After successful prosthetic valve replacement surgery, patients must pay attention to the following important issues in order to maintain a good quality of life and avoid various adverse complications. 1, life and diet Life should be regular, and ensure adequate sleep. The home environment should be clean and hygienic, and windows should be opened and ventilated frequently to maintain the appropriate temperature and humidity of the living environment. Within 2 weeks after surgery, do not take a bath, but take a shower or wipe your body. Do not carry heavy objects for 3 months after surgery to avoid adverse effects on the healing of the sternum. Do not sleep on your side for 3 months after surgery, as the sternum has not yet healed completely and is prone to misalignment. In the early postoperative period, friends and relatives should be declined to visit the patient at home, which will lead to both patient fatigue and cross-infection; and should not go to crowded public places to prevent infection diseases. Neither stay in bed all day nor overexert yourself. Maintain appropriate activities and perform appropriate physical activities according to their own heart function status. Most patients after valve replacement can usually return to work in 3 to 6 months, but the workload should be gradually increased. Recurrent cardiac function should be rested promptly. In the early postoperative period, adequate protein and caloric intake should be maintained to facilitate the body’s recovery from the major surgical trauma. In the later stages, while paying attention to food nutrition, arrangements should be made according to their own conditions and based on the principles of hygiene, health and reasonableness. In case of patients with cardiac insufficiency, the intake of water and salt in the diet should be controlled to avoid further increasing the burden on the heart. Patients are advised to eat small and frequent meals and not to overeat again in a short period of time, which will lead to excessive weight gain and increase the burden on the heart. 2. Outpatient follow-up After discharge, patients should usually visit the hospital for regular monthly checkups for six months at the beginning to understand the anticoagulation and cardiac function status. Then, the follow-up period will be gradually extended according to the physical condition. You should visit the hospital as soon as possible if you have the following conditions: inability to lie down at night, shortness of breath and cough; low urine, abdominal distention, lower limb edema; frequent premature beats and tachycardia. Three to six months after discharge from the hospital, a comprehensive physical examination should be performed, including echocardiography, chest X-ray and electrocardiogram, after which the examination should be repeated more than once a year. In the early postoperative period, the patient’s cardiac function is still unstable, and he should continue to take cardiac drugs and diuretics under the guidance of the outpatient physician. Later, as the patient’s cardiac function gradually improves, the amount of medication can be gradually reduced and discontinued, but do not stop or increase or decrease the amount of medication at your own discretion. 3.Anticoagulation Patients who undergo heart valve replacement need oral warfarin anticoagulation after surgery. Patients with biologic valves (not combined with atrial fibrillation) are usually anticoagulated for 3-6 months, while those with mechanical valves require lifelong anticoagulation. The index for monitoring anticoagulation is prothrombin time, and PT is standardized to obtain an international normalized ratio. When the INR value is less than 1.8, the dosage should be increased; when the INR value is greater than 2.5, the dosage should be reduced; when the INR value is greater than 3.0, stop taking warfarin for one time, go to the hospital the next day for blood test and recheck, and adjust the dosage according to the laboratory results, or be guided by the doctor to use the drug. In the first month after surgery, it is recommended to check the anticoagulation index once a week; after stabilization, it will be changed to once a month. A balanced diet should be consumed to eliminate the effects of eating certain types of food for a long time on anticoagulation. When visiting the doctor for other medical conditions, remind the doctor that you are an anticoagulated patient so that he or she does not prescribe medication that affects anticoagulation. When taking over-the-counter medications, also read the medication instructions carefully to avoid adverse effects on anticoagulation. Each dose of warfarin should be recorded, and the record should include the date, dose and laboratory results, so that it is easy for you to find the dosing pattern, and it is convenient for the doctor to guide the dosing accordingly when you visit the doctor. In the anticoagulation, if there is a large subcutaneous bruising, hematuria or oral bleeding, you should seek medical attention. 4. Pregnancy and childbirth Women of childbearing age who have had their mechanical valves replaced face greater risks during pregnancy and childbirth than normal mothers because they need to take warfarin anticoagulation for life. Warfarin can cause warfarin syndrome in 5% to 10% of fetuses at 6 to 12 weeks of gestation, and after 36 weeks of gestation, it can cause bleeding tendency in both the mother and the fetus. For this reason, women who have a request for valve replacement need to receive guidance from an experienced physician at a large obstetrics and gynecology center or general hospital. In general, pregnant women taking warfarin doses greater than 5 mg/day have a higher risk of warfarin syndrome in the fetus and are treated with heparin replacement therapy during the first 12 and after 36 weeks of pregnancy; pregnant women taking warfarin doses less than 5 mg/day have a low risk of this syndrome in the fetus and require heparin replacement only after 36 weeks. Although, there is no shortage of examples of women with mechanical valve replacement who have given birth to healthy babies, the risks that mothers and infants need to face throughout the maternity process should be a prudent concern for every patient and her family who expects to become a mother. 5. Endocarditis In patients with valve replacement when bacteria invade the organism, the bacteria can easily reach and plant themselves in the prosthetic material of the replacement valve with the blood circulation. Because the artificial material has no blood vessels to grow, antibacterial drugs do not easily reach it, causing bacteria to multiply and causing endocarditis. Bacteria form superfluous organ shedding, which can cause ischemia in the organs at the embolization site, such as blockage in the cerebral vessels, which can lead to brain infarction or abscess; bacteria destroy the heart tissue, which can cause perivalvular abscess and perivalvular leakage; and destroy the conduction tissue, which can cause heart conduction block. Therefore, once prosthetic valve endocarditis occurs, it is very difficult to treat and has a high mortality rate. Therefore, patients with valve replacement should have their skin wounds cleaned and disinfected promptly to avoid septic inflammation. Oral inflammation and dental caries should be treated promptly by a doctor. Once an infectious lesion occurs, while dealing with the lesion, sensitive antibiotics should be selected for adequate amount and duration of treatment to prevent local inflammation from evolving into endocarditis to the greatest extent possible, causing therapeutic difficulties. 6. Need for other surgeries When patients with valve replacement need to undergo other larger surgeries, anticoagulants can cause an increased risk of intraoperative and postoperative bleeding. In this case, warfarin can be discontinued 3 days before surgery and replaced with low-molecular heparin 5000 U subcutaneously 2 times/day. Discontinue low molecular heparin 12 hours before surgery, and continue heparin anticoagulation while taking warfarin 5mg/day when little bleeding is observed after surgery, and discontinue heparin after 2 days of overlap, continue warfarin anticoagulation and adjust warfarin dosage according to INR value. 7.Some special examinations Postoperative computed tomography scans are feasible in patients with flap replacement, but because medical suture wire is used to suture the sternum and the mechanical flap has a metal component, MRI cannot be performed.