Discharge Planning for a Mechanical Heart Valve

The insertion of a mechanical heart valve is major open-heart surgery. It will require a recovery period of several weeks, perhaps months, assistance from family and friends, adherence to instructions and close consultation with health care providers. Discharge planning for a mechanical heart valve patient is far easier for both the individual and family when the plan for a return to health is understood by all.

Discharge Planning

• The typical hospital stay after this procedure is five to seven days with the first one to two days spent in the intensive care unit (ICU). During this period, hospital staff will provide discharge instructions and help prepare the patient and family for the skills required to convalesce at home. It is important to have friends or family available to stay with the patient for at least the first one to two weeks upon the return home. In some cases, professional help may be enlisted. "The nursing staff will contact a home care agency near your home to arrange a home nursing assessment the day after your discharge," according to Brigham and Women's Hospital in Boston. "Additional services available through the home care agencies for patients who meet criteria include physical therapy, occupational therapy, and the services of a home health aide or social worker."

  If arrangements were not made previous to leaving the hospital, patients must remember to schedule appointments with their cardiologist and primary care physician within two weeks of discharge, and the cardiac surgeon four to six weeks post-discharge. While waiting for this time to elapse, most physicians or hospitals will have a nurse follow up with the patient via phone.

  Patients in exceptional circumstances and in need of round-the-clock professional care will, based upon their level of insurance coverage, sometimes be referred and transferred to an extended-care facility for physical or occupational therapy.

Home Recovery

• The majority of people return home immediately from their hospital stay and can expect significant recovery to take four to six weeks. During this time, patients should expect pain in the chest, especially around the incision. A poor appetite for up to a month is common as is depression, mood swings, constipation, fatigue, a sense of confusion or loss of short-term memory, and shortness of breath. It is normal for the arms to feel extremely week for the first month, sleep difficulty to occur for several months, and for an itch or numbness to remain around the chest incision for six months or more.

Activity

• It is important to begin to slowly ramp up activity during recovery at home. Heavy lifting and any extensive exercise is to be avoided in the first few weeks, but simple walking and movement about the home is fine. "Walking is a good exercise for the lungs and heart after surgery. Take it slowly," says the Wake Forest University Baptist Medical Center. "Climbing stairs is okay, but be careful. Balance may be a problem, so hold onto the railing. Rest part way up the stairs if you need to."

  Light household chores like the folding of clothes is acceptable but avoid any activity that requires any sort of pulling on the chest. Patients are advised to avoid driving for at least six weeks following surgery.