Rehabilitation after heart valve surgery

The NHS says severe valve disease usually needs surgery either to repair the valve or to replace it with an artificial valve or one made from human or animal tissue. The BHF explains that mitral and aortic valves are the most commonly affected.

The approach changes recovery. Open surgery involves cutting through the breastbone, while the BHF also lists a mini thoracotomy, partial sternotomy, multiple small cuts and transcatheter procedures. Smaller access generally means a shorter recovery, although the underlying valve problem and your general fitness also count.

Mechanical valves are made from carbon, the BHF says, and are usually offered to younger people because they last longer. They need lifelong anticoagulant medicine because the valve is a foreign object that can encourage clots.

Tissue valves are made from animal tissue, such as pig or cow heart tissue, and the BHF says they are usually offered over the age of 60, and that most people with them do not need blood thinners. Whichever type you have, rehabilitation is a good time to learn how to take medicines and what to report.

The BHF says that after a minimally invasive procedure most people can do most normal activities after about 6 weeks, including working, driving and sex, whereas after open heart surgery this usually takes up to 12 weeks.

These are published averages. Your age, the valve operated on, whether you also had bypass grafts and how active you were beforehand all affect your own pace. Your surgical team will tell you when particular activities are safe.

The BHF says the wound can feel sore, itchy or numb while healing and that you will be given information on caring for it and signs to watch for. Seek advice for redness, discharge or fever.

In the early weeks, walking is the main exercise, built up gradually, with breathing exercises to keep the lungs clear. Avoid heavy lifting or strain through the chest until your team says healing is sufficient.

Cardiac rehabilitation, with supervised exercise and information sessions, is commonly offered after heart surgery, though the BHF valve pages do not set out a programme. Ask your cardiac nurse whether you are eligible locally, since provision varies.

If you are referred, expect an initial assessment so exercise can be set at a safe level, followed by regular sessions and advice on medicines, diet and emotional wellbeing.

BHF driving guidance says to stop driving for at least 4 weeks after heart valve surgery. The BHF advises talking to your doctor or nurse specialist about living with a repaired or replaced valve, including follow-up arrangements.

People with mechanical valves need regular blood tests to check that anticoagulation is in range. Carry a card or record of your valve type so any clinician treating you knows about it.

The NHS describes endocarditis as a serious condition in which the heart becomes infected. It is a recognised risk with valve disease, and artificial material adds to it, so you should report unexplained fever or feeling unwell promptly. Good dental hygiene and regular dental check-ups are sensible, and your cardiology team can tell you whether any special precautions apply to you.

The NHS says pregnancy can make heart valve disease symptoms worse, although many people can have a safe pregnancy with specialist monitoring. Anyone with a replacement valve who is considering pregnancy should talk to their cardiology team first, because anticoagulation plans may need review.