Recommendations for patients after heart valve replacement surgery

General rules

As a rule, with coronary heart disease , the process of narrowing the lumen of the artery by cholesterol plaque is irreversible and increasing. Restoring the narrowed lumen of an artery with an atherosclerotic plaque using medication does not give the desired effect. Therefore, in most cases with severe stenosis , surgical methods of treating coronary artery disease (bypass surgery, stenting) are the only effective ones to normalize blood circulation in the heart muscle, prevent the threat of myocardial infarction and restore a person’s ability to work.
The operations of coronary artery bypass grafting (CABG) and stenting of the coronary arteries are quite complex and in order to obtain a lasting postoperative effect it is necessary to lead a certain way of life. In particular, diet after heart surgery is the most important component of the treatment process during the rehabilitation period. Moreover, properly organized nutrition after heart surgery allows you to avoid the return of angina and repeated vascular operations.

Nutritional risk factors for the continued development of atherosclerosis and coronary artery disease and, accordingly, repeated vascular operations include:

• high energy value of the diet, contributing to the development of obesity ;
• deficiency of polyunsaturated fatty acids, which normalize cholesterol and reduce its deposition on the walls of blood vessels;
• excess content in the diet of fats containing saturated fatty acids (animal and confectionery fats);
• excessive consumption of cholesterol with a lack of foods in the diet that normalize the metabolism of cholesterol and fats;
• excessive consumption of easily digestible refined carbohydrates (sugar and products containing it);
• increased consumption of table salt, which reduces the activity of fat metabolism enzymes;
• insufficient content in the diet of foods rich in fiber - wholemeal bread, vegetables, cereals, fruits, berries, which reduces the process of removing cholesterol through the intestines;
• excessive consumption of animal proteins, which disrupts vascular permeability, blood clotting and negatively affects fat metabolism;
• insufficient consumption of magnesium, zinc, potassium, iodine, vitamins A , C , B6 , PP , carotene , which slows down the breakdown of cholesterol and disrupts lipid metabolism;
• improper diet with rare and heavy meals.

Accordingly, the general principles of dietary nutrition after CABG and vascular stenosis are to reduce the energy value of the daily diet to 2400-2600 kcal with the consumption of 70-90 g of proteins (animal proteins are reduced to 50%), 80 g of fats (40% vegetable) and 300- 350 g of carbohydrates (with a decrease in the intake of easily digestible carbohydrates).

The protein content in the diet should be no more than 1.0-1.2 g per 1 kg of body weight and is ensured by including fish, low-fat dairy products, seafood in the diet, moderate consumption of lean meat and meat products and limiting the consumption of egg yolks and offal.

Foods rich in extractives and cholesterol are limited in the diet. Table salt is reduced to 5 mg/day. Animal and cooking fats are completely excluded. Increase foods containing dietary fiber (vegetables, cereals, fruits), vitamins , especially C and E and microelements (potassium, iodine, magnesium), which are rich in seafood (squid, seaweed, mussels, shrimp) in the form of independent dishes or as part salads

The consumption of “white” varieties of fish is recommended, since fatty acids from fish fats improve cholesterol metabolism and normalize blood clotting properties, reducing the risk of blood clots . The volume of free fluid is limited to 1.2-1.5 l/day.

Diet after coronary artery bypass surgery

The purpose of dietary nutrition after cardiac coronary artery bypass surgery is primarily to limit the intake of animal and culinary fats containing polyunsaturated fatty acids, low-density lipoproteins, cholesterol and triglycerides, which form cholesterol plaques in the lumen of blood vessels. All fried foods and especially red fatty meat and fatty fish are excluded from the diet. Cold-pressed olive oil is allowed from vegetable fats.

Of fish products, the diet should include “white” varieties of fish (cod, hake, flounder), as well as types of fish with a high content of fish oil - tuna, herring, salmon, sardine. Nutrition after bypass surgery should include a high content of fruits and vegetables, both fresh and frozen, and freshly squeezed juices.

folic acid , is useful for maintaining cardiovascular activity . It is recommended to include in your diet foods containing iodine - shrimp, mussels, seaweed, squid, as well as wholemeal bread, yeast-free bread, whole grains, and cereals.

The diet after cardiac bypass surgery includes 4-5 meals a day, excluding hot or cold foods. Salt in minimal quantities. Portions should not be plentiful. Requirements for culinary processing of products provide for the replacement of deep frying in animal fats with boiling, stewing, and steaming. The volume of free fluid is no more than 1-1.2 l/day.

Diet after cardiac stenting

Cardiac stenting, although it is a minimally invasive surgical method with a relatively short recovery period for the patient, also requires adherence to an anti-cholesterol diet for the rest of his life. Ignoring dietary nutrition leads to the continued development of atherosclerosis of the coronary vessels and the formation of new plaques, narrowing their lumen.

In principle, nutrition after stenting of cardiac vessels is similar to nutrition after vascular bypass surgery. The basis of the diet should be foods that prevent the development of atherosclerosis: fish (at least 2 times a week), lean meat and poultry, virgin vegetable oils, fresh vegetables/fruits high in fiber, seafood, wholemeal bread, whole grain products , nuts, low-fat dairy products.

Polyunsaturated fatty acids ( omega-3 ) contained in fish oil and vegetable oils reduce the content of triglycerides and low-density lipoproteins in the blood and increase the content of beneficial high-density lipoproteins. Fiber from plant foods effectively binds and removes cholesterol from the intestines.

