Last updated: 11/24/2009

The patient receives continued cardiac monitoring in the intensive care unit and usually remains in intensive care for 24–48 hours after surgery. Ventilation support is discontinued when the patient is able to breathe on his/her own. If mechanical...

circulatory support and inotropic agents (a substance that influences the force of muscle contractions, e.g. digitalis) were needed during the surgical procedure, they are discontinued as cardiac function recovers. Tubes draining blood from the chest cavity are removed as bleeding from the surgical procedure decreases. Prophylactic antibiotics are given to prevent infective endocarditis and the recurrence of rheumatic carditis.

Both mechanical and biological tissue valves require anticoagulation therapy after surgery, and while patients are hospitalized their anticoagulant status is monitored and dosages are adjusted accordingly. Patients with biological tissue valves can discontinue anticoagulation therapy within three months of implantation, but those with mechanical valves must take an anticoagulant (aspirin, warfarin, or a combination of the two) for the rest of their lives. These patients are regularly monitored for INR values, which are maintained between 2.0 and 4.5.

If the patient recovers normally, discharge from the hospital occurs within a week of surgery. At discharge, the patient is given specific instructions about wound care and infection recognition, as well as contact information for the physician and guidelines about when a visit to the emergency room is indicated. Within three or four weeks after discharge, the patient is seen for follow-up office visit with the physician, at which time physical status will have improved for evaluation. Thereafter, asymptomatic, uncomplicated patients are seen at yearly intervals. Few limitations are placed on patient activity once recovery is complete.