2. Contents
• Introduction
• Types of heart valve
• Valve replacement :- Need
Procedure
Contraindication
• Artificial valve / mechanical valve
• Plans of post operative physiotherapy
• Exercise program
• References
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3. Introduction
• Valve replacement surgery is the replacement of one or more of the
heart valves with an artificial heart valve
• Valve replacement surgery has improved
the outcome of patients with valvular heart disease
• Slow increment exercise is indicated
for patients because of their reduced
functional ability
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4. TYPES OF HEART VALVE
Aortic valve
• Valve between
left ventricle
and aorta
• One of the
semilunar valve Mitral valve
• Located
between left
atrium and left
ventricle
Pulmonic valve
• Located
between right
ventricle and
pulmonary
artery Tricuspid valve
• Located
between right
atrium and right
ventricle
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14. Role of the Physiotherapist
• Physiotherapist is concerned with physical aspects of recovery
• Minimizing the deconditioning effects of bed rest
• Enhancing cardiovascular and musculoskeletal functioning
Assessment
Breathing
exercise
Assisted
exercise
Stair climbing
Ambulation
Active exercise Daily activities
Home exercise
program
Follow up
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17. Day of operation :-
• Monitor the vitals like
temperature, blood pressure ,
ECG, pulse rate and respiratory
rate
• Help the patient to sit in half
lying position
• Support the incision and
encourage to take deep breaths -3
reps
• Encourage for huffing at least
once
• Patient head and trunk fully
supported with pillow
Day -1
• Breathing exercise
• Coughing and huffing
• Relaxation
• Elevation of arm on operated side
(if medial sternotomy B/L arm)
• Ankle and toe movements
• Hip and knee bending and
stretching
• Incentive spirometry
Day -2
• Same as day 1
• Patient is trained to sit up
himself
• Elevation of arm on
operated side (if medial
sternotomy B/L arm)
Protocol
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18. Day - 3
• Same as of day 2
• Arm and trunk exercise
• Short walk in ward
• Swinging exercise during walking
• Chest expansion exercise
Day : 4 - 14
• Patient is encouraged to go
to toilet independently
• Chest expansion exercise
• By day 5-7 ,patient must
ascent stairs
Home exercise program
• Breathing exercise
• Thoracic expansion
exercise
• Walking
• Activities of daily living
• Follow up
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19. Precaution
• Incision used in heart surgery is breastbone
(sternum) , so avoid activities that put stress on
your sternum while its healing
• Do not advice to lift push or pull more than
10pounds
• Advice to get in and out of bed without using
arms
• Safely climb stairs without pulling on rails
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20. FITT Principle
Frequency :
Minimum of 3 days
per week
Intensity
According to rate of
perceived exertion .
It can also be
monitored by heart
rate and talk test
Type
Aerobic exercise
Resistance exercise
Time
Gradually increase
the duration by 5-10
mins
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21. Exercise
Ankle exercise
Move feet up and down at ankles -10 reps
Move feet together in circles -10 reps
Static quadriceps :
Press the back of knee against the bed
.heels should lift off the bed
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22. Gluteal exercise
Tighten buttocks together hold for 5
seconds and relax
Straight leg raise
Lift the leg off the bed ,keeping the
knee straight
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26. Reference
• 1) Textbook of physiotherapy for cardio-respiratory cardiac surgery
and thoracic surgery conditions – GB Madhuri
• 2) https://drbillsukala.com/heart-valve-surgery-exercise-guidelines/
• 3) physical therapy after cardiac surgery –UW Medicine
• 4) physiotherapy for respiratory and cardiac problems – Jenifer A
Pryor
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