Physical activity after valve replacement

Often, patients are sent for valve replacement if, before surgery, there were manifestations of chronic heart failure, which impair exercise tolerance and do not allow patients to move freely and actively.

The operation improves well-being, but patients often have no idea whether they can increase the load, in what specific mode to do this and to what limits. To determine the exercise regime, it is best for the patient to undergo a rehabilitation program in a sanatorium. An individual set of physical exercises will be selected for him, which he will perform under the supervision of a doctor. Gradually, taking into account the dynamics, the motor mode will expand. As a result, by the end of the rehabilitation period, a person will be able to live a full active life, freely endure everyday and other stresses.

If the patient does not plan to undergo rehabilitation in a sanatorium, he should contact a cardiologist with questions related to physical activity. You can clarify any questions with your doctor: the ability to engage in certain sports, lift weights, drive a car, etc.

In the first weeks, during the recovery period after surgery, it is very important to control the degree of stress. It is necessary to be active to such an extent that, on the one hand, it does not overload the heart, and on the other, does not slow down recovery and does not contribute to the development of complications.

Some patients move little because planning loads and performing exercises require discipline, diligence, and effort. Those who are too lazy to exercise should remember that physical activity improves the prognosis of heart disease, trains the cardiovascular system, has a general healing effect and helps to achieve better results from the operation.

Authorized Products

To reduce cholesterol levels and minimize the risk of developing atherosclerosis and angina, it is necessary to include foods containing polyunsaturated fatty acids, complex carbohydrates and fiber in the diet. The menu should include soups made with vegetable broth with the addition of cereals (beetroot soup, cabbage soup, borscht) and potatoes. For second courses, it is recommended to use lean varieties of red meat (veal, lean beef) and poultry (turkey, chicken), and rabbit. Low-fat varieties of white fish (cod, hake, tuna, flounder) and seafood (mussels, squid, shrimp, seaweed) are extremely healthy. As for fats, the use of vegetable oils (sunflower, olive), preferably cold-pressed, is recommended.

The diet should include dairy products (low-fat kefir, fermented baked milk) and low-fat cheeses. Be sure to include baked goods made from wholemeal flour, yeast-free bread, whole grains, oatmeal cookies and porridge in your diet. You should increase the amount of fruits and vegetables consumed in any form and method of culinary processing. The diet should include freshly squeezed juices from berries (blackberries, strawberries, blueberries) and fruits, almonds, walnuts. Fresh garden herbs and cereal dishes are a must. It is useful to use decoctions of rose hips and wheat bran to improve blood circulation.

Table of permitted products

Fully or partially limited products

All types of fatty meat, bacon, lard, any sausages, pates and meat pastes, as well as offal - liver, heart, brains - should be excluded from the diet. Broths containing meat, mushrooms and fish are prohibited. All fried foods, animal and cooking fats, mayonnaise and margarine are completely excluded from the diet. The consumption of butter, high-fat dairy products (sour cream, cream), and cheese is limited. Consumption of chicken eggs is limited to 3-4 eggs per week. You should not include fish and crustacean caviar, fatty fish (sprats, sardines) in your diet.

From the list of products you need to cross out white bread, confectionery, ice cream, carbonated drinks, as well as sugar and products containing it, honey. It is recommended to replace sweets with dried fruits. The restriction also applies to products with a high salt content (pickles, canned food, smoked meats). After vascular surgery, the consumption of chicken egg yolks, products made from butter/puff pastry, rice, semolina, pasta, as well as products containing a lot of caffeine (chocolate, strong tea, coffee, cocoa), which cause vasospasm and increase heart disease, is completely prohibited. activity. The consumption of sweet carbonated drinks, raisins, grapes, various spices and all types of alcoholic drinks is not allowed.

Table of prohibited products

Reviews and results

As evidenced by medical practice and reviews from most patients, dietary nutrition after bypass surgery and testing of heart vessels is the most important component of the treatment process and the prevention of further progression of atherosclerosis.

• “... At the age of 65 I was admitted to cardiology with acute coronary syndrome. We did stenting, a regular metal stent (Multi-Link VISION). There were no complications. The only medications prescribed were Plavix, Cardiomagnyl and Egilok. Cholesterol is 5.3, they prescribed an anti-cholesterol diet, which, according to doctors, I need to follow for life. And now I’ve been sitting on it for more than 6 months. I don’t feel any particular inconvenience, since there are many permitted foods in the diet”;
• “... After stenting the coronary vessels (4 stents) 3 years ago, the lipid profile is still unsatisfactory. For normalization, strict therapeutic nutrition was recommended. I followed this diet immediately after the operation, but then I relaxed and began to break it. Now I’m starting to eat again on the doctor’s recommendation, I hope it will help.”

Pain syndrome

After surgical treatment of cardiac arrhythmia or other disease, pain often persists in the wound or muscles. You can use anesthetic ointments, but applying them to healing wounds is prohibited. The latter can itch due to hair regrowth: you can get rid of this unpleasant sensation - in consultation with your doctor - by using a moisturizing lotion.

But some symptoms must be reported to your doctor. For example, about clicking movements of the sternum, about an increase in temperature of more than 38 ° C or not so high, but prolonged. We must not ignore the fluid that is released from the postoperative wound, swelling, redness and other signs uncharacteristic of healing.