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Aortic Valve Replacement: Before Your Surgery

Picture of mechanical and tissue valves and where they fit in the heart

What is aortic valve replacement surgery?

Aortic valve replacement gives you a new aortic heart valve. The new valve may be mechanical or made of animal tissue. You and your doctor can decide before surgery which type of valve is best for you.

The aortic valve opens and closes to keep blood flowing in the proper direction through your heart. When the aortic valve does not close properly (aortic valve regurgitation) or is very tight and narrow (aortic valve stenosis), blood does not flow through the heart the right way.

You will be asleep during the surgery. In an open-chest surgery, your doctor will make a cut in the skin over your breastbone (sternum). This cut is called an incision. Then the doctor will cut through your sternum to reach your heart. In a less invasive surgery, your doctor will make a cut between your ribs. Your sternum is not cut.

The doctor will connect you to a heart-lung bypass machine, which is used to add oxygen to your blood and move the blood through your body. This machine will allow the doctor to stop your heartbeat and replace the valve.

After the doctor has replaced your aortic valve, he or she will restart your heartbeat. Then the doctor may use wire to put your sternum back together. Your incision will be closed with stitches or staples. The wire will stay in your chest. The incision will leave a scar that may fade with time.

You may stay in the hospital for 3 to 8 days after surgery.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
Understand exactly what surgery is planned, along with the risks, benefits, and other options.
If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
Tell your doctor ALL the medicines and natural health products you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

Having surgery can be stressful. This information will help you understand what you can expect and how to safely prepare for surgery.

What happens on the day of surgery?

Follow the instructions exactly about when to stop eating and drinking, or your surgery may be cancelled. If your doctor has instructed you to take your medicines on the day of surgery, please do so using only a sip of water.
Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
Do NOT shave the surgical site yourself.
Remove all jewellery, piercings, and contact lenses.
Leave your valuables at home.

At the hospital or surgery centre

Bring a picture ID.
Before surgery you will be asked to repeat your full name, what surgery you are having, and what part of your body is being operated on. The area for surgery may be marked.
A small tube (IV) will be placed in a vein, to give you fluids and medicine to help you relax. Because of the combination of medicines given to keep you comfortable, you may not remember much about the operating room.
You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
The surgery will take about 3 to 5 hours.

After surgery

You will go to the intensive care unit (ICU) right after surgery. You will probably stay in the ICU for 1 or 2 days before you go to your regular hospital room.
You will have a breathing tube down your throat. This is usually removed within 6 hours after surgery. You will not be able to talk or drink liquids while the tube is in your throat. After the tube is removed, your throat will feel dry and scratchy. Your nurse will tell you when it is safe to drink liquids again.
As you wake up in the ICU, the nurse will check to be sure you are stable and comfortable. It is important for you to tell your doctor and nurse how you feel and ask questions about any concerns you may have.
You will have a thin plastic tube, called a catheter, in a vein in your neck. It is used to keep track of how well your heart is working. This is usually removed in 1 to 3 days.
You will have chest tubes to drain fluid and blood after surgery. The fluid and extra blood are normal and usually last for only a few days. The chest tubes are usually removed in 1 or 2 days.
You will have several thin wires coming out of your chest near your incision. These wires can help keep your heartbeat steady after surgery. They will be removed before you go home.

Going home

Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, cardiac rehab, driving, and getting back to your normal routine.

When should you call your doctor?

You have questions or concerns.
You don't understand how to prepare for your surgery.
You become ill before the surgery (such as fever, flu, or a cold).
You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.