Aortic Valve Stenosis Surgery: Is Follow-Up Care Necessary?

After any cardiac surgical procedure, including aortic valve replacement, follow-up care is essential. This is particularly important for patients who have undergone surgery for aortic valve stenosis. Whether a biological or mechanical valve has been implanted, regular check-ups help ensure the long-term success of the procedure and the patient's overall heart health.

Why Follow-Up Is Important

For patients with a bioprosthetic (tissue) valve, post-operative evaluations focus on detecting signs of valve calcification, deterioration, or structural damage. In contrast, those with a mechanical valve require monitoring for abnormal blood flow, potential tissue overgrowth (pannus formation), and blood clot development.

One of the most critical aspects of post-surgery evaluation, regardless of valve type, is ruling out paravalvular leakage — a condition where blood leaks around the edges of the replaced valve. This can lead to symptoms like shortness of breath or fatigue and may require further intervention.

Recommended Follow-Up Schedule

Typically, patients are advised to schedule follow-up appointments at specific intervals: one month, three to six months, and six to twelve months after surgery. Ideally, annual check-ups should continue afterward. However, if a patient feels well and has no symptoms, less frequent visits may be acceptable under a physician's guidance.

Special Considerations for Mechanical Valve Recipients

Patients with mechanical heart valves require more intensive monitoring due to the lifelong need for anticoagulation therapy. These individuals must take blood thinners like warfarin to prevent clots. As a result, regular blood tests are necessary to maintain the International Normalized Ratio (INR) within a target range, ensuring the medication is effective without increasing bleeding risks.

Long-Term Monitoring Tips

Even years after surgery, it's recommended that mechanical valve patients undergo an echocardiogram at least once a year. Blood tests should be performed more frequently, typically every one to two months, depending on INR stability and physician recommendations. Consistent monitoring significantly enhances safety and helps prevent complications.