My father is 63 years old, has had diabetes for a long time, and recently discovered he has 3/4 mitral valve regurgitation. Can he have heart valve replacement surgery? (Minh Tuan, Binh Duong)
Reply:
Not only in heart surgery, but in all surgeries, diabetic patients face more risks during and after surgery than normal people. These risks include:
Hypoglycemia : Patients must fast for 6-8 hours before surgery. Therefore, the risk of hypoglycemia in diabetic patients is very high if insulin doses are not monitored and adjusted.
Infection : High blood sugar and low immunity increase the risk of infection, causing patients to use more antibiotics.
Slow-healing wounds : When blood sugar is uncontrolled, combined with a high risk of infection, wounds take a long time to heal and are prone to necrosis.
Diabetics need to control their blood sugar well before and after heart surgery. Photo: Freepik
Your father has had diabetes for many years. He can still undergo heart valve replacement surgery. However, to minimize the risk, he needs to control his blood sugar well before surgery, and maintain a diet rich in protein (found in eggs, chicken breast, oats, cheese, milk, tuna, etc.). Protein is an important ingredient that helps wounds heal quickly, strengthens tissue at the surgical site, and increases the body's ability to withstand surgery.
In addition, you should encourage your father to exercise regularly to increase resistance, helping the body recover quickly. The family also needs to encourage him to stay mentally comfortable, not too stressed because if he is stressed both physically (undergoing surgery) and emotionally (anxious, nervous) can increase blood sugar levels, making the surgery more risky.
Finally, if your father drinks alcohol or smokes, he should stop immediately. Abstaining from alcohol will help the body control blood sugar better. Meanwhile, quitting smoking will help the breathing process go more easily, shortening the time to remove the ventilator after surgery.
After surgery, blood sugar often fluctuates a lot because the patient cannot eat normally, often vomits, is sedentary, and some people are stressed. Therefore, the patient will be monitored and have their blood sugar checked regularly. Depending on the medical condition, the doctor will have measures to maintain blood sugar levels within the allowable range.
After heart surgery, people with diabetes often take longer to recover than people without underlying conditions. Therefore, you and your family need to be mentally prepared to take care of your father for a long time. During this time, you must pay attention to signs of infection, such as fever, red incision, hot to the touch, swelling, increased pain or discharge... If the patient has any unusual signs, it is necessary to notify the doctor for immediate treatment.
In addition, after surgery, patients should walk gently, turn around and exercise regularly even when lying in bed. Many diabetic patients lose feeling in their toes and fingers, so they do not feel pain from ulcers. Exercise will help prevent the risk of skin ulcers.
Most importantly, after your father is discharged from the hospital, in addition to following the follow-up schedule and taking prescribed medication, it is necessary to control his blood sugar well. This helps maintain the effectiveness of the surgery and prevent dangerous complications of diabetes.
MSc. Dr. Huynh Thanh Kieu, Head of Department of Cardiology 1
Cardiovascular Center Tam Anh General Hospital, Ho Chi Minh City
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