Post-discharge recuperation activities and review of patients
(1) Generally, patients need to rest for 3-6 months after flap replacement. During the rest period, they can take walks and perform light housework activities, and gradually increase the amount of activities to the extent that they do not feel strained.
(2) After discharge from the hospital, it is necessary to maintain a happy mood, maintain an optimistic and positive attitude and firm belief, and can participate in some relaxing recreational activities, do not be impatient and worried, so as to facilitate a faster recovery.
(3) There may be some mental and emotional changes and memory loss after extracorporeal circulation surgery, which will disappear in most patients, so there is no need to worry.
(4) Although the skin incision heals after surgery, it takes a long time for the sternum to heal (about 3-6 months), so heavy physical activities cannot be performed. As the body recovers, some patients may feel muscle tension or even pain in the neck, shoulder and chest, which will improve with functional exercise.
(5) Review at the hospital 3-6 months after discharge. At this time, the heart function gradually improves, and the post-surgical effect can be evaluated. Review at the hospital should be done promptly if you encounter the following.
① Chest pain rather than incisional pain.
②Heart rate is lower than 60 beats/min or higher than 120 beats/min.
③The presence of heart rhythm disturbances, such as frequent premature ventricular beats, paroxysmal supraventricular tachycardia, irregular heartbeat or pulse.
④Persistent high fever of 38 degrees or more, or infection.
⑤ Edema in the lower limbs, sudden weight gain, shortness of breath, panic, shortness of breath, and coughing up foamy sputum.
⑥Nausea and vomiting with no obvious cause, yellow sclera and skin staining, etc.
(7) Sudden syncope, coma, hemiparesis, aphasia or pain in the lower limbs, chills, pallor, etc.
(8) Bleeding phenomena such as subcutaneous bleeding, hematuria and black stool
(6) Prosthetic valve failure can lead to very serious consequences, the following symptoms should be promptly sought, such as 2 or more to be considered as prosthetic valve failure, if necessary, the need for valve replacement surgery.
①Progressive onset of low heart sounds and heart murmurs.
②Sudden deterioration of cardiac function that cannot be controlled by medication.
③Embolism of brain, kidney, intestine and extremities.
④Severe hyperthermia with confirmed diagnosis of infective endocarditis.
⑤The presence of hemolysis, manifested by progressive anemia and hematuria.
(6) Echocardiography demonstrates poor prosthetic valve mobility or thrombosis.
(7) When the patient has an irregular heartbeat, he should rest and go to a nearby hospital for ECG examination. If it is atrial premature beats, it can be controlled with adequate rest and cardiac stimulants such as digoxin, etc. If it is ventricular premature beats, it should be controlled with drugs as early as possible, and the cause should be actively sought to see if there is hypokalemia, hypotension, etc. to treat its root cause.
(8) For those who develop atrial fibrillation within 3 months before surgery, atrial fibrillation can be removed after surgery as long as the cardiac function is well maintained. Pre-operative atrial fibrillation is longer, and because patients are more adapted to atrial fibrillation, even if atrial fibrillation exists after surgery, it has little effect on cardiac function and can be left untreated. If atrial fibrillation is still present after cardiopulmonary diuresis and the patient is not adapted to it, the patient can be treated with drug defibrillation or electric defibrillation in the hospital six months after the operation when the cardiac function improves significantly. In cases of persistent atrial fibrillation, the heart function is poor, so do not forcefully correct the fibrillation to avoid danger, but should be treated with cardiac diuresis.
(9) Cardiac function is an indicator of the extent of the patient’s pathology. The effect of treatment can be clarified according to the changes of preoperative and postoperative cardiac function.
In conclusion, after valve replacement, although the patient’s symptoms are significantly improved, in order to maintain good cardiac function, keep the normal operation of the prosthetic valve, and prevent various post-valve replacement complications, it is necessary to insist on regular follow-up and keep in touch with the doctor to facilitate timely detection of problems and timely treatment.