Aortic valve replacement recovery. What to expect

[Slangy2011]

Hi, my husband is due to have OHS for a new valve in the next ccouple of months. This was picked up last July and the stenosis is now severe. He is 46. My question is how much care will he need when returning home from the hospital? How much time off work will I need and can he be left at home on his own?

[Ageingfast]

dear Slangy

For the first two weeks it is essential to have someone care for him. If you are not at home then perhaps he could go to a care home for a couple of weeks. Or to a relative for a couple of weeks.

I was happy to be left at home for a couple of hours, but not all day.

He should be walking a little every day, from day one.

He is young for this op, so recovery should be faster than average. I am older and it was about 14 weeks.

I got stronger and stronger every couple of days. My cat was a great support.

I have now enjoyed five years with a faultless heart. It’s a fantastic op.

Sooty

[Slangy2011 in reply to Ageingfast]

Thank you so much for your reply. I work at a school in the office, but they aren't very supportive of people having time off! Obviously, my husbands care comes first, so I am happy to be off and look after him. I just wanted to know what to expect really and give them a warning of how long I need off and be prepared for an argument. We only found out the news last week and he is extremely anxious about the operation. He is very sporty but started to have chest pains about 3 months ago. He is worried about the recovery time and if he will be able to do all the things he can do now. I am trying to be as supportive as I can!

It's great to hear you got stronger and stronger every day. We also have a cat and dog so I am hoping they can turn into therapy animals.

Glad to hear the op was a success for you.

[Ageingfast in reply to Slangy2011]

I was beside myself with anxiety before the op. But as I walked into the hospital reception area, I was met by a nurse and the anxiety melted. It was then a ten day stay in hospital, where they did the three preliminary scans etc (often done as an outpatient but so much better as an inpatient). No visitors ( covid) but that was actually preferable. You will probably visit most days (?).

I came home in an ambulance. Door to door, very nice.

The first two weeks at home were not easy and included a nurse visit to take out the “stitches” . They weren’t real stitches and the removal was good. I spent most of the time watching TV or cuddling my cat.

Went out for a short walk every day. Building up the distance every day. Also did some exercises as prescribed by the hospital nurses.

No lifting anything heavier than a half kettle of water. No lifting anything above shoulder height. I could make a hot drink but not a full meal.

Sat up in bed, not laying down, so I needed the spare bedroom. Created a semi circle of pillows plus a “ teddy “ under my knees.

Could get to the toilet ok. Helpful we live in a bungalow.

Needed help to wash properly in the shower. Needed my hair washed.

I had no problems with the scar, whereas plenty of men do have issues.

Things got easier every day.

But none of this helps you regarding booking your time off work. If you have family to help then maybe you could arrange some support. We don’t have any family support.

It will be stressful for you. I came very very close to death but recovery was steady and good. The cardiac wards are way better than general wards. Almost certain to get your own room. First class staff all round.

It is a much easier recovery for us males.

Time for my supper

Sooty

[Slangy2011 in reply to Ageingfast]

Yes his anxiety is terrible. The doctor has given him beta blockers now to keep him calm. He had health anxiety before this anyway so adding this on top had tipped him over the edge.

The whole process has happened really fast so he only saw a consultant last year and then had an echo in Jan. We got a call from the hospital saying he needs surgery so it's been difficult as we haven't had anyone to talk to face to face about it all. We are now waiting for an appointment with the surgeon.

Yes I am planning on going to the hospital every day. It's about an hours drive away so not too bad.

I will definitely ask for 2 weeks off work then. They will be able to cope without me but just are not very sympathetic. When I have asked to attend his last appointment, they said no at first but I went anyway.

Is he going to need to sleep on his own when he gets back from hospital? We do have a spare room so I can go in there.

[Ageingfast in reply to Slangy2011]

I found that my first two weeks at home were a bit tricky, but after that I encouraged my wife to go and see her friends etc etc.. But its easy for us as we are both retired and get our pensions paid throughout.

