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More and more biological valves have been used in aortic valve replacement in the world due to their unique advantages; however, due to the poor durability of biological valves and other reasons, valve deterioration is an inevitable problem of artificial biological valves. Once severe valve deterioration occurs, it can lead to valve stenosis or regurgitation, which may result in cardiac enlargement and cardiac insufficiency and often require valve re-replacement. Surgical valve replacement has long been the gold standard for the treatment of aortic valve deterioration, but since biological valves are mostly used in the elderly and there is a high risk of surgical valve re-replacement, many patients are rejected from surgery. In recent years, due to the accumulation of experience in transcatheter aortic valve replacement (TAVR) and related technical advances, it has been increasingly applied in the treatