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heart valve replacement.pptx
Valve replacement surgery replaces one or more faulty heart valves with an artificial heart valve. The document discusses the different types of heart valves, when valve replacement is needed, and the procedures for replacing the aortic, mitral, and tricuspid valves. It outlines the role of physiotherapy in the pre-operative and post-operative care of patients, including a daily exercise protocol from the day of surgery through discharge and a home exercise program. The goal is to minimize deconditioning and enhance cardiovascular and musculoskeletal function through breathing exercises, range of motion, ambulation, and activities of daily living.
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heart valve replacement.pptx
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- 2. Contents • Introduction • Typesof heart valve • Valve replacement :- Need Procedure Contraindication • Artificial valve / mechanical valve • Plans of post operative physiotherapy • Exercise program • References 2 anniet250999@gmail.com
- 3. Introduction • Valve replacementsurgery 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 3 anniet250999@gmail.com
- 4. TYPES OF HEARTVALVE 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 4 anniet250999@gmail.com
- 5. Aortic valve replacement Need :- Aorticstenosis ,aortic regurgitation Procedure :- 1) Percutaneous catheter ballon valvuloplasty (PBV) 2) Tran catheter aortic valve replacement (TAVR) 5 anniet250999@gmail.com
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- 7. MITRAL VALVE REPLACEMENT Need :- Mitralstenosis ,Mitral regurgitation 7 anniet250999@gmail.com
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- 10. TRICUSPID VALVE REPLACEMENT Need :- Tricuspidvalve stenosis , tricuspid valve regurgitation , tricuspid atresia Procedure :- Anuloplasty 10 anniet250999@gmail.com
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- 14. Role of thePhysiotherapist • 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 14 anniet250999@gmail.com
- 15. Plan of PhysiotherapyCare - Pre Operative 15 anniet250999@gmail.com
- 16. Plan of PhysiotherapyCare - Post Operative 16 anniet250999@gmail.com
- 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 17 anniet250999@gmail.com
- 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 18 anniet250999@gmail.com
- 19. Precaution • Incision usedin 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 19 anniet250999@gmail.com
- 20. FITT Principle Frequency : Minimumof 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 20 anniet250999@gmail.com
- 21. Exercise Ankle exercise Move feetup 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 21 anniet250999@gmail.com
- 22. Gluteal exercise Tighten buttockstogether hold for 5 seconds and relax Straight leg raise Lift the leg off the bed ,keeping the knee straight 22 anniet250999@gmail.com
- 23. Splinted coughing Shoulder ROMExercise 23 anniet250999@gmail.com
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- 26. Reference • 1) Textbookof 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 26 anniet250999@gmail.com