Preventing infection and clot formation are the two most important things after valve surgery. All people with abnormal or replaced heart valves should take specific antibiotics before having any medical procedure. Ask your cardiologist about this. Dental work is particularly important (even a visit to the oral hygienist): mouth and gum bacteria dislodged during these procedures enter the circulation, and quickly settle on the abnormal/replaced valve, causing Infective Endocarditis, a potentially fatal condition.
With an abnormal heart valve, and especially after valve replacement surgery, ANY fever or sudden change in symptoms must be regarded as a medical emergency – this could be infective endocarditis.
When mechanical valves are used, lifelong Warfarin is needed to prevent clot formation. Clots on the valve physically prevent it from functioning correctly, and bits of clot can break off causing a stroke, heart attack or lung embolus. Regular INR tests must be done to check the degree of blood clotting and adjust the Warfarin dosage. Because Warfarin can cause fetal abnormalities, young women needing valve replacement surgery who still want to have children are often advised to choose a biological valve, even though this means another operation later.
All those with known valve problems or replaced valves, especially if on Warfarin, should wear a Medic Alert tag – this could be life-saving in an emergency situation.
But can you prevent valve disease?
Of course! One of the commonest causes of valve disease in our country is childhood rheumatic fever, following a streptococcal infection of the throat. Here antibodies are formed which cross-react with heart tissue, damaging the heart and valves. Appropriate antibiotic treatment of all “Strep throats” in children significantly reduces the incidence of valve disease later on. DO NOT IGNORE YOUR CHILD’S SORE THROAT.
Birth defects cannot be prevented. However, effective treatment of common conditions associated with valve disorders (such as high blood pressure and heart disease) will help to decrease the incidence and severity of these valve problems.