1.How to review cardiac surgery patients after discharge? When discharged from the hospital, cardiac surgery patients should keep their discharge medical records and go to the hospital outpatient clinic for a review during the period of 3-6 months. During the review, they should pick up their medical records and the results of the tests done by other hospitals, such as electrocardiogram, X-ray chest radiographs, and laboratory tests, for reference. You can also contact the hospital by letter to find out how active you are, what kind of work and physical activities you can do, what symptoms or discomfort you have, what you eat and drink, how much you urinate every day, whether you have been to the hospital for checkups lately, and if so, please send the results of the checkups with your letter, and what kind of medications you are taking, and what the dosage and method of taking them are. After heart surgery, patients should consult a doctor for review in the following cases. (1) Infection in any part of the body. (2) Unexplained fever. (3) Significant shortness of breath and swelling. (4) When there is bleeding tendency such as subcutaneous bleeding and hematuria. (5) When new cardiac arrhythmia occurs. (6) Sudden fainting, hemiplegia or lower limb pain, pallor. 2.What special treatment should be done for valve replacement patients during surgery and delivery? During the period of anticoagulation after valve replacement, surgery may be required for trauma or other diseases, or women of childbearing age may face labor and delivery, which must be properly recognized and handled. (1) Anticoagulation and Surgery: Anticoagulation can be stopped for minor body surface surgery that is easy to pressurize for hemostasis, such as good compression after tooth extraction. For thoracic puncture, anticoagulants should also be stopped, but close observation should be made to see if there are any signs of bleeding. When deep surgical operations are carried out, as it is not easy to put pressure on the trauma, it is easy to bleed more than one, such as curettage, thoracic and abdominal surgery and some other elective surgeries, anticoagulants should be stopped for 2-3 days in advance, and anticoagulants should be reintroduced in 36-48 hours after the operation. In case of emergency surgery, vitamin K can be used, anticoagulation can be terminated immediately, and coagulation can be monitored by prothrombinogen time, these measures are determined by the doctor, but the patient must explain his/her anticoagulation situation to the medical staff. (2) Delivery and anticoagulation: It is better to avoid pregnancy for women with valve replacement. In case of pregnancy, anticoagulants during pregnancy will have some effect on the fetus, especially in the first three months, and if possible, hospitalization can be done, and heparin anticoagulation can be used instead and warfarin can be applied in the future under the supervision of the medical staff. Half a month before the expected date of delivery, you should be hospitalized, switched to heparin anticoagulation, and examined by a doctor, given medication and determined the mode of delivery. If there is not much vaginal bleeding 3 days after delivery, then start anticoagulation as appropriate. (3) Maintenance of heart function after surgery and delivery: heart function should be improved after valve replacement, only occasional shortness of breath and panic, can engage in light manual labor and normal work, is able to follow the burden of re-operation and pregnancy, delivery. If you can only live on your own, can not engage in any physical activity, a little activity that is panic and shortness of breath, indicating that the heart function is poor, there is not much compensatory capacity, you should avoid pregnancy, such as pregnancy should be aborted, otherwise the damage to cardiac function, the opposite of what is intended. Minor surgery is not a big burden on cardiac function, so don’t worry about it. In the case of emergency surgery of moderate or above, or near delivery, when the cardiac function is not well compensated, it should be handled carefully in the hospital under the close supervision of specialized doctors, so as to get through the surgery or delivery safely. In addition, when undergoing surgery or delivery, attention should be paid to choosing the appropriate anesthesia method and striving for smooth anesthesia to avoid affecting the cardiopulmonary function as much as possible. During the operation, the bleeding should be stopped carefully, and antibiotics should be used before, during and after the operation to prevent infection. 3.How to grasp the rule of anticoagulation therapy? After a mechanical valve is installed in the heart, lifelong anticoagulation is necessary. Otherwise, coagulation will occur in the valve and its vicinity resulting in blood clotting, which not only affects the opening and closing function of the valve, but also causes embolism in important organs of the body. Therefore, it is necessary to take some kind of anticoagulant after valve replacement surgery to reduce blood coagulation and prevent embolism. However, if the anticoagulant is used improperly or in excess, it can easily cause bleeding tendency. Therefore, taking anticoagulants after surgery is a long-term and meticulous task, but as long as you figure out the dosage and regularity of the medication, and master the observation method, it will naturally become a part of your daily life, and will not be a burden. (1) Routine anticoagulation therapy: Anticoagulants are applied from the 2nd day after mechanical valve replacement. The variety of medication and the method of administration are chosen and adjusted by the doctor, and the patient only needs to follow the doctor’s instructions and cooperate closely. When discharged from the hospital, the doctor will give clear instructions on the medication to be taken and the dosage, and the patient can take the maintenance dosage according to the doctor’s instructions after being discharged from the hospital. (2) Pro-measurement and adjustment of drug dosage: at the beginning of hospital discharge, the activity of prothrombin time should be checked once every 1-2 weeks, and the prothrombin time should be maintained at 1.5-2.0 times of the normal control (i.e., the normal control is 12 seconds, and it should be reached at 18-24 seconds), and if there is a bleeding tendency, it should be decreased by 1/2 or suspended for 1 day, and then half of the dosage should be taken for a review for 3-5 days. Prothrombin time or activity stabilized within a satisfactory range for 1 consecutive month, can be extended to review the prothrombin time. (3) Anticoagulation for bioprosthetic valve replacement: Anticoagulation should be performed in the early period after bioprosthetic valve replacement (3 months for sale), and prolongation of the prothrombin time by 1.5 times (18-20 seconds) is sufficient. Sometimes aspirin plus Pansentin is used instead of anticoagulants. 4.How to spend the early recuperative life safely after surgery? Recuperation is the main focus for 3 months after surgery. In 3-6 months after surgery, according to your heart function, physical strength and the nature of your work, you can consider half-day light work and half-day rest. Physical labor must be gradual, from light to heavy, and if there is no discomfort, then you can do it; if you feel tired, panicky and short of breath, then you should stop it immediately. Six months after surgery, depending on your situation, you can consider resuming full-day work, gradually to normal work. Three months after the operation is an important stage to overcome the trauma of the operation and rehabilitate your body, you should carefully recuperate and do the following: (1) According to your physical condition, you should carry out appropriate indoor and outdoor activities, according to your strength, and gradually, in order not to cause panic and shortness of breath to the extent. (2) Cold weather in winter, the slightest discomfort immediately consult a doctor. (3) Diet should be nutritious and varied, and eat more fruits if possible. (4) Maintain a happy mood and participate in recreational activities as appropriate. (5) Continue to take all kinds of medicines instructed by the doctor on time, especially digitalis preparations. (6) Three months after the operation, you should go to the hospital for a detailed examination and decide the future convalescence policy according to the result. (7) Contact the hospital by phone if you feel unwell. (8) Please take warfarin as prescribed by the doctor after the operation and keep in touch with the hospital for the rest of your life.