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My mother has undergone aortic valve replacement surgery. Is it fine to shift her from ICU?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Chithranjali Ravichandran

Published At April 21, 2021
Reviewed AtJanuary 2, 2024

Patient's Query

Hi doctor,

After aortic valve and mitral valve replacement surgery for heart failure and long-term pulmonary artery hypertension (50 to 60), weakened kidney function (100 to 200 ml of urine per day), a hemofiltration machine is used. The question is, can the patient be moved outside ICU?

Hi,

Welcome to icliniq.com.

I am taking into consideration both valves are functioning normally, and the patient was on proper oral anticoagulation (e.g., vitamin K antagonists) to prevent clots. Right now, the patient is in heart failure with low urine output - After electrolyte correction, normal functioning of the valve, extensive failure management, and the patient is not breathless while sitting and lying down. Only you can move the patient out of ICU. After discharge also fluid intake should be monitored. She may need iron sucrose IV supplements for anemia correction because valves cause hemolysis. The patient is in decompensated heart failure, the prognosis is not favorable. Do share her echocardiography reports.

Patient's Query

Hi doctor,

Thanks doctor, for your feedback. Please see the attached latest echocardiography report. Now my mom's doctor insisted that she needs to stay in ICU. However, due to the pandemic, family members are not allowed in the ICU, so we want to move her out. She is so anxious to move out and stay with us. If we move my mom from the ICU, how long can she stay by herself before we can send her to ICU again? Thanks.

Hi,

Welcome back to icliniq.com.

According to this report, LV systolic function is acceptable (not mentioned ejection fraction in percentage), and the LV cavity is not dilated. Valve's functioning is not mentioned. I am considering both valves functioning normally. I think it is a good report, and the patient should improve or already improved from heart failure. Urine output should be good in this LV function if there are no renal/kidney primary issues. According to the heart or cardiac point of view, I find her in good condition. Suppose she is still in failure symptoms other causes to be seen like anemia, heart rhythm, valvular function, electrolytes. With proper medicines and fluid intake moderation according to urine output, she can stay for a pretty good time by herself. (Monitor fluid intake, hemoglobin levels, INR, and valvular function). It seems now the main problem is with kidneys. I think only for hemofiltration should she be in ICU in between, she can come out as cardiac function is acceptable.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Prashant Valecha
Dr. Prashant Valecha

Cardiology

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