So your thinking of two weeks off is sensible.

I found it very good without any visitors in the hospital. Mind, if others had visitors it might not have been so good.

Can I reiterate that I had the three pre op tests as an inpatient. My neighbour was to and fro as an outpatient for these tests. Plus, the surgeon wants the latest test results so I am dismayed that most hospitals do the three tests as outpatients.

We have a spare bedroom, so I set up camp in the spare. I think wife then got better sleep. I wanted some light on for a while. But its not essential. Both these bedrooms are immediately next to a bathroom, so that was jolly good.

There are many alternative scenarios. Maybe he will be offered the TAVi, thats a very different scenario.

Before the op I was slightly senosed then moderate then severe. I never got to critical.

I was so nervous beforehand that I was virtually unconscious. But once in hospital it was fine. I am now far less wound up about future hospital trips.

Immediately post op it was a strange and severe experience. The drugs are necessarily heavy to keep us asleep for the long surgery. Surgeon rang wife as soon as I was out the theatre, but I was then in ICU for many hours afterwards. Then ITU (?right terminology) for another night. The care on heart wards was totally different from general wards. They watched me continually and cheered me up a lot. Having my own room was very helpful.

Undoubtably it is hard on the patients partner.

But please be assured the recovery is good. And total.

I had a non metallic valve but maybe your husband will need metal. Either one is a far better thing than being dead.

My op was observed by several students. Not youngsters, but quite senior nurses and trainees. Their enthusiasm was amazing. I insisted they did not tell me the gory details. Ignorance is bliss, but not everyone is like me.

If he gets the op during the next two or three months then that will be ideal. Convalescing in warmer weather.

Larneybuds is spot on.

Best wishes

Sooty

[Larneybuds in reply to Slangy2011]

Good morning....first of all for your husband the waiting is the worst part and the overthinking of what it might all be like. Once in hospital the cardiac team are great at calming you down and after the op they are fantastic at managing pain relief etc. and looking after you. It depends on the hospital but I believe if all goes ok it's about a five day stay...they don't keep you for long if the op was straightforward with no infection or complications and they get you up walking fairly quickly .This operation is carried out so often and the success rate is very high. I found doing the coughing and chest exercises for weeks before my op really helped. I personally had to stay in hospital for quite a while due to an infection but had little help when I came out because my partner had started his chemotherapy at the same time and was too poorly. I just took thinks very steadily.. rested as often as I could. It's important to walk daily...no lifting or anything strenuous but I think your body is good at telling you what you can and can't do. I prepared quite a few meals and froze them before I had my op. Fairly important to have a good 'prop up' support in bed and chairs. I would think if your husband needs any assistance it will be for the first week after the operation but after that, if things go well, he should be able to cope but just take it easy. Recovery isn't always text book and everyone is different so everyone has their own journey and story to tell but I wish you both all the best and hope all goes well. X

[Slangy2011 in reply to Larneybuds]

Thank you. What are the coughing and chest exercises you did before?

[Larneybuds in reply to Slangy2011]

I was given an information sheet but there are plenty of instructions on the internet for coughing and chest exercises. It's important, especially after your op to keep lungs clear and mucus off your chest. I started doing them before my op then carried on after. They gave me a rolled up towel to press against my chest in hospital to assist with coughing and I continued with that at home...think that's fairly standard in most hospitals. I'm sure all will be absolutely fine. I am a great believer in positivity and determination and it certainly helped keep me buoyant about recovery. It's not a walk in the park but it's also not as bad as I thought it would be 😀xx

[Redfloyd in reply to Ageingfast]

My cat who is not thin insisted on doing CPR, there must have been a smell like catnip on the operation site 😂

[timelucky]

I've had the op twice @ (1990 & 1999). It's a mindset thing in my opinion. For the first week it was essential to have help on demand (for want of a better term). The second week it was first thing in morning & night. Lunchtimevwas nice but not essential. After that I wanted to be alone as much as possible because it's easy to be killed by kindness & one really has to pick yourself up & get on with life. I got myself together using a VHS cassette of calensthetics but I understand that most people are offered cardiac rehab which sounds like a great idea.

