# Aortic Valve Replacement: A Case Report Exploring the Psychological Impacts of Cardiac Surgery

## TL;DR

This case report highlights how the psychological stress of aortic valve replacement surgery can hinder recovery, especially when caregiving responsibilities are involved.

## Contribution

The paper emphasizes the need for integrating psychological assessment into post-AVR recovery management.

## Key findings

- Psychological distress can slow recovery after aortic valve replacement surgery.
- Stress is linked to physiological mechanisms like inflammation and impaired immune function.
- Follow-up assessments were not shared with the GP, highlighting a gap in holistic care.

## Abstract

With over 5000 successful aortic valve replacements (AVR) carried out across the UK, thousands of patients leave hospital physiologically and physically treated, with the expectation that they will gradually integrate back into their day‐to‐day routines. However, the psychological burden associated with the surgery is often underestimated. We describe a 55‐year‐old male attending a cardiology clinic with severe aortic regurgitation due to thickened aortic valve cusps. He was admitted for 9 days at a specialist hospital 2 h away from his home for AVR, requiring him to leave his wife for whom he is the sole carer. The burden of caregiving, coupled with the stress of surgery and post‐operative recovery, led to heightened psychological distress, impeding his recovery. The burden and stress were measured using the Short Form‐36 (SF‐36) health survey and self‐reported daily ratings of pain, physical discomfort, weakness, depression, and irritability. While most recover physically after open‐heart surgery, psychological distress can slow overall recovery. Stress and inadequate recovery are linked through physiological mechanisms, including heightened inflammatory responses and impaired immune function. The patient's well‐being and remission progression were assessed through follow‐up clinic visits and SF‐36 questionnaires. Importantly, these were not reported back to the GP upon hospital discharge, representing a gap in holistic recovery management. The discussion elaborates on the necessity of integrating psychological assessment in AVR recovery and how stress pathways affect long‐term outcomes. Recovery should not be focused solely on the physical aspects of surgery but also on the psychological and social impacts.