication, the patient must go to the hospital for a review, and must not stop the medication without permission. Adherence to anticoagulation therapy There are two main types of prosthetic valves, one is a biological valve and the other is a mechanical valve. Because the prosthetic valve is a “foreign body” to the heart, blood can easily clot on the prosthetic valve, which can lead to thromboembolism (e.g., cerebral infarction) or prosthetic valve dysfunction. Therefore, all “valve replacement” patients require anticoagulation therapy. In general, patients with bioprosthetic valves require oral warfarin for 6 months, after which the drug can be tapered. Patients with mechanical valves and those with atrial fibrillation require lifelong anticoagulation (warfarin). Anticoagulation after “valve replacement” is a long-term and delicate task. Improper anticoagulation can lead to thromboembolism (under-anticoagulation) or bleeding (over-anticoagulation), which can be life-threatening. Patients taking warfarin should visit the hospital regularly to check their coagulation parameters. Usually, anticoagulation therapy should be started the day after surgery. The doctor will give the patient a dose of warfarin based on the prothrombin time measured each day. At the time of discharge, the doctor will clearly inform the patient how large a dose of warfarin is required each day. After discharge, the prothrombin time will continue to change as the amount and structure of the patient’s diet changes. Therefore, patients should have their prothrombin time rechecked regularly after discharge. During the first two months, the patient should be rechecked every 1 to 2 weeks. If the prothrombin time is stable, it can be extended to once a month. If the prothrombin time is stable for one year, the interval between reviews can be extended, but not longer than 2 months. Patients should also pay attention to whether they have gum bleeding, nose bleeding, skin bruising, increased menstruation, etc. during the medication period, and if so, they should also seek medical attention. It is important to note that some drugs can affect the efficacy of anticoagulant drugs and should be avoided at the same time. If necessary, the dose of anticoagulant drugs should be adjusted promptly. For example, indomethacin (anti-inflammatory pain), aspirin, metronidazole, sulfonamides will enhance the anticoagulant effect, vitamin K, phenobarbital, meprobamate (Meprobamate), birth control pills and hormonal drugs will reduce the anticoagulant effect. In addition, if the patient is combined with hepatobiliary disorders and heart failure, the body’s production and secretion of vitamin K will reduce the role of anticoagulants will be enhanced, and the dose of anticoagulants should be reduced as appropriate.