Recovery after heart valve replacement: week by week

Your pathway depends on whether you had open surgery, keyhole surgery or TAVI, and on your age and general health. NHS.UK says recovery is usually quicker with keyhole surgery and quicker still after TAVI. The table collects the ranges stated by NHS.UK and the BHF. Details of the operation are in the guide to heart valve replacement.

After open or keyhole surgery NHS.UK says you usually go to intensive care and are connected to machines checking your heart and lungs, with oxygen through a mask, pain relief and tubes in the chest that are taken out after one or two days. Nurses and physiotherapists help you out of bed and moving from the day after. You can go home once doctors are happy that you can get around safely, and someone must drive you.

After TAVI, NHS.UK says the stay is about two to three days. Pain, soreness, and a wound in the chest or at the catheter site are expected, along with pain in the chest, back or shoulders and less appetite for the first few days.

NHS.UK says you will usually feel tired for the first few weeks and suggests arranging help for at least the first few days at home. Start being active, such as walking, as soon as you feel well enough, and follow the care team's advice about wound care and building up fitness. The BHF suggests smaller meals, eaten more often, if appetite is low, and says you may feel tired, confused and not very hungry for a few days.

The BHF says wounds can feel sore, itchy or numb while they heal, and suggests avoiding tight clothing over the chest wound. Contact your GP, 111 or the team if the wound is hot, red, more painful, swollen or discharging smelly pus.

The BHF says to avoid anything strenuous like carrying heavy bags or hoovering until the wound has healed, usually 8 to 12 weeks after open heart surgery, and NHS.UK says no heavy lifting for three months. You may be offered cardiac rehabilitation, a programme of exercise and support.

The BHF suggests asking the hospital team what exercise you can do and when, including sex and intimacy, based on your surgery and health. NHS.UK says you should find that symptoms such as chest pain and breathlessness improve. If you take warfarin, be careful with activities that could cause cuts or bruising and carry the alert card.

Driving: NHS.UK says not for at least four weeks, or three months if you hold a bus, coach or lorry licence, and to tell the DVLA if you hold such a licence. GOV.UK says to ask your doctor how an operation affects your driving, to tell the DVLA if you are still unable to drive three months after, and that failing to do so can result in a fine. Driving against medical advice may affect insurance, according to GOV.UK guidance for doctors.

Work: no source retrieved gives a fixed date, so the usual approach is to agree it with your surgeon or cardiac rehabilitation team, with desk work generally easier than physical work. Smoking should be avoided, according to NHS.UK, and help is available if you want to stop.

NHS.UK says to look after your teeth and gums, because dental problems can lead to a serious infection of the heart called endocarditis, and to tell your dentist about your valve because you may need antibiotics before treatment. If you have a mechanical valve you will be prescribed an anticoagulant, usually warfarin, for life, and the page says to carry the anticoagulant alert card.

Most replacement valves last 15 to 20 years or longer if mechanical, according to NHS.UK, and symptoms returning may mean the valve needs checking.

NHS.UK says to call your care team if the wound is more sore or red, bleeds or oozes pus, you have a high temperature or feel very hot, cold or shivery, or you have palpitations. Call 999 or go to A&E for a throbbing, swollen, warm leg or arm, sudden breathlessness with sharp chest pain or coughing blood, or difficulty speaking, moving a limb or a drooping face, and do not drive yourself.