You also have zoom etc to keep an eye on things in real time if need be because sometimes reassurance at the right moment is just the ticket.

Be Lucky

[Redfloyd]

I had AVR and CABG as an emergency last September. I had pneumonia while in hospital which delayed my discharge so I was 2 weeks post op by the time I came home and had to do taxi and train. By then I was able to walk and do stairs easily. I thought when I got home I would be confined to upstairs as we don't have a downstairs toilet but I was happy going up and down stairs. From day 1 at home I was ok on my own as long as I had meals prepared for me. I could make a cup of something but just had to be very careful and aware when lifting the kettle or opening fridge door. A week later I was walking 1/2 mile, a week after that I was walking in to my local town, standing around talking to people, having coffee, actually having a nice time. Of course everybodys recovery is different, your husband has got age on his side, I had weight on my side, I'm 70kg at a push so getting out of bed or standing up from sitting wasn't an issue and relatively young (61)Unfortunately at 6 weeks post op I picked a virus/bug thing which knocked me back a lot, even my wife and friend struggled to get over it. The cough that went with this was very painful. I think if I hadn't of picked up this bug I would have recovered much better and quicker.

[DWizza]

Hi, plenty of us on here that have had OHS for various things . I had quadruple bypass following nstemi in July 2023. I can empathise with your husband re worrying aboyt getting back to sport and physical activity. The first job though is to recover , let the sternum heal and walk ( not allowed to walk the dog in early days incase it pulls on the lead , keeping arms in the tube is key) Plus adjust to any new meds.

I focused on increasing my walks by a few minutes , progressive overload, then when I reached 5k I increase the intensity of parts of the walks. He should get an invite to a rehab class. I was back riding motorbike after about 3 months , went back to yoga after 8 months . Sternum was still tender and chest muscles took an age to settle down . I found that swimming really helped my chest muscles and break down scar tissue. I did 5k parkruns after about 6-7 months. Physical work round our small farm I took gradually , heavy work carrying feed bags , hay bales , heavy wheelbarrowing. I’m sure he’ll make a great recovery from the procedure , just take the advice of the medical team regarding his new valve ( I’m not familiar with this).

The mental aspects are quite tough . I’m sure I had (have) a touch of PTSD post my heart attack and surgery. We definitely have to make some changes and accept our new selves . I posted monthly updates and achievements on this forum for my first year. I really value this forum and the support is incredible. Maybe he should get involved ? I consider myself very fortunate and loving my rebirth.

Post quadruple bypass surgery

[Slangy2011 in reply to DWizza]

He has joined this forum but not in the right head space yet to read anything. I think he is scared if someone has written there were complications etc then it will make him feel worse. I am passing on the information to him and I think it's helping.

It's turned our life upside down as had a job offer abroad and accepted it so we were planning on relocating when we got this news so it's been pretty hard to get our head around.

Thank you for your support.

[DWizza in reply to Slangy2011]

I can understand. receiving the news is a terrible shock and devastating. I cried like a baby a few times in hospital after my family had visited. I was the last person everyone thought would have a heart attack. Sport all my life, rugby, marathons , weight lifting , martial arts ,club cycling .. 🤦🏼. I thought I’d be having a stent or two like some of my old school buddies who were also fit. The shock of being told I would be having at least a triple bypass really hit me and family. Thankfully open heart surgery is common and well practiced . My surgical team out at ease , the consultant and anaesthetist briefed me and described it as “a bit of plumbing and sewing , the anaesthetist has the hardest job, you’re so fit and young too, not like our usual clients , it’ll be fine “

Complications , there will always be a chance of a complication , even taking the medication after… we don’t have any choice other than jump into the seat of a roller coaster ride. I wish him and you well.

