Going home after a trans-catheter aortic valve implantation (TAVI)

Going home after a trans-catheter aortic valve implantation (TAVI)

Going home after a trans-catheter aortic valve   implantation (TAVI)

This leaflet aims to answer your questions about going back to your every day activities after your trans-catheter aortic valve implantation (TAVI). If you or your family have any further questions, or if you would like more information, please do not hesitate to contact us using the number on the back page.

When can I leave hospital?

Following your TAVI procedure you can expect to be in hospital for up to seven days. Before you go home your nurse will check your wound and ensure that you have a two week supply of medication. If you take warfarin the nurse will ensure that you have a follow up appointment to have blood tests.

You will need to be accompanied by a relative or friend on your journey home.

If you need to use our patient transport service, a member of our team needs to assess whether you are eligible. This involves a brief telephone interview and is completely confidential. Assessments must be carried out at least 48 hours before you need to travel. If you think you may be eligible for this transport service, please contact the Patient Transport Assessment Team .

For a minimum of six weeks please do not:

  •  Carry heavy shopping
  •  Vacuum
  •  Do any gardening
  •  Do any activity which requires you to take weight through your arms and may cause a strain on your chest or stomach
  •  Do any exercise, including swimming, dancing and cycling. However, you should aim to walk every day .
Travelling after your procedure

Provided you have had no complications, you will be able to fly:

  •  one week after your TAVI if you had a cut made in your groin
  •  two weeks after your TAVI if you had a cut made in your chest.

Despite this, if you are planning a holiday, it may be better if you wait at least six weeks before travelling, as it is unlikely that you will get the best out of your break before then. If you wish to fly within three months of your procedure, check with your doctor and the airline, as each has its own procedure.

After leaving hospital

Although it is less invasive than having open heart surgery, having a TAVI is a very traumatic event and as well as affecting your physical health, it can affect you emotionally. This is a normal part of recovering from surgery and these feelings will pass.

Some people who have had a TAVI have reported the following symptoms/problems after the procedure. Some are caused by the procedure itself and others by the anaesthetic – you may wish to refer to your copy of the leaflet, Having an anaesthetic for more information. The symptoms are usually temporary and settle over the first few days or weeks after the procedure.

  •  Altered sense of smell/strange taste in the mouth: The anaesthetic causes this and it is common for people to lose their appetite. Try to have small meals little and often.
  •  Blurred vision/dots in front of eyes: This occurs as a result of the surgery. It is recommended that you do not have an eye test within the first three months after your surgery to allow this to settle.
  •  Nightmares/hallucinations or difficulty sleeping: Sleep disturbance is common following any operation and will usually settle once you are at home and get back into your normal routine. You may find it is initially best to sleep on your back for comfort.
  •  Muffled hearing/heightened awareness of heartbeat: You may be particularly aware of this when you are lying on your side at night. Again, this is perfectly normal, but can cause concern. Try a different sleeping pattern to see if this helps.
  •  Voice sounds different or hoarse: This occurs as a result of the breathing tube we put in your throat during the operation. This will improve over time.
  •  Sore or numb bottom: It is important to remain as active as you can after your surgery and not sit in one position for long periods.
  •  Constipation: This can occur as a result of inactivity and the strong painkillers you need to take after the procedure. You can ask us for a laxative to help this. Please tell your nurse if your bowels have not opened before you go home.
  •  Loss of concentration/memory problems: Many people find they are unable to concentrate on things like reading a book or newspaper. Be patient with yourself – as you recover your concentration levels will return to normal.
  •  Arm, shoulder or wrist pain/numbness: This can occur as a result of the surgery. The position of your arm during the procedure can sometimes cause this temporary problem.
  •  Ankle and leg swelling in both limbs: This can occur during the first few weeks after your procedure. It will settle down, but you should speak to your physician if it does not start to improve. If you notice swelling in just one leg, see your physician.

How should I care for my wound?

You will have an incision/scar in your groin or on your chest, depending on where we made the cut to perform your TAVI.

It is normal for your groin to be tender for a few days after the angiogram. It is also normal for a bruise to develop.

However, if you notice any of the following please contact us :

  •  A hard tender lump under the skin around the area of incision (although a pea-sized lump is normal)
  •  Any increase in pain, swelling, redness and/or discharge at the site
  •  A cold foot on the same side as the angiogram
  •  A raised temperature/fever.

If your groin starts to bleed you should apply pressure to the area keeping your leg as straight as possible (lying down if you can):

You can shower when you get home but avoid rubbing the wound site. Do not have a bath. Do not put creams, talcum powder or soap directly onto the groin site for up to a week after the angiogram to avoid irritation and reduce the likelihood of infection.

Will I be in pain?

If you have had a cut made in your chest, we will give you a two week supply of painkillers to go home with. You still may need painkillers for up to six weeks so you may need to get more from your physician. Take these tablets as directed until the pain begins to ease and then slowly reduce the dose. You may still be taking the odd dose after six weeks and this is perfectly normal. The pain is normally around the wound, but can also be felt around the neck, shoulders, or back.

Initially the side of your chest may feel numb to the touch, but as the nerve endings around the wound begin to knit back together, you may experience tingling or pins and needles. You may also notice sharp stabbing pains where the chest drain was. These pains will diminish over time and painkillers should help.

Certain movements such as raising your arms to get something off a shelf or picking something up off the floor may cause some discomfort initially and it is therefore best to avoid certain activities to allow your chest wall to heal. If you have any concerns about activities, please talk to your specialist nurse, cardiac rehabilitation nurse, or surgeon before you take up strenuous activities. Returning to activities will be different for each individual, but see below for a guide.

Will I need to do any specific exercises?

Walking is the best form of exercise you can take following a TAVI and it is essential for your recovery. You may find that the amount you can manage varies from day to day.

For the first one or two weeks after your surgery it is best to exercise little and often. Begin by walking around the house and taking short walks outside. Once you are comfortable walking on flat ground, try walking up hills slowly, resting as necessary.

Aim for two 15 minute walks, one in the morning and one in the afternoon, each day. At week three or four, gradually increase this – your aim is to be able to walk for 30 minutes, five days a week.

You may find this difficult if you have mobility problems, so just do what you can manage as it’s important to be as active as possible.

Always wait at least one hour after eating before you exercise, and plan your exercise into your day to avoid taking on too much and tiring yourself out.

When can I return to normal activities?

Everyone is different so recovery times can vary. As soon as you are walking comfortably around the home you can carry out light housework such as washing up, dusting, laundry, small amounts of ironing (while sitting down) and light weeding in the garden. None of these activities should make you feel extremely breathless – if they do you are working too hard and need to slow down.

Will I have a follow-up appointment?

A follow-up appointment will be organised for you one month after your operation, whilst you are there you may have a chest scan known as a trans-thoracic echocardiogram. You will receive notification of this by post. If you do not receive your appointment letter within three weeks of leaving the hospital, please contact the nurse case manager.

We will give you a letter, which lists your tablets and what happened to you in hospital. A copy of this will also be sent to your physician.

What should I do if I have a problem at home?

If, after discharge, you have any further queries or general concerns, please do not hesitate to contact us. We are always happy to help.

If you have a question outside of these hours please contact the ward that you were on. Explain that you were a TAVI patient and tell them the day you were treated. A nurse or doctor will happily answer you questions if possible, or advise you on the best course of action to take.

  •  Chest pain.
  •  Increasing shortness of breath.
  •  Increased swelling in your ankles
  •  Any signs of infection (a red or inflamed wound, temperature, fever).
 

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