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“What About Exercising After Heart Valve Surgery?” Asks Brent

By Adam Pick on July 9, 2014

I received a great question from Brent about exercise after heart valve surgery. In his email, Brent writes to me, “Adam – I’m an active guy who likes to play racquetball, swim, hike, bike, golf and bowl. I was diagnosed with severe aortic stenosis and recently told I need surgery. I feel pretty darn good at 66 even though I do get winded a little easier these days. How long after surgery can I do all the things I’m doing now? Is there anything I should do after surgery to help me exercise sooner than later? Thanks, Brent”

Heart Running Cartoon

To provide Brent a great answer, I contacted Dr. Rawn Salenger, a heart valve surgeon from the University of Maryland, who has a clinical interest in how patient recovery from heart surgery. So you know, Dr. Salenger is an incredibly nice guy, who has successfully operated on many patients from our community including Kathleen Ryan, Gene Bove and Jeffrey Moore.

In Dr. Salenger’s response to Brent’s question, he starts by discussing the advantages of heart valve surgery and the time needed for the sternum to heal:

The goal of aortic valve surgery is to improve your survival and your quality of life. You should be able to get back to doing everything you are doing now and likely will have increased exercise tolerance. The rule of thumb is to wait three months before engaging in the activities including racquetball, swimming, hiking, biking, golfing and bowling. The main reason for that is to allow sternal (breast bone) healing. At three months, the sternum is mostly, although not entirely, healed.

Then, Dr. Rawn Salenger discusses the importance of walking after surgery:

Early after surgery, usually the next day, patients start to walk with assistance. This progresses to walking independently which will likely occur for you prior to discharge from the hospital. Walking inside and outside is encouraged for the next several weeks. Daily walks are great and you should stop when your body tells you to – don’t push yourself too hard. Beginning 4-6 weeks after surgery, your cardiologist can release you to begin a formal outpatient cardiac rehabilitation program. This entails exercising under the supervision of professionals and the program is designed to safely transition you back to an active lifestyle.

Lastly, Dr. Salenger addresses the benefits of cardiac rehab:

Cardiac rehab is recommended for all patients except in the uncommon situation where there is a medical reason not to exercise. To be safe, patients should be checked by their cardiologist and cleared prior to enrolling in a rehab program. Overall, patients who attend cardiac rehab are more active long term which is beneficial. The rehab program may be too easy for some patients who are in great shape but it is still a safe, supervised way to get back into exercise. Based on your pre-operative level of activity, you should expect to be active for a long time after getting your new valve. Good luck!

Many thanks to Brent for his question and a special thanks to Dr. Rawn Salenger for sharing his clinical experience and research with our patient community.

Keep on tickin!
Adam

Written by Adam Pick
- Patient & Website Founder

Written by Adam Pick - Patient & Website Founder

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

Patricia says on July 10th, 2014 at 7:27 pm

Hi Brent,
Sports? Yeah! Listen to your body and follow your intuition but don´t cross the line too soon. I remember wanting to swim immediately after surgery…I could not wait to have my incision healed. Starting with yoga helped a lot. I can only encourage you. Be wise, be patient.

Ron Bumpus says on July 16th, 2014 at 4:20 pm

Hi Brent,
I recently had my Aortic valve and root replaced on 2/24/2014. after my week in the hospital I was able to do stairs with little to no discomfort. like Dr.Salenger mention most of the hard activities should wait until the breastbone is healed. Currently I am 5 months post op, I have been actively going to the gym 4 days per week, I have absolutely 0 issues / or pain on or around the chest. so just give it a little time and you should be just fine …..

Ron

Peter says on July 16th, 2014 at 4:58 pm

Hi Brent – I am 54 and had my aortic valve replaced on 16th May. Like you I was very active pre-surgery (mainly jogging, MTB) and this helped y recovery immensely. I was up and walking 2 days after surgery and doing stairs after 3 days. I was discharged 5 days after surgery and then started at 20 minutes slow walks around the block by my house. After walking every day since then and gradually building up I now find 1hr quite easy and this is on hill country. I even did a 90 minute hike on some hill tracks last weekend. Today I intend to get on my mountain bike but I will be limiting this to relatively “on road” because I don’t want to risk falling off until at least 3 months after surgery. My own experience is that there are good days and bad days post-recovery ( I did end up in hospital again 3 weeks after surgery, for one night, with extremely bad shoulder pain, but this was attributed as being referred pain due to the nerves being unsettled from the surgery. This is gradually settling down). The key is to listen to your body and gradually increase activity “softly softly”, and certainly no major weight bearing stuff until at least 3 months. I use a Suunto HR monitor that gives me some guidance on programs and – because I tend to overdo things – tells me when to take a rest day!! Works for me. Good luck! Peter (New Zealand)

