Patient discussions
Patients are encouraged to do moderate exercise, but patients with severe AR and left ventricular end-diastolic diameter >65 mm should be advised to avoid active sport.[37] Those on anticoagulation are advised to avoid contact sport.
Patients should be advised of the possible complications of having a prosthetic valve, such as thromboembolism, infective endocarditis, haemolysis, structural valve failure, and arrhythmias. They are advised to seek medical help if they become suddenly breathless, develop a fever, or experience palpitations or sudden onset of weakness of a limb, or complete or partial loss of sight.
Patients should also be advised about the risks of being on anticoagulation, the main one being haemorrhage. The patient should report unusual bruises, bleeding gums, coughing up blood, dark urine, and black bowel movements. Ideally, they are advised to avoid any activity that may increase their chances of bruising or bleeding, such as contact sport. They are also reminded that they should tell the pharmacist, doctor, and dentist that they are taking warfarin, as some medications affect how the drug works: for example, broad-spectrum antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs). Patients are encouraged to attend every appointment to have their international normalised ratio checked.
Cardiac rehabilitation is strongly recommended following aortic valve replacement procedures as it is beneficial in cardiac recovery and shown to decrease the risk of hospitalisation and mortality within 1 year following cardiac valve surgery.[38]
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