Each year, 4 to 8% of people with an artificial valve are confronted with complications. The biggest problems appear in the first months after the operation. About a third of new biological valves show wear after 10 years.
How to recognize them?
In the event of prosthetic valve thrombosis, the physical condition deteriorates rapidly. You are short of breath, you have pain in your chest, and you may pass out. The heart rate quickens, blood pressure drops, and the pulse becomes weak. This can all go hand in hand with the signs of heart failure: legs swollen from the buildup of fluid (edema), inability to lie flat (shortness of breath), and sometimes a swollen stomach (from the buildup) liquid).
An infection (around the heart valve or pericardium) is usually accompanied by fever and poor appetite.
Often a leaky valve does not cause any symptoms. But sometimes anemia develops gradually. The characteristic signs are pallor and rapid fatigue.
The wear of a biological valve is very slow and very difficult to recognize.
If the pericardium is inflamed, you suffer from fever, lack of appetite, poor general condition and palpitations. This complication usually starts within a few weeks after the operation.
How does the doctor follow up?
Since most complications occur within 3 months of inserting the artificial valve, the cardiologist performs a follow-up examination after 3 months and after 1 year. If you have a fever, see a general practitioner immediately.
As long as you are taking blood thinners, your GP will check your blood regularly, usually every 3 to 4 weeks. It is extremely important that coagulation remains within certain narrow limits. This is why the treatment is constantly adapted according to the results of the blood test. If the treatment must be adapted, the checks will be more frequent.
If you have a mechanical valve, you need to take blood thinners for life. If you have a biological valve, the blood thinners are replaced by a small dose of aspirin, starting 3 months after the operation, to reduce the risk of a clot. In this case, monthly blood checks are no longer essential.
If complications are suspected, a complete blood test and ultrasound of the heart (echocardiography) will be performed.
What can you do?
Carefully write down the results of the blood tests. To do this, you will receive a special card on which you can mention the results, as well as the dose of anticoagulant to take every day. Always take your medications carefully, preferably every day at around the same time. If your blood becomes “too liquid” you risk bleeding. The first signs are sometimes blood in the urine or a bleeding nose. In this case, consult the doctor. Take your temperature every day for 3 months after the procedure. If you have a fever, see the doctor right away.
What can your doctor do?
The follow-up remains the main task of the general practitioner. He will quickly identify and treat any complications. To do this, he will need to examine you regularly. During these tests, he listens to the sounds of the heart (which are different when there is (a problem) with prosthetic valves), takes your blood pressure, assesses any symptoms and detects signs of heart failure. If he suspects an infection, he will also have a blood test.
In case of fever for no apparent cause, the doctor will always follow, as a precaution, the hypothesis of an infection of the prosthesis because it is a serious complication.
If you have a prosthetic valve thrombosis, you will be admitted to the hospital, where you will be given thrombolytics (medicines which should dissolve the clot). Sometimes it is necessary to force the valve to open by inserting a catheter into the heart. If necessary, this procedure will be followed by a reoperation on the valve with the help of open heart surgical instrument set.
Biological valves are subject to very careful checks to detect any signs of wear. If necessary, they are replaced.
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