Heart Valve Surgery

Your damaged valve may be repaired or replaced. If suitable, a repair of your valve will be preferred. If a repair is not possible, the surgeon will then replace your heart valve. Depending on your heart condition and valve affected, your surgeon will counsel you on the best option.

Valve can be repaired with an annuloplasty ring, and other repair techniques.

Valves can be replaced with either:

• Mechanical (metal and plastic) options
• Tissue (animal heart tissue)

Pre-Admission

• All the necessary tests (e.g. blood tests, X-Ray, etc) will be done within two weeks before your admission to the hospital. In this way, you will only need to be admitted the day before surgery, helping you save on your hospital bill.
• Should any of your tests be abnormal, you can be treated in time so as not to delay surgery. You may also be booked into the Anaesthesia Outpatient Consultation Clinic (AOCC) to screen your investigations and ensure that there are no other issues to address before surgery.
• You should stop smoking at least 2-3 weeks before surgery to enable faster recovery and to reduce the risk of complications.
• You should eat a healthy balanced diet and rest well before the surgery.
• Traditional alternative herbal remedies - such as Traditional Chinese Medicine, Jamu, Ayurvedic treatments etc. - should be stopped three weeks before surgery, as these can interfere with the body's response to major surgery and increase the risk of serious complications.
• When you come for your blood tests and orientation, you will be given a bottle of anti-bacterial soap for bathing. Please use this three consecutive days before admission to reduce your risk of infection.

Admission

• You will usually be admitted a day before your heart surgery. You may need to be admitted earlier if your condition needs to be optimised or improved first to make the surgery safer.
• A team of doctors will perform a thorough check on you to ensure that everything is in order.
• They will explain the surgery to you again, and you may also address any further concerns with them.
• The Anaesthetist will visit you to ensure no new issues have arisen since your AOCC consult and to address any further questions you may have about the anaesthesia.
• You are recommended to shower with antibacterial soap both the night before and on the morning of the surgery in order to reduce your risk of infection.
• You will not be allowed to eat or drink after midnight.

Operation and post-operative care

• Your surgeon will advise on the expected duration of the surgery based on the requirements of the operation.
• After your operation, you will be transferred to the Cardiothoracic Intensive Care Unit (CTICU) for close monitoring during your recovery phase.
• Before you transfer from the CTICU back to the general ward, the monitoring lines and urine catheter that were inserted just before the start of your operation will be removed. Chest tubes inserted during the operation may be removed in the CTICU or general ward.
• A routine hospital stay is usually about 4-7 days if no complications arise. Patients who are deconditioned after surgery and need more intensive therapy to regain their strength may benefit from a period of inpatient rehabilitation in a community hospital. This will be assessed by the Physiotherapy and Occupational Therapy teams in the ward.
• Recovery usually take 4-6 weeks. Depending on your work commitments, you may be granted a longer period of hospitalisation leave in order to complete your cardiac rehabilitation before returning to work.
• You will be given an appointment for early review by the surgical team. This usually takes place 2-3 weeks after hospital discharge, enabling the team to review your wound healing, blood tests, ECG and chest X-ray results.
• You will also be given appointments to see your Cardiac Surgeon and Cardiologist.
• Cardiac Rehabilitation is strongly recommended to optimise the long-term benefits of heart surgery. After discharge, you will be referred to the Cardiac Rehabilitation Programme either at the NUHCS Heart Clinic at NUH, or at a hospital near you.