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| {{Aortic insufficiency}} | | __NOTOC__ |
| | {{Aortic insufficiency surgery}} |
| '''For the WikiPatient page for this topic, click [[Aortic valve surgery (patient information)|here]]'''; '''For the main page of aortic insufficiency, click [[Aortic insufficiency|here]]''' | | '''For the WikiPatient page for this topic, click [[Aortic valve surgery (patient information)|here]]'''; '''For the main page of aortic insufficiency, click [[Aortic insufficiency|here]]''' |
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| {{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}, [[Varun Kumar]], M.B.B.S., [[Lakshmi Gopalakrishnan]], M.B.B.S., [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]][mailto:msbeih@perfuse.org] | | {{CMG}}; '''Associate Editor-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]][mailto:msbeih@wikidoc.org]; [[Varun Kumar]], M.B.B.S., [[Lakshmi Gopalakrishnan]], M.B.B.S; {{USAMA}} |
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| '''Related Key Words and Synonyms:''' Aortic valve replacement. | | '''Related Key Words and Synonyms:''' Aortic valve replacement. |
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| ==[[Aortic insufficiency surgery preoperative evaluation|Preoperative Evaluation]]== | | ==[[Aortic insufficiency surgery preoperative evaluation|Preoperative Evaluation]]== |
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| | ==[[Aortic insufficiency surgery valve selection|Valve Selection]]== |
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| ==[[Aortic insufficiency surgery procedure|Procedure]]== | | ==[[Aortic insufficiency surgery procedure|Procedure]]== |
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| ==[[Aortic insufficiency surgery recovery|Recovery]]== | | ==[[Aortic insufficiency surgery recovery|Recovery]]== |
| ===Recovery===
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| '''Recovery at Hospital'''
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| The patient may spend 4 to 7 days in the hospital after surgery (much less in Minimally invasive mitral valve surgery-3 to 5 days). Then patient will wake up in the[[intensive care unit]] (ICU) and recover there for 1 or 2 days. Two to three tubes will be in the patient's chest to [[drain]] fluid from around the heart. They are usually removed 1 to 3 days after surgery.
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| The patient may have a [[catheter]] in the bladder to drain urine, and may also have intravenous lines to get fluids. Nurses will closely watch monitors that show information about the [[vital signs]] (pulse, temperature, and breathing).
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| The patient will be moved to a regular hospital room from the ICU. The nurses and doctors will continue to monitor the heart and vital signs until the patient is stable enough to go home. The patient will receive pain medicine to control pain around the surgical incision site.
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| A nurse should help the patient to slowly resume some activity, and the patient should begin a physical therapy program to make the heart and body stronger.
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| A temporary [[pacemaker]] may be placed in the patient's heart if the heart rate becomes too slow after surgery.
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| '''Recovery at Home'''
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| The patient should be informed about the following:
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| *Taking care for his or her healing incisions.
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| *Recognizing signs of infection or other complications.
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| *Coping with after-effects of surgery.
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| *Followup appointments, medicines, and situations when he or she should call the doctor right away.
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| *When he or she can go back to daily routine, such as working, driving, and physical activity.
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| After-effects of heart surgery are normal. They may include muscle pain, chest pain, or swelling.
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| Other after-effects may include loss of appetite, problems sleeping, constipation, and mood swings and [[depression]]. After-effects usually go away over time.
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| Less recovery time is needed for off-pump heart surgery and [[minimally invasive]] heart surgery.
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| '''Ongoing Care'''
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| Ongoing care after valve surgery may include periodic checkups with the doctor. During these visits, the patient may have blood tests, an [[EKG]] (electrocardiogram),[[echocardiography]], or a [[stress test]]. These tests will show how the patient's heart is working after the surgery.
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| Routine tests should be done to make sure the patient is getting the right amount of the blood-thinning medicine in case of mechanical valve placement.
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| The patient may be advised to change his or her lifestyle, this includes: quitting smoking, making changes to diet, being physically active, and reducing and managing stress.
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| ==[[Aortic insufficiency surgery prognosis|Outcomes & Prognosis]]== | | ==[[Aortic insufficiency surgery prognosis|Outcomes & Prognosis]]== |
| ===Outcomes and Prognosis===
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| Most valve surgery operations are successful. In some rare cases, a valve repair may fail and another operation may be needed.
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| The risk of death or serious complications from isolated aortic valve replacement is typically quoted as being between 1-3% of cases, depending on the health and age of the patient, as well as the skill of the surgeon and the health care institute. The patient's past history of heart surgery affects the mortality rate as well.