Alan says on July 16th, 2014 at 5:19 pm

Hi Brent – I am 58 and had my aortic valve and 4 inches of aorta replaced on April 21. Before my surgery I was very active with much hiking and biking as well as pretty significant weight lifting. Now (eleven weeks post-op) I was hiking in the mountains of Colorado, rode a bike for half a day (on fairly level terrain), swam one day (a gentle breast stroke), worked out in the gym lifting weights (20 – 40 pounds depending on the movement) and all without pain and no shortness of breath despite the altitude. The last time I was in Colorado (before my surgery) I had severe breathing problems and passed out while skiing. I agree the secret is to get moving again as soon as possible, pace yourself, and get adequate rest. Walk, walk, walk. Definitely no weights until three months after surgery.

Michael says on July 17th, 2014 at 1:51 am

I’m a bicyclist but not a very competitive one. I really didn’t want to go through the procedure of having my aortic valve replaced but did so when my cardiologist said that if I didn’t do it, I’d be selling my bikes in a few years because I would no longer be able to ride.

I didn’t ride until they took me off coumadin since my cardiologist said that if I hit my head in a fall, the “results could be catastrophic.” I went through the same rehab that everyone else has described. Three months after surgery, I went on my first road ride, we did 22 miles and I noticed on my heart rate monitor that my heart beat was consistently lower than it had been before my surgery.

It wasn’t that long when I was back in the saddle. I rode for quite a while until I did an endo on my mountain bike resulting in two fractures and a shoulder separation. Bones aren’t doing so hot I guess and the muscles aren’t as good as they used to be but the old heart just keeps pumping away.

In the end, replacing that valve ended up making me a stronger rider. I wasn’t expecting that to happen but it did.

Bob Eldi says on July 17th, 2014 at 5:23 am

Brent – I’m 72 & had a bovine aortic valve replacement in Feb. ’13 – I’m also very active – I walked a ton as soon as possible & resumed light weight leg exercises at 6 weeks – I’m not sure I’d golf or play racquetball until 6 months, but swimming, hiking, etc. should be fine. It’s the sudden twist that I avoided for 6 months – your body will tell you – good luck in the rehab – you will feel much better than before – Bob

Peter Bertolo says on July 17th, 2014 at 7:48 am

Hi Brent
Two years ago I was dianosed with aortic valve stenosis and had to have it replaced with a mechanical valve. I was 58 years old at the time and in reasonably good shape..The surgery went very well and I was out of the hospital in 5 days. At home I did as much walking as possible and incresing the distance every day. After one month I was walking 2 miles three times per day. My recovery was going very well and I was completely pain free. I kept my walking regiment on for another month until I decided one day to try to swing a golf club, as i was itching to get back to playing golf. I started with chipping then long irons and then a driver. After 15 minutes it was very clear that I could make a full swing with a driver with no ill effects. The next day I played a round of golf with no issues whatsoever (except I was still a lousy putter). Three months after my surgery, I went to our annual South Carolina golf vacation. I played 8 rounds of golf over 7 days. There was no fatigue and no pain. The only issue I had was the excessive loss of blood during surgery. The doctors decided not to give me a transfusion as the loss of blood wasn’t too bad. The result was that I became anemic and it resulted in a little less energy (but not too bad) and constant chills. With the help of iron supplements I was able to get back to normal in a few months. Today 2 years after surgery, I go to the gym 3 times a week and play golf whenever work does not get in the way.My health is very good.
My suggestions to you is to stay positive about the surgery, and after the surgery stay as active as possible but don’t overdue it. As someone mentioned listen to your body.
I wish you the best of luck.
Pete- Toronto, Canada

Anne Shannon says on July 17th, 2014 at 10:08 am

Hi Brent,

The patient you should look up is Barry Stone from NM. He had his AVR about two years ago and to read the list of accomplishment since surgery will be encouraging.
Barry followed my journal and went to Cleveland Clinic and had the same surgeon I did. We both had our valves replaced in a minimally invasive surgery and our recoveries were pretty easy. Two summers ago, Barry was on his way to a family event in Colorado and contacted me. He stopped by my house for lunch and gave me one of his race bibs for “leading” him via my journal through surgery. His visit and gift meant so much to me!

