Dear patient, we are Dr. Zhu Yan, the deputy chief physician in charge of you. You will be admitted to our department after a period of medication in preparation for your upcoming surgery, so here are just a few notes about what to expect before the surgery. We will send you similar information about the surgery and the post-surgery period in due course. 1. You must give a truthful answer and medical history. You must not conceal important past treatments or medications. In particular, if you have hypertension or diabetes, you must tell us about the sandwich, the course and the current medication. In addition, you must tell us about the history of drug allergy, otherwise you will be at risk if the above diseases are not diagnosed during the perioperative period. 2.About coronary angiography If you are over 50 years old, you must have a coronary angiography before surgery in order to determine whether you also have coronary heart disease. If you have combined coronary artery disease, you will have to undergo coronary artery bypass surgery at the same time as the n replacement surgery. This is to prevent you from having a coronary artery bypass surgery after a recent valve surgery. The time of the examination is when you have completed all tests, have no significant abnormalities in the laboratory tests, can lie down, can tolerate the angiography, and have no clear symptoms such as heart failure. Coronary angiography is performed in the catheterization laboratory of the Department of Cardiology. However, you do not need to worry about these things, we have a good idea of your condition and will arrange it for you, all you have to do is rest well. 3.About the operation time Every patient wants to come to the operation, but in fact, the operation is only one part of a series of treatment. The whole treatment process includes preoperative examination, clear diagnosis, preoperative medication to adjust the heart function, surgery, postoperative monitoring, postoperative continued treatment and other major steps. Among them, preoperative medication adjustment is very important. During the years of your illness, your heart has been working for you in a pathological state, and it is still unknown whether its energy reserves, edema level, contraction strength can be restored and whether it can withstand the surgical blows. In addition, the surgery has an impact on your entire body. The liver and kidneys must also be adjusted to work well now that you are having surgery, and if any of these organs strike after surgery, you are paying the price of your life. Pre-operative poor heart function will increase your post-operative treatment time in the ward, pre-operative less adjustment for a day, after surgery may have to stay in the ward for several more days — the cost of the ward for a day is nearly 10,000 yuan; and the purpose of your visit must be a better life, not just surgery, as doctors we also want to ensure the safety of surgery, so you must not be in a hurry. 4, about pre-operative medication Patients are generally admitted to the hospital with varying degrees of cardiac insufficiency; in addition, cardiac surgery requires intraoperative cardiac arrest, myocardial incision and suture operation, which itself can cause damage to the heart function, so pre-operative medication such as infusions are often required. Specific treatment measures include correcting cardiac and pulmonary insufficiency, improving liver and kidney function, enhancing myocardial nutrition, improving coagulation status, and making necessary drug preparations for surgery. Completion of preoperative adjustments generally takes about 3-20 days depending on the patient’s cardiac function. The preoperative patient’s medication is selected from a large number of drugs, and is considered as comprehensively as possible, based on the principle of doing more with less. However, there will still be some discomfort during the treatment, such as painful infusion, nausea and anorexia. These symptoms are normal and are the body’s normal reaction to the drugs. They are usually within the patient’s tolerance range. If you feel that the reaction is too strong to be tolerated, please let us know when we check in and we will stop the medication for you. However, stopping the medication may have an effect on the treatment effect. 5. About diet and night rest Due to the special nature of heart disease, you should not drink a lot of water during the whole hospitalization period, including daily water, soup, porridge and various drinks. It is also not advocated to eat a lot of various fruits, especially watermelon. A more appropriate approach is to make sure that you are not thirsty. But you can drink some milk every day. We ask that family members be advised to prepare a book to record the patient’s daily urine volume and time for reference. We ask about urine volume every day when we check in. Patients who smoke should stop smoking as early as possible before surgery. Patients often have poor rest at night and cannot sleep. Patients can ask the nurse on duty for “sleeping pills” before going to bed. It is the duty of the nurse on duty to bring it to you after reflecting to the doctor on duty. 6.Pre-operative preparation The patient’s examination results have been returned, the diagnosis is clear, and the function of the heart and important organs has improved. The department will conduct a detailed pre-operative discussion of your admission data, assess the risks of surgery, formulate a surgical plan, and determine the date of surgery. After the surgery date is set, the treating physician will make an appointment to have a preoperative conversation with the patient and family, including details of the surgery and expected outcomes. The anesthesiologist will explain the role of anesthesia and the expected results, and the nurse will give nursing instructions and tell you how to breathe deeply and other exercises after the surgery. The patient and family are required to sign a document such as an informed consent for the surgery, including possible complications, accidents and risk factors during and after the surgery, which must be signed by the patient and family. This document is legally binding and indicates that the patient agrees to the procedure and assumes the risks associated with the procedure. In addition, a series of preoperative preparations such as enemas, antibiotic testing, and skin preparation are performed. To reduce the risk of infection, the skin incision site is debrided and washed, and personal items such as glasses, dentures, watches, jewelry, money or clothing must be given to the family before entering the operating room. Family members should wait in a specific place during the surgery to avoid disturbing the medical staff. We will take you about intraoperative and postoperative precautions before the surgery. Any questions can be asked to me when I check in. 7. About blood for surgery It is well known that the blood supply is currently tight throughout the country, so hospitals may ask relatives and friends of patients coming to the hospital for surgery to donate blood. Our hospital has high requirements for incoming blood for medical use. High blood pressure, lesbians on their period, colds, advanced age, after drinking alcohol or even eating too greasy in the morning will be refused to donate blood. Therefore, please pay attention to the above points for those who have the intention of blood donation and just eat some light food in the morning when you come to donate blood. 8. Surgical situation After entering the operating room, several monitoring devices will be placed on the patient’s hands and legs. Cannula needles will be placed at the arteries and veins. Since anesthesia puts the patient to sleep, the procedure is painless and the patient has no memory of the surgery. An extracorporeal circulation device replaces the pumping function of the heart and the breathing function of the lungs, temporarily stopping the heart so that the surgeon can replace or repair the heart valve. A typical valve replacement procedure takes about 4-5 hours, after which a cardiac surgeon and an anesthesiologist will escort the patient back to the monitoring unit. Patients are usually awake from anesthesia about 3-5 hours after surgery. The tracheal tube is usually removed the same or next day after surgery. The patient is usually kept in the care unit for 2-3 days and can be transferred to the general ward if all vital indicators are stable and there are no specific complications.