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| Patient with mechanical valve may hear a quiet clicking sound in his chest. This is just the sound of the new valve opening and closing, and a sign that the new valve is working.
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| '''Mechanical Versus Biological Valves'''
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| Mechanical heart valves do not fail often. They last from 12 to 20 years. However, blood clots develop on them. If a blood clot forms, the patient may have a stroke. Bleeding can occur, but this is rare.
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| [[Biological]] valves tend to fail over time <ref name="pmid8469251">{{cite journal| author=Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Rahimtoola S| title=A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease. | journal=N Engl J Med | year= 1993 | volume= 328 | issue= 18 | pages= 1289-96 | pmid=8469251 | doi=10.1056/NEJM199305063281801 | pmc= | url= }} </ref><ref name="pmid11028464">{{cite journal| author=Hammermeister K, Sethi GK, Henderson WG, Grover FL, Oprian C, Rahimtoola SH| title=Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial. | journal=J Am Coll Cardiol | year= 2000 | volume= 36 | issue= 4 | pages= 1152-8 | pmid=11028464 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11028464 }} </ref>, but they have a lower risk of blood clots. Patients with a biological valve may need to have the valve replaced in 10 to 15 years. Patients with a mechanical valve will need to take a blood-thinning medicine for the rest of their lives.
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| ==[[Aortic insufficiency surgery complications|Complications]]== | | ==[[Aortic insufficiency surgery complications|Complications]]== |
| ===Complications===
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| '''Risks of any surgery'''
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| *Blood clots in the legs that may travel to the lungs.
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| *Blood loss.
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| *Breathing problems.
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| *Infection, including in the lungs, kidneys, bladder, chest, or heart valves.
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| *Reactions to medicines.
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| *Nausea and vomiting.
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| *Abnormal or painful scar formation.
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| *Allergic skin reaction
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| '''Possible risks from having [[open-heart surgery]]'''
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| *[[Heart attack]] or stroke.
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| *Heart [[rhythm]] problems; such as [[atrial fibrillation]].
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| *Infection in the cut, which is more likely to happen in people who are obese, have [[diabetes]], or have already had this surgery.
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| *Memory loss and loss of mental clarity, or "fuzzy thinking."
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| *[[Post-pericardiotomy syndrome]], which is a low-grade fever and chest pain. This could last for up to 6 months.
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| '''Prosthetic heart valves are associated with a variety of complications'''
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| *Structural deterioration, particularly with bioprosthetic valves.
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| *Valve obstruction due to [[thrombosis]] or pannus formation.
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| *Systemic [[embolization]].
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| *Bleeding.
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| *[[Endocarditis]] and other infections.
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| *Left ventricular systolic dysfunction, which may be preexisting ([[Heart failure]]).
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| *[[Hemolytic anemia]].
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| ==[[Aortic insufficiency surgery videos|Videos]]== | | ==[[Aortic insufficiency surgery videos|Videos]]== |
| ==Videos==
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| ===Severe aortic insufficiency in patient after aortic valve replacement 1===
| | {{WH}} |
| {{#ev:googlevideo|-3829359717394053857}} | | {{WS}} |
| | | [[CME Category::Cardiology]] |
| ===Severe aortic insufficiency in patient after aortic valve replacement 2===
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| {{#ev:googlevideo|-1139143783733805104}} | |
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| ===Severe aortic insufficiency in patient after aortic valve replacement 3===
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| {{#ev:googlevideo|-7501177211861270942}}
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| ===Severe aortic insufficiency in patient after aortic valve replacement 4===
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| {{#ev:googlevideo|-4027195456056520519}}
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| ===Severe aortic insufficiency in patient after aortic valve replacement 5===
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| {{#ev:googlevideo|3983126063629833286}}
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| ===Severe aortic insufficiency in patient after aortic valve replacement 6===
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| {{#ev:googlevideo|5313961274473108141}}
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| ===Severe aortic insufficiency in patient after aortic valve replacement 7===
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| {{#ev:googlevideo|-1049019986268408841}}
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| ===Severe aortic insufficiency in patient after aortic valve replacement 8===
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| {{#ev:googlevideo|1577454681656420080}}
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| ==References==
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| {{reflist|2}}
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| [[Category:Cardiology]] | | [[Category:Cardiology]] |
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| [[Category:Surgical procedures]] | | [[Category:Surgical procedures]] |
| [[Category:Valvular heart disease]] | | [[Category:Valvular heart disease]] |
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| {{WH}}
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| {{WS}}
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