Yesterday was the four anniversary of my new bovine valve. My quality of life has been excellent since that operation. Sending you many positive thoughts as you go through this process!

Anne Shannon

Hi Brent says on July 17th, 2014 at 7:09 pm

My name is Bob Stoltz and I had my aortic valve replaced when the diameter went from mild, medium to severe (1.2 cm to. .6 cm ). I followed it with echocardiograms for ten years with no problems of any kind. ( I always exercised, weights, bicycling, jogging etc) It did not change for the last two years, and the doctor thought it may have stabilized.

It did not stabilize, and I had typical symptoms, shortness of breath, fatigue etc. I had the valve replaced on October 6 2013 with a Carpentier- Edwards Magna Ease aortic valve prosthesis.

In January 2014 I was back to 60% of where was before the surgery.– and now July 2014 I am better than I was before my surgery. I jog 6mph on the treadmill for one hour each day.(I do cheat a little, hold on to side rails, to relieve some weight from my knees)
I just went for walk on the Appalachian trail which is close to where I live. I bicycle, lift weights, and use all of the Nautiis equipment in our Gym. I am really happy, enjoying my life just like before. Thank God for these wonderful surgeons!! I am 82 years old. You will be happy with your progress also, believe me.

Peter Willard says on July 19th, 2014 at 12:35 pm

I like reading about the people that had a valve replaced or are about to I had a bovine valve in Feb.2010 I am 72 and it would be nice to know what other valves people choose and why.
thank you
Pete

Ellie Mankin says on July 25th, 2014 at 12:05 am

I have been diagnosed with A-FIB in 05/10/2013, heart failure on 12/12/2014, and 2 leaky valves (Tricuspic Valve and Mitral Valve) on 06/25/14. Prior to my heart failure, I am very active gardener, coffee farmer (Kona, HI), doing my own house cleaning, lots of party entertaining, etc., etc. I am of age 66 but my condition since 12/12/2014 had put a halt to my quality of life. I am on heavy medication of Lasix, Potassium HCL, Digoxin, Spironlactone, Xalreto, Atorvastatin, Metaformin (since 07/01/14), Tamoxifen (breast cancer survivor since 04/2010), stopped taking Metolazone (06/28/14 – ended 07/07/14).

Is surgery the best solution to regain a much quality of life than loosing my breath, difficulty in exertive type of activity and so on. I also since I am placed on Lasix and Potassium, I am suffering from severe leg cramps nightly to the point where I am under anxiety tension due the constant pain and lack of sleep – leg cramps comes between 2:00am through 6:30am.

Please give me a suggestion to to discuss with my cardiologist.

BOBS STOLTZ says on August 6th, 2014 at 9:29 am

Hi Ellie,
I had severe aortic stenosis, with leaky tricuspid and mitral valves. The anxiety and shortness of breath was intolerable. I had my aortic valve replaced, my tricuspid valve repaired (banded) and my mitral valve repaired with a clip.It was done on Oct 9, 2013 They also repaired my coronary valves at this time .
The results were fantastic, I am much better than I was before the surgery. Everything that could go wrong went wrong with me–and the post operative recovery. was hard.
but I would not be here if I had not had this done. My advice, get it done before more damage results to your heart valves. I feel like a young man again, and I am 82 years old!
Good luck!!

BOBS STOLTZ says on August 6th, 2014 at 9:30 am

Rhonda Summerfield says on September 2nd, 2014 at 5:07 pm

Hi Adam,
I see my surgeon on the 9.9.14. I have found out that he is a good one Geoffrey Wall is his name and I am from Australia. My Cardiologist only told me that I would be getting mechanical valves as I didn’t like the idea of the pig ones having to be replaced in 6 years. I since heard about the Bovine valve which lasts for 20 years and think I would like to get those ones as I don’t take medication which the mechanical ones require. He told me nothing about replacing the aorta as it has blown out near the lungs to over 5mm. I have been told by other people that it will be taped up. My question is can I get the Bovine valves from America as I feel that would be best for me. My surgery will be open heart and I believe the valves can be replaced by keyhole surgery is that right in my case? I am a public patient.Thank you.

Rhonda

DJ says on October 28th, 2014 at 5:49 pm

I am nine months post aortic valve replacement surgery. Since I have some other issues to deal with, i.e., spinal and hip joint pain, I am not moving as fast I think I should be. Netther am I exercising as much as I want to.
The good part is, I am doing what I can do and expect to get rid of these aches and pain soon.
The cardiologist is still monitering me. Next week, I have to get more blood work (they are still working on stabilizing my meds), and another echo cardiogram.