Valve-sparing Aortic Root Replacement

Prior to Procedure
Your doctor will likely do the following:

• Physical exam
• Chest X-ray
• Lab work
• Echocardiogram
• Electrocardiogram (ECG, EKG)
• Cardiac catheterization

Talk to your doctor about your medication. You may need to stop taking certain medication for one week before surgery, such as:

• Blood-thinning drugs, such as warfarin (Coumadin)
• Anti-platelet drugs, such as clopidogrel (Plavix) 
• Diabetes medications, such as metformin (Glucophage)

Your doctor may also ask you to:

• Eat a light meal the night before. Do not eat or drink anything after midnight.
• You may be given special antibacterial soap to use prior to your surgery. 
• Arrange for a ride to and from the hospital.
• Arrange for help at home after the procedure.

Anesthesia
General anesthesia will be used. You will be asleep.

Description of the Procedures
During a valve-sparing aortic root replacement, the enlarged section of the aorta is replaced with an artificial graft (tube). The aortic valve remains in place, and the valve is sutured inside of the graft.

Immediately After Procedure
You will be monitored in the intensive care unit, where you will have the following interventions:

• Heart monitor
• Pacing wires to control heart rate
• Tubes connected to a machine to drain fluids from the wound
• Breathing tube or an oxygen mask
• Catheter inserted into the bladder

How Long Will It Take?
The surgery can take anywhere from 3 to 5 hours.

How Much Will It Hurt?
Anesthesia prevents pain during surgery. You may be given medication for any pain during recovery. Pain levels vary from patient to patient.

Average Hospital Stay
The average stay is 4 to 7 days.

Postoperative Care
At the Hospital

• To reduce the risk of fluid buildup in your lungs, you will be instructed to breathe deeply and cough 10 to 20 times every hour.
• Efforts will be made to get you out of bed and walking as soon as possible.
• Dressings will be removed in a day or two. Pacing wires and chest tubes will be removed within the first few days.

At Home
When you return home, do the following to help ensure a smooth recovery:

• Take medicines as directed by your doctor, such as:
  • Antiarrhythmics
  • Blood thinners
  • Cholesterol-lowering medicine
  • Blood pressure medicine
  • Pain medicine
• Follow your doctor's guidelines for caring for your incisions
• Weigh yourself every morning
• Be sure to follow all of your doctor's instructions

Recovering after Surgery/What to Expect
Every patient’s recovery can be different. You will need to shower, daily, with a mild soap. Ask your doctor when it is safe to take a bath or soak in water. You may find that there will be some areas of discomfort in the area of surgery that can last for several weeks. Also, it is common that you may feel tired for many weeks following this type of surgery. 

You will be asked not to do any type of heavy lifting for two months that will cause pain at the surgical site. People with jobs requiring strong physical activity may require additional time before resuming those types of activities. Be sure to ask your doctor when you can drive and return to work.

When to Call Your Surgeon:

• Pain that you cannot control with the medication you have been given
• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision sites
• Nausea and/or vomiting that you cannot control with the medication you were given after surgery or that lasts longer than expected
• Cough, shortness of breath, or chest pain
• Pain, burning, urgency, frequency of urination, or persistent blood in the urine
• Gaining more than four pounds within one or two days
• Pain and/or swelling in your feet, calves, or legs, or sudden shortness of breath or chest pain

In case of an emergency, call for medical help right away.