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Your Care Experience:
Valve Replacement
2
To hear your heart valve isn’t
working properly is frightening.
In fact, not long ago, valve
replacement would have meant
open heart surgery. Thankfully,
that’s not the case today, and
especially not at Banner Health.
Among the country’s leading practitioners of two new life-saving
valve replacement procedures, Banner Health is committed to
increasing your life expectancy and improving your quality of life.
Our approach is much less invasive, leaving you less to worry
about and more to live for. Your heart-healthy future starts here.
Why Choose Banner?
4
Our Experience at Work for You
Banner Health employs 280
heart doctors, including
cardiologists, interventional
cardiologists, cardiothoracic
surgeons and vascular
surgeons, to ensure you get
the best possible care.
Ourheartprogramhasbeen
nationallyrecognizedforeight
yearsbyWatsonHealth(formerly
TruvenHealthAnalytics)asone
ofthetop50cardiovascular
programsinthecountry.
We’ve been consistently
named one of Becker’s Hospital
Review’s 100 Hospitals with
Great Heart Programs.
4
50280 100
Whether you’re having a TAVR (transcatheter aortic valve replacement) or a TMVR (transcatheter mitral
valve replacement) with MitraClip®, you couldn’t be in better hands. Our world-renowned physicians are
leaders in their fields, providing compassionate care using the most advanced technologies available.
5
At Banner Health, your heart team brings
together the talents and expertise of specialists
in all areas of care for the best outcome for you.
Your cardiothoracic surgeon and interventional
cardiologist work together to plan and perform
your valve replacement procedure.
Your valve clinic coordinator serves as your and
your family’s contact, scheduling appointments
and answering questions.
Your imaging specialists develop a full picture of
your cardiovascular health.
Your anesthesiologist carefully administers your
anesthetic and monitors your blood pressure,
heart rhythm and other vitals throughout
the procedure.
Our Team in
Your Corner
6
The Banner Health heart team includes
specialists from many different areas, all
engaged in the care of the patient to determine
the best treatment or therapy. It’s a group effort
that involves the patient, family members and
loved ones in the decision-making process.
Michael S. Kim, MD
Interventional Cardiology, Colorado
7
TAVR (transcatheter aortic
valve replacement)
A TAVR is for those diagnosed with aortic valve
stenosis. The procedure repairs the aortic valve
without removing the damaged valve.
TMVR (transcatheter mitral valve
replacement) with MitraClip®
A TMVR is for those diagnosed with mitral valve
regurgitation. The procedure repairs a leaking mitral
valve with an implanted clip.
Valve Replacement Surgeries
Rest assured, our Banner Health surgeons have a wealth of experience in both of these new,
advanced procedures for valve replacement.
What to Expect
9
During Your
Procedure
Your comfort is our first priority. When you arrive
at the pre-op area, we’ll do everything we can to
make sure you’re calm and at ease. Your nurse
will bring in key members of your heart team to
answer any last-minute questions, and when
you’re ready, your anesthesiologist will carefully
administer your anesthetic.
A TAVR procedure is conducted in a hybrid
operating room equipped with the most
advanced medical imaging devices. Your heart
team will use these to guide your new valve
(inside a flexible, thin tube) through an incision
in your leg up to your heart.
A TMVR with MitraClip® procedure takes place
in a specialized room called a cath lab, where
your heart team will guide the MitraClip®
device
through a vein in your leg up to your heart.
10
Because valve replacements are serious procedures, it’s important to prepare by
getting yourself in the best condition you can. Begin by eating healthy foods and
getting plenty of rest.
Wear loose, comfortable clothing that’s easy to slip on and off, and pack items
from home that put you at ease (slippers, socks, etc.). For women, remember
to pack a front-fastening bra.
Care Team Tips
Ask your doctor about the medications you should stop up to a week before the
procedure, as some blood thinners aren’t surgery-friendly. Avoid alcohol, nicotine
and food after midnight on procedure day.
11
Michael S. Kim, MD
Interventional Cardiology, Colorado
Our surgeons are some of the most
experienced in the country with the
MitraClip® device. So, patients seeking
care at Banner Health will have the
benefit of being treated by surgeons who
are very familiar and comfortable with
this complex technology.
12
Your Recovery
13
After Your
Procedure
After your procedure, you’ll be taken to the
ICU, where our experienced staff will closely
monitor you. Within six to eight hours, you’ll
be taken to the step-down unit.
The average hospital stay for either of
the two procedures is 24 to 48 hours, so
you might go home the very next day.
14
Care Team Tips
Don’t be afraid to ask for help. After a TAVR procedure, you’ll need support for the
first day or so, and after a MitraClip® procedure, even longer.
Get up and walk as soon as you can, starting with short walks with a partner until
you’re steady. Your doctor may recommend a cardiac rehab program with a trainer
to guide you.
