After Your Transcatheter Aortic Valve Replacement (TAVR)

You have just had surgery to replace your aortic valve with a new biological tissue valve. When you go home, follow all instructions you receive from your health care provider for medicines, pain control, diet, activity, and wound care. Make sure to go to all your follow-up appointments. You should feel better after your surgery. But complete recovery may take several weeks. How long depends on whether the surgery was done through your groin, underneath the collarbone, or between your ribs. All of these methods are thought to be less invasive than open heart surgery. This means fewer complications and a shorter recovery time. Below are some general guidelines to follow as you heal.

Follow your health care provider's directions for recovery at home. It may take several weeks to get back to your normal routine. Using the groin artery is the least invasive method and heals the fastest. TAVR done between your ribs needs a larger incision and takes longer to recover from.

While you recover:

• Take medicine as directed. Take pain medicine, blood thinners, and any other medicine exactly as your provider advises. You will likely need to take aspirin and another blood thinner (antiplatelet) for a while. You'll need to take the aspirin for the rest of your life. Be sure your provider knows about all other medicines you take. This includes over-the-counter medicines and dietary supplements.
• Care for your incision. It's normal for your incision to be bruised, itchy, or sore while it heals. It may take a week or more to heal. A surgery site between your ribs will take longer to heal than one in your groin. Care for the bandage and incision as advised. Don't put powder, lotion, or ointment on the incision until it's healed. If you notice swelling, redness, any discharge, or a lot of bruising at the site, call your provider right away.
• Shower carefully. Unless you're told not to, you can shower after you get home. Use warm water and a mild soap. Don't use hot water, because it can make you feel lightheaded. Don't take a bath until your health care provider says it's okay. And don't sit in a swimming pool or hot tub until your provider okays it. If your surgery was between your ribs, you may need to keep the incision site dry for a certain period.
• Do only activities that your provider says are okay. Your provider may tell you not to do strenuous activities for a week or more. This includes no heavy lifting. Instructions on what to do are different depending on how your surgery was done. Your provider will give you specific instructions that are right for you.
• Don't drive if you take opioid pain medicine. These medicines can make you feel sleepy. It's not safe to drive or operate heavy machinery while taking them.
• Walk regularly. One of the best ways to get stronger is to walk. If your provider agrees, start with short walks at home. Walk a little more each day. Take someone with you until you feel okay to walk alone. Your provider may recommend a cardiac rehab program. This will allow you to be closely monitored by trained staff during exercise. Most insurance companies will cover these programs.

Call 911 right away if you have:

• Chest pain.
• Trouble breathing.
• Signs of a stroke. These include sudden numbness or weakness in the face, arms, or legs.
• Fainting (syncope).

Contact your health care provider right away if you have:

• A bowel movement that is bright red.
• Bleeding that is frequent or lasting, such as nosebleeds.
• Chills or a fever of 100.4°F (38°C) or higher, or as your provider directs.
• Dizziness or lightheadedness.
• Redness, swelling, bleeding, warmth, or fluid draining at the incision site.
• Weight gain of more than 2 to 3 pounds in 24 hours or more than 5 pounds in 1 week.
• Swelling in your hands, feet, or ankles.
• Shortness of breath that doesn't get better when you rest.
• Pain that gets worse or doesn't go away.
• A fast, slow, or irregular pulse.
• Worsening or severe fatigue.
• Other signs or symptoms as advised by your provider.

Follow-up visits with your health care provider help make sure you're recovering well. In fact, to keep feeling your best, you'll need regular checkups for the rest of your life. During these visits, you may have:

• Blood tests. These are to monitor the function of your heart and kidneys and to check for anemia.
• Echocardiograms. They check how well your heart and new heart valve are working.
• Electrocardiograms (ECGs). These tests can show if your heart rhythm has changed after your valve replacement.

• Learn to take your own blood pressure and pulse. Keep a record of your results. Ask your health care provider which readings mean that you need medical care.
• Weigh yourself every day, and keep a record of this. It's normal for your weight to rise or fall 2 to 3 pounds in a day. Anything more than this could mean you are retaining fluid and developing heart failure. Tell your provider right away if this is the case.
• Tell all your health care providers and dentists that you've had a valve replacement. Before any dental procedure, you will need to take an antibiotic to protect your new heart valve.
• Take any prescribed blood thinners exactly as directed.
• Make lifestyle changes as advised by your provider. Keep in mind that healthy habits, such as exercise and a healthy diet, can strengthen your heart.
• Tell your provider about any new symptoms.