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Question
Posted by: M | 2006/11/08

AORTIC VALVE

At the age of 75 years my father underwent an aortic valve replacement as a result of aortic stenosis. The op went well and he was discharged from the hosptal within a week, after 3 days in ICU. It is now 5 weeks after the op and generally he is recuperating well, but some days he feels extremely tired, cold and feverish. How long could one expect him, at his age, to take to recover and what are the 'danger signs' that we should look out for. We are planning to take him away for a holiday, with travelling time about three hours. He will not be driving and we will stop halfway--- any precautions you advise us to take?

Thanking you in advance.

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Our expert says:
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Dear M,

It can take up to three months for an older patient to get back to normal after such a major op. Blood loss during the surgery can cause a temporary anaemia, and this plus the physiological stress of the operation can cause protracted tiredness. A chest infection, wound infection, or even a deep vein thrombosis can give a similar picture.

However, I am a little concerned at the fact that he is not only tired, but cold and feverish – this is a highly significant fact. The biggest danger for “valve” patients is that of infection on the valve itself – this is called Infective Endocarditis ( IE), and can have exactly those same symptoms. IE can be a deadly complication, and any suspicion of IE MUST be acted upon immediately.

Please phone your Dad’s cardiac surgeon asap, and ask for an urgent appointment. Please explain that he is TIRED, but also FEELS COLD AND IS FEVERISH. The surgeon will arrange for blood cultures to be done, to detect, and if necessary identify, the bacterium responsible, so that the correct antibacterial can be used.

I certainly would not advise travel until this is sorted out, and the cause of his symptoms is found and treated.

Good luck.

HeartDoc.

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