Include as many heart-healthy foods — such as fish, whole grains, fruits and
vegetables — as you can in your post-op diet. Most important, avoid processed or
high-fat, sugary foods and reduce your sodium intake.
15
I was getting a little bit too old for a heart
operation, but my surgeon told me about a
patient who was 92, and if he could do it, I can.
Banner has kept me going; they took care of me
completely. Now, I go golfing every Saturday —
my rehabilitation program has given me a lot
of strength. If it wasn’t for Banner, I wouldn’t be
doing the things that I’m doing.
Doug Arthur
Sun City West, Arizona / Valve Replacement Patient
16
Q&A: The Basics
How much pain will I be in?
You’ll be under anesthesia throughout the procedure and should feel no pain. Once at home, you should
be able to manage any discomfort with pain medications and instructions provided by your doctor.
Q:
What medications will I need to take?
Your doctor may prescribe blood-thinning medications, such as Coumadin, to help reduce the risk of
developing a blood clot after the procedure. You’ll also be able to resume any medications you were taking
prior to surgery, in addition to baby aspirin and Plavix. You can expect to take aspirin for the rest of your life.
Q:
How physically limited will I be when I return
home?
Immediately after a TAVR procedure, get up and walk around the house as much as you can, taking stairs
slowly, with rests. Gradually increase your activity and your walking speed, lengthening your walks until
you are walking a half hour a day, five to six days a week. After a MitraClip®
procedure, avoid strenuous
activities for at least the first month. You may need one to four weeks to fully recover.
Q:
17
Q&A: What You’re Really Wondering
When will I be able to drive?
Avoid driving for at least one to two weeks after a TAVR or MitraClip® procedure. Ask a friend
or family member in advance to help (or sign up for a ride-sharing service), and check with your
doctor before getting back behind the wheel.
Q:
When will I be able to have sex?
It’s normal to be concerned about returning to regular sexual activity after a TAVR or MitraClip®
procedure. Feel free to ask your doctor if you have any questions, but, typically, you can resume
sexual activity whenever you’re comfortable and ready.
Q:
When will I start feeling like myself again?
Expect to have fewer occurrences of breathlessness and chest pain right away. Gradually, you’ll
regain your energy, and you’ll have more stamina and less fatigue in the days and weeks after surgery.
Q:
18
Arrange for a loved one to take you home and stay by
your side for 24 hours.
Create a log to track your medication regimen. That way,
you don’t have to rely on memory alone.
Sign up for an on-demand help service for assistance
with unanticipated or minor needs, such as picking up
supplies or walking the dog.
After TAVR, you may soon be able to climb stairs and
do other physical tasks you weren’t able to before. But
it’ll take time. Recovery after a MitraClip®
procedure will
depend on your condition and stamina beforehand.
Your ‘What Do I Need?’ Checklist
Ask your doctor about any convenience items to buy
now, such as support pillows, a shower stool or a long-
handled shoe horn.
Thoroughly clean your home, stocking up on disposable
items such as plates, cups and utensils.
Purchase or prepare plenty of premade meals — or sign
up for an on-demand meal or grocery delivery service.
If your bedroom is located upstairs, consider a
temporary relocation to the first floor.
Remove tripping hazards, such as loose cords or rugs.
Share a spare set of keys with somebody you trust in
case of an emergency.
Evenbinge-watchinghasitslimits.Thinkaboutalternative
formsofentertainment,suchasreadingorcrafting.
Start a healthy diet and be as active as you can so that
you’re as strong as possible for your procedure.
Pre-Op Recovery
Notes
If your friends and family members are far away, use this checklist to help set yourself up for a successful recovery.
19
Offer emotional support to help ease anxiety.
Stock the house with plenty of fluids and comfort aids.
Check with your loved one’s insurance provider
regarding questions about copayment or deductible.
Make sure your loved one washes his chest with soap and
water the night before surgery to help minimize the risk
of infection.
Help your loved one review and fill out post-op paperwork.
FeelfreetovisityourlovedoneintheICU,butknowit’s
allowedonlyforshortperiods.TheBannerHealthICU
teamwillmonitorheruntilit’stimetomovetoanewroom.
Prepare for a TAVR procedure to last one to one and a
half hours. A MitraClip® procedure will take a little longer
— two to two and a half hours on average.
Since your loved one won’t be able to drive home, drive
him to the hospital one hour prior to the procedure.
Pinpoint the nearest pharmacy en route from the hospital
so you can pick up pain medication on the way home.
The ‘How Can I Help?’ Checklist
Procedure Day
Handle household tasks and monitor recovery.
Ensure your loved one takes medications as scheduled.
Encourage movement around the house.
Prevent heavy lifting of anything over 10 pounds for two
weeks.
Accompany your loved one to follow-up visits.
Communicate any health issues or concerns as soon as
they arise.
