1 Life Care 1.1 Wound Care If the wound has healed, bathing can be started. Do not immerse the wound directly in the bathtub or swimming pool until the doctor has given permission. Do not use excessively hot water, which can cause dizziness, and avoid spraying water directly on the wound. Do not rub the wound, use neutral soap when cleaning the wound, be gentle and then gently dry the wound with a dry towel. This is also a better time to check for changes in the wound and to get in touch with your doctor if there is redness, swelling or oozing. Jia Fan, Cardiovascular Surgery Department, Baotou Central Hospital 1.2 Activity Regular exercise is an important part of maintaining a healthy life. Three months after surgery, according to the physical condition, indoor and outdoor activities are appropriate, according to the amount of strength, in order not to cause panic and shortness of breath; 3-6 months after surgery, according to the heart function, physical strength and the nature of work, half-day work; 6 months after surgery can be considered for all-day work. Physical work must be gradual, avoid strenuous activities, and those with poor heart function should follow medical advice and should not be forced. 1.3 Diet Low cholesterol, low fat and high fiber food is ideal. Cholesterol is higher in animal foods (e.g. meat, eggs and dairy products), highest in beef and pork, and lower in chicken and fish, but these foods are best baked, grilled, boiled or steamed, not fried, to prevent increased fat content. VitK-rich foods have antagonistic effects on anticoagulant drugs, which can shorten the prothrombin time and affect the anticoagulant effect of warfarin, such as spinach, tomatoes, cauliflower, fresh bowls of beans, pork liver, lean meat, fruits, etc. Therefore, long-term monotonous consumption of a certain green vegetables containing VitK, avoid overeating or excessive dieting, smoking and alcohol abuse are strictly prohibited. 1.4 Sexual life and marriage If you can climb two flights of stairs, you can also resume sexual life, but there are some things that must be noted: if you feel tired or nervous, wait until you feel more comfortable before having sex; if the position makes you have chest discomfort, then try another position; if you feel distracted before sex, you need to relax yourself, touch and hug each other more. Female patients should use contraception after marriage, the method can take contraceptive pills or apply contraceptive tools, should not use contraceptive ring, so as not to cause chronic inflammation to form lesions. Female patients with good cardiac function 1 to 2 years after surgery who require childbirth must maintain close contact with the doctor throughout the pregnancy process and receive guidance on pregnancy care and life. 2 Psychological adjustment After mechanical valve replacement, patients can smell the mechanical sound of heart valve switching in a quiet state, which is uncomfortable in the early stage and even affects sleep. They should maintain an optimistic and calm state of mind, learn to self-regulate, self-control, and self-care, do not get excited and less angry, ensure sufficient sleep, and take oral sedative-hypnotics if necessary. 3 Take anticoagulant precautions Patients with prosthetic mechanical valve replacement need to take anticoagulant drugs for life, and there is a risk of mechanical valve thrombosis causing arterial embolism when anticoagulation is insufficient, and there is a risk of bleeding when anticoagulation is excessive, so anticoagulation is a life-safety issue that must be mastered. At present, the oral drugs used for anticoagulation therapy in China are mainly coumarin-based drugs (warfarin-based). (1) During the medication period, we must carefully observe whether there are signs of bleeding, if there are black stools, hematuria, larger unexplained bruises, vomiting coffee-like substances, nosebleeds or gum bleeding, excessive menstruation in female patients, etc., we should promptly consult the doctor, review INR, and reduce the amount of anticoagulants under the guidance of the doctor. Pay attention to avoid trauma and other factors that cause bleeding in daily life, such as bleeding from skin incisions caused by shaving. (2) There are many drugs that interfere with the anticoagulant effect of warfarin. Some drugs have antagonistic effect with warfarin and shorten the time of prothrombin, such as VitK, barbiturates, estrogen, oral contraceptives, etc. Patients should be instructed to pay attention to them in their daily life to ensure safety. Some drugs have synergistic effects with warfarin to prolong the prothrombin time, such as antipyretic analgesics, chloramphenicol, broad-spectrum antibiotics, long-acting sulfonamides, salicylates, etc. Therefore, the application of other drugs during anticoagulation must be taken under the guidance of a doctor. (3) Require medication to be taken at the same time fixed every day with accurate dosage. Patients are instructed to time the alarm clock, send messages by pager, and send letters from family members to supervise, etc. so as not to forget, and if they forget to take it on one day, no additional dose should be taken the next day. (4) While taking warfarin, prothrombin time should be kept within 1.5 to 2.0 times the normal control value. The anticoagulation monitoring program requires once every 2 weeks for the first 2 months after discharge, once every 2 to 3 weeks for 2 months to 6 months, and once every 2 to 3 months after 6 months. (5) Explain to the doctor that you are taking anticoagulants in the following cases, and use antibiotics first to prevent infection as prescribed by the doctor. All dental operations: routine scaling, extractions, fillings, operations on the gums and dental bed; any major surgery; some minor operations as follows: abscess drainage, tonsillectomy, appendectomy, prostate surgery, childbirth; operations that can cause trauma to the tissues of the body: bladder examination, rectal and colon examination, etc. 4 Other medication considerations The improvement and recovery of cardiac function in patients after valve replacement requires a process, generally about 6 months, and in a few patients, more than a year. Therefore, cardiac diuretic and cardiac function support therapy should still be given six months to one year after surgery, and potassium chloride should be added at the same time. During the period of taking cardiac drug digoxin, we should closely observe whether there are symptoms of digitalis toxicity, such as loss of appetite, nausea and vomiting, headache, irritability, weakness, yellow-green vision, etc., and heart rate <70 times/min, we should stop the drug and go to the hospital in time. 5 Contact a doctor in time Pain and itching around the wound is normal, some blurring and generalized aches and pains are also normal. You should contact a doctor if the following signs and symptoms occur: severe ankle edema; pain in the calf; severe pain in the chest or wound; difficulty in breathing; exudate at the wound; headache and dizziness; temperature >37.5℃; rapid weight gain; wound dehiscence, etc. 6 To prevent accidents, carry a personal information card with you Card with the patient’s name, address, name and dose of the medication used, and the content of the heart valve replacement to facilitate resuscitation in the event of an emergency. 7 Summary Effective self-management of patients discharged from the hospital with prosthetic mechanical heart valve replacement and timely contact with the physician in case of discomfort are important for improving quality of life and preventing postoperative complications.