Our Summary

Transcatheter pulmonary valve replacement (TPVR) is a common procedure done in children’s heart clinics. However, there are no standard rules on how to prevent blood clotting after this surgery. To understand the current practices, a survey was sent to heart doctors who perform this procedure. Out of 109 responses, around 77% of doctors prescribe only Aspirin after the surgery, while the others give an additional medicine to prevent blood clotting. Most doctors (78%) don’t tell patients to avoid certain types of aspirin, and 86% don’t mention that they should avoid certain medicines for stomach acid. Also, 67% don’t advise against using certain painkillers. There was also a big difference in how much aspirin doctors prescribe, with some giving a fixed amount regardless of the patient’s weight, some adjusting based on weight, and others giving a high fixed amount. The survey shows a big difference in practices after TPVR around the world, which could potentially lead to early valve failure. This suggests a need for more research and the development of standard guidelines on how to prevent blood clotting after TPVR.

FAQs

  1. What is transcatheter pulmonary valve replacement (TPVR)?
  2. What are the current practices to prevent blood clotting after TPVR?
  3. Why is there a need for more research and the development of standard guidelines on how to prevent blood clotting after TPVR?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pulmonary valve replacement is to follow their prescribed medication regimen closely. This may include taking aspirin or other blood thinning medications as directed to prevent blood clots from forming around the new valve. It is important to discuss any concerns or questions about medication with your healthcare provider and to follow up regularly to monitor your progress and ensure the valve is functioning properly. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support overall heart health and recovery after surgery.

Suitable For

Patients who are typically recommended for pulmonary valve replacement are those with congenital heart defects such as Tetralogy of Fallot, pulmonary atresia, or pulmonary regurgitation. These patients may experience symptoms such as shortness of breath, fatigue, chest pain, or fainting episodes due to a dysfunctional pulmonary valve. Pulmonary valve replacement may also be recommended for patients with previous surgical repair of a congenital heart defect who develop complications such as pulmonary valve stenosis or regurgitation.

In addition, patients who have undergone transcatheter pulmonary valve replacement (TPVR) and are at risk of blood clotting may be recommended certain medications to prevent clot formation. These patients may include those with a history of blood clotting disorders, previous clot formation, or other risk factors for clotting. It is important for healthcare providers to individualize treatment recommendations based on each patient’s medical history and risk factors.

Timeline

Before the pulmonary valve replacement:

  • Patient undergoes various diagnostic tests and consultations to determine the need for the procedure
  • Patient is informed about the risks and benefits of the surgery and given instructions on pre-operative preparation
  • Surgery date is scheduled and patient may need to stop certain medications or follow a specific diet leading up to the procedure

After the pulmonary valve replacement:

  • Patient is closely monitored in the hospital for any complications or issues post-surgery
  • Patient may need to stay in the hospital for a few days to recover and receive appropriate care
  • Patient is given specific instructions on post-operative care, including medications, follow-up appointments, and physical activity restrictions
  • Patient undergoes rehabilitation or physical therapy to aid in recovery and improve overall heart health
  • Patient is advised on long-term management of their condition, including lifestyle changes and potential future treatments

Overall, the timeline of a patient before and after pulmonary valve replacement involves thorough preparation, careful monitoring, and ongoing support to ensure a successful outcome and improved quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about pulmonary valve replacement include:

  1. What are the risks and benefits of pulmonary valve replacement surgery?
  2. What alternative treatment options are available for my condition?
  3. What is the success rate of this procedure in patients with similar conditions to mine?
  4. What is the expected recovery time and rehabilitation process after the surgery?
  5. What medications will I need to take after the surgery to prevent blood clotting?
  6. Are there any dietary or lifestyle changes I should make to help prevent blood clotting?
  7. What are the signs and symptoms of a blood clot that I should watch out for after the surgery?
  8. How often should I follow up with you after the surgery, and what tests will be done to monitor my progress?
  9. Are there any restrictions on physical activity or travel that I should be aware of after the surgery?
  10. Are there any potential long-term complications or risks associated with pulmonary valve replacement that I should be aware of?

Reference

Authors: Shibbani K, Garg R, Zahn EM, Mclennan D. Journal: Pediatr Cardiol. 2021 Oct;42(7):1640-1646. doi: 10.1007/s00246-021-02652-8. Epub 2021 May 29. PMID: 34050375