Shop for and prepare heart-healthy foods, especially
fruit, vegetables, whole grains and fish.
Pre-Op
Recovery
Share or print the following checklist with friends and family members so they know what to expect and how to help.
20

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Your Care Experience: Valve Replacement

  • 2. 2 To hear your heart valve isn’t working properly is frightening. In fact, not long ago, valve replacement would have meant open heart surgery. Thankfully, that’s not the case today, and especially not at Banner Health. Among the country’s leading practitioners of two new life-saving valve replacement procedures, Banner Health is committed to increasing your life expectancy and improving your quality of life. Our approach is much less invasive, leaving you less to worry about and more to live for. Your heart-healthy future starts here.
  • 4. 4 Our Experience at Work for You Banner Health employs 280 heart doctors, including cardiologists, interventional cardiologists, cardiothoracic surgeons and vascular surgeons, to ensure you get the best possible care. Ourheartprogramhasbeen nationallyrecognizedforeight yearsbyWatsonHealth(formerly TruvenHealthAnalytics)asone ofthetop50cardiovascular programsinthecountry. We’ve been consistently named one of Becker’s Hospital Review’s 100 Hospitals with Great Heart Programs. 4 50280 100 Whether you’re having a TAVR (transcatheter aortic valve replacement) or a TMVR (transcatheter mitral valve replacement) with MitraClip®, you couldn’t be in better hands. Our world-renowned physicians are leaders in their fields, providing compassionate care using the most advanced technologies available.
  • 5. 5 At Banner Health, your heart team brings together the talents and expertise of specialists in all areas of care for the best outcome for you. Your cardiothoracic surgeon and interventional cardiologist work together to plan and perform your valve replacement procedure. Your valve clinic coordinator serves as your and your family’s contact, scheduling appointments and answering questions. Your imaging specialists develop a full picture of your cardiovascular health. Your anesthesiologist carefully administers your anesthetic and monitors your blood pressure, heart rhythm and other vitals throughout the procedure. Our Team in Your Corner
  • 6. 6 The Banner Health heart team includes specialists from many different areas, all engaged in the care of the patient to determine the best treatment or therapy. It’s a group effort that involves the patient, family members and loved ones in the decision-making process. Michael S. Kim, MD Interventional Cardiology, Colorado
  • 7. 7 TAVR (transcatheter aortic valve replacement) A TAVR is for those diagnosed with aortic valve stenosis. The procedure repairs the aortic valve without removing the damaged valve. TMVR (transcatheter mitral valve replacement) with MitraClip® A TMVR is for those diagnosed with mitral valve regurgitation. The procedure repairs a leaking mitral valve with an implanted clip. Valve Replacement Surgeries Rest assured, our Banner Health surgeons have a wealth of experience in both of these new, advanced procedures for valve replacement.
  • 9. 9 During Your Procedure Your comfort is our first priority. When you arrive at the pre-op area, we’ll do everything we can to make sure you’re calm and at ease. Your nurse will bring in key members of your heart team to answer any last-minute questions, and when you’re ready, your anesthesiologist will carefully administer your anesthetic. A TAVR procedure is conducted in a hybrid operating room equipped with the most advanced medical imaging devices. Your heart team will use these to guide your new valve (inside a flexible, thin tube) through an incision in your leg up to your heart. A TMVR with MitraClip® procedure takes place in a specialized room called a cath lab, where your heart team will guide the MitraClip® device through a vein in your leg up to your heart.
  • 10. 10 Because valve replacements are serious procedures, it’s important to prepare by getting yourself in the best condition you can. Begin by eating healthy foods and getting plenty of rest. Wear loose, comfortable clothing that’s easy to slip on and off, and pack items from home that put you at ease (slippers, socks, etc.). For women, remember to pack a front-fastening bra. Care Team Tips Ask your doctor about the medications you should stop up to a week before the procedure, as some blood thinners aren’t surgery-friendly. Avoid alcohol, nicotine and food after midnight on procedure day.
  • 11. 11 Michael S. Kim, MD Interventional Cardiology, Colorado Our surgeons are some of the most experienced in the country with the MitraClip® device. So, patients seeking care at Banner Health will have the benefit of being treated by surgeons who are very familiar and comfortable with this complex technology.
  • 13. 13 After Your Procedure After your procedure, you’ll be taken to the ICU, where our experienced staff will closely monitor you. Within six to eight hours, you’ll be taken to the step-down unit. The average hospital stay for either of the two procedures is 24 to 48 hours, so you might go home the very next day.
  • 14. 14 Care Team Tips Don’t be afraid to ask for help. After a TAVR procedure, you’ll need support for the first day or so, and after a MitraClip® procedure, even longer. Get up and walk as soon as you can, starting with short walks with a partner until you’re steady. Your doctor may recommend a cardiac rehab program with a trainer to guide you. Include as many heart-healthy foods — such as fish, whole grains, fruits and vegetables — as you can in your post-op diet. Most important, avoid processed or high-fat, sugary foods and reduce your sodium intake.