[Bluenose10]

I had AVR in September after a long wait in hospital, I was not allowed home for being in the cardiac ward meant I was 30 seconds from help in case off what they called an 'event', my stenosis was presumably severeNothing did happen and I was back home a week after the operation itself

[andy110519]

Hi, I had my OHS for a mechanical aortic valve nearly 6 years ago aged 49. I was out of hospital after a week and the first 2 weeks at home there had to be someone there 24 7 just in case. Also, particularly in the first week, I didn't feel able to do much and very little energy, short concentration span, not even a half hour TV programme and not up to much conversation.However, there were improvements every day and I increased my length of walk each day and was surprised how quickly I was far better than I had been when I was first home. I did listen to my body and didn't push it to begin with and made use of my 2 teenage daughters.

I was back doing 5k runs within the year although still some discomfort at that time when bending over to tie laces, still can't lie on my left side for long.

Take care

Andy

[Bluenose10]

Sorry, Bluenose 10 again, I pressed the wrong key! As I was saying... Post-op I was festooned with wires and tubes and the experienced staff looked after me well and kept me active. At home I had, and you will need, support for the first week or so. A son came to stay to do the lifting and carrying and some personal care such as washing my hair, you shouldn't/don't lift your arms above your head, You will be provided with a timetable of when you should start to do what; sweeping and hoovering come in late as they put strain on the freshly joined sternum. The sternum is the issue, aortic valve replacement in the absence of anything else wrong means that the heart is basically ok once more, if requiring support with medication such as aspirin. Don't do too much too soon, but do take exercise, walk a little further each day. We live off a lovely street with many trees and each day we went to one more tree. The cardiac rehabilitation course helps too. AVR is a transformational procedure, I am so grateful to have experienced it. Now five months on I am grand, a new man, a walking man once more, but just not today as I have an attack of gout, I wish there was a procedure which could cure that!

[yellowren]

Hello Slangy

Your husband is not much older than my husband was when he had his Aortic valve replaced. He’s now nearly 70 and had his first aortic valve replacement 30 years ago when he was 40. He was born with a bicuspid valve which was discovered 10 years before the op and carefully monitored until he needed surgery again when the valve became too leaky. He chose to have a biological valve. He was also sporty but when the leak was discovered he was advised to stop taking part in competitive sport so that he didn’t put too much pressure on his heart.

He worked up until two days before the op. It went well and he was back at work and fighting fit after 12 weeks. 2 years later he completed his first London to Brighton bike ride for the BHF and did it for the following two years.

Ageingfast and Redfloyd’s replies about care are spot on. At the time of my husband’s first op I worked part time in the evenings for the NHS; the oldest of our children was 8 and the 2 youngest were three. Because the surgery was planned I was able to save my annual leave and use it in a block.

Fast forward 11 years and the biological valve broke down, we were told this could happen 10-15 years after the first op. It was a very different experience this time. He began feeling very tired and lethargic but his cardiologist wasn’t concerned and didn’t feel it necessary to refer him urgently to St Thomas’s. It took six months before he saw the Cardiologist at St Thomas’s who was very concerned at the state of the valve and told us to go home and be prepared to be called back in within the week for a new valve replacement. The call came two days later and four days after the first trip to St Thomas’s my husband was in the operating theatre. Having become so poorly before the op meant that his recovery took a lot longer and it was another six months before he was fit enough to return to work.

By this time, like you I was working in a school office so I totally understand your problem. However my immediate boss was very family minded and supportive and he made it possible for me to have the two weeks off that I needed to care for my husband when he came home. The deal was that I made up the time during the next school holiday which was only a few weeks away. I was contracted to work two weeks of the summer holidays anyway so it was a short break that year but meant that I could be there for my husband during those important two weeks.

I’m not sure that I’m being very helpful, I guess it’s a matter of how flexible your line manager can be and if you have colleagues who can cover for you, if it comes to it you may have to consider contacting your GP for support if the stress begins to affect your health. You need to be physically and mentally fit for what’s ahead of you. Difficult as it is it’s important to take care of yourself

I wish you and your husband well.

Rose