Recovery time from Mitral Valve Replacement

RNKPCE · Mar 1, 2004

I work telemetry unit and we get the open hearts both bypass and valve replacement usually 1st day post op if on their clinical path. The valves sometimes take a little longer to recover but not usually significant. It usually has to do more with what shape they are in pre op. For instance if a patient has sx on Monday usually home by Saturday, Friday if younger and really doing well. The pain lessens gradually. Most patients are on oral pain meds by 2nd post op day. The patients are usually up in a chair in ICU at least once before coming to our unit. Once on our unit the expectation is to have pt up in chair for all meals and ambulating 3-4 times a day by 2nd post op day. The open heart patients have a tendency to go into Atrial fib 2nd-4th post op day, I would say 30-40%. All open heart patients seem to have a down day usually 2nd-3rd post op day, the effects of sedation have really worn off, the lack of good sleep hits, and they just don't feel well this is normal and discussed in our pre op teaching materials. Appetites are usually poor this is normal. Freq our surgeons don't even have a restricted diet such as low na or low fat/chol because they just want to stimulate appetite. Don't push eating if he doesn't feel like it. Encourage pain med so patient can be as comfortable as possible to do activities and triflow, coughing etc.

Hope this is of some help.

suzanne4, RN · Mar 2, 2004

I agree with above. The most important thing to remember is that each patient is discharged on an individual basis, at least USUALLY with hearts.

Is there any type of support system for him in his town? A couple of things to take into consideration, especially if he is living on his own...............

1. Does he have to walk up any steps to get into his home?

2. Does he have a bathroom close by his bed?

3. Is there a shower,or bathtub only?

This may help give you some ideas as to what will be needed post-op.

Hope that this helps.

RNKPCE · Mar 2, 2004

Suzanne4 is right it is individual. But more often then not most patients are discharged in a 4-7day post op window. With 5-6 days being most common at least where I work. But as a nurse you have to be the patient's advocate and let the docs know if you don't think they are ready and why.

Patients that live alone may go to a skilled nursing for a week. We recommend the patient not be left alone the first several days home. But this world isn't ideal. I had a 52 year old recently that was going home alone with a neighbor to check on him.

A lot of our patients shower on the day of discharge while still at the hospital. This is usually the most strenous activity they will have done, lifting the arms above the shoulders to wash hair is very tiring. We tell patient that when home pace activities. Don't plan on waking up showering, shaving, eating breakfast and dressing all in one hour like pre-op. Space things out.

Also though the patients don't stay in critical care as long the patient still need their rest, so limit visitors to immediate family while in hospital and the first week at home.

Twink · Mar 2, 2004

Thanks for the insight and helpful info!

You all are awesome

Twink