  • 15. 15 I was getting a little bit too old for a heart operation, but my surgeon told me about a patient who was 92, and if he could do it, I can. Banner has kept me going; they took care of me completely. Now, I go golfing every Saturday — my rehabilitation program has given me a lot of strength. If it wasn’t for Banner, I wouldn’t be doing the things that I’m doing. Doug Arthur Sun City West, Arizona / Valve Replacement Patient
  • 16. 16 Q&A: The Basics How much pain will I be in? You’ll be under anesthesia throughout the procedure and should feel no pain. Once at home, you should be able to manage any discomfort with pain medications and instructions provided by your doctor. Q: What medications will I need to take? Your doctor may prescribe blood-thinning medications, such as Coumadin, to help reduce the risk of developing a blood clot after the procedure. You’ll also be able to resume any medications you were taking prior to surgery, in addition to baby aspirin and Plavix. You can expect to take aspirin for the rest of your life. Q: How physically limited will I be when I return home? Immediately after a TAVR procedure, get up and walk around the house as much as you can, taking stairs slowly, with rests. Gradually increase your activity and your walking speed, lengthening your walks until you are walking a half hour a day, five to six days a week. After a MitraClip® procedure, avoid strenuous activities for at least the first month. You may need one to four weeks to fully recover. Q:
  • 17. 17 Q&A: What You’re Really Wondering When will I be able to drive? Avoid driving for at least one to two weeks after a TAVR or MitraClip® procedure. Ask a friend or family member in advance to help (or sign up for a ride-sharing service), and check with your doctor before getting back behind the wheel. Q: When will I be able to have sex? It’s normal to be concerned about returning to regular sexual activity after a TAVR or MitraClip® procedure. Feel free to ask your doctor if you have any questions, but, typically, you can resume sexual activity whenever you’re comfortable and ready. Q: When will I start feeling like myself again? Expect to have fewer occurrences of breathlessness and chest pain right away. Gradually, you’ll regain your energy, and you’ll have more stamina and less fatigue in the days and weeks after surgery. Q:
  • 18. 18 Arrange for a loved one to take you home and stay by your side for 24 hours. Create a log to track your medication regimen. That way, you don’t have to rely on memory alone. Sign up for an on-demand help service for assistance with unanticipated or minor needs, such as picking up supplies or walking the dog. After TAVR, you may soon be able to climb stairs and do other physical tasks you weren’t able to before. But it’ll take time. Recovery after a MitraClip® procedure will depend on your condition and stamina beforehand. Your ‘What Do I Need?’ Checklist Ask your doctor about any convenience items to buy now, such as support pillows, a shower stool or a long- handled shoe horn. Thoroughly clean your home, stocking up on disposable items such as plates, cups and utensils. Purchase or prepare plenty of premade meals — or sign up for an on-demand meal or grocery delivery service. If your bedroom is located upstairs, consider a temporary relocation to the first floor. Remove tripping hazards, such as loose cords or rugs. Share a spare set of keys with somebody you trust in case of an emergency. Evenbinge-watchinghasitslimits.Thinkaboutalternative formsofentertainment,suchasreadingorcrafting. Start a healthy diet and be as active as you can so that you’re as strong as possible for your procedure. Pre-Op Recovery Notes If your friends and family members are far away, use this checklist to help set yourself up for a successful recovery.
  • 19. 19 Offer emotional support to help ease anxiety. Stock the house with plenty of fluids and comfort aids. Check with your loved one’s insurance provider regarding questions about copayment or deductible. Make sure your loved one washes his chest with soap and water the night before surgery to help minimize the risk of infection. Help your loved one review and fill out post-op paperwork. FeelfreetovisityourlovedoneintheICU,butknowit’s allowedonlyforshortperiods.TheBannerHealthICU teamwillmonitorheruntilit’stimetomovetoanewroom. Prepare for a TAVR procedure to last one to one and a half hours. A MitraClip® procedure will take a little longer — two to two and a half hours on average. Since your loved one won’t be able to drive home, drive him to the hospital one hour prior to the procedure. Pinpoint the nearest pharmacy en route from the hospital so you can pick up pain medication on the way home. The ‘How Can I Help?’ Checklist Procedure Day Handle household tasks and monitor recovery. Ensure your loved one takes medications as scheduled. Encourage movement around the house. Prevent heavy lifting of anything over 10 pounds for two weeks. Accompany your loved one to follow-up visits. Communicate any health issues or concerns as soon as they arise. Shop for and prepare heart-healthy foods, especially fruit, vegetables, whole grains and fish. Pre-Op Recovery Share or print the following checklist with friends and family members so they know what to expect and how to help.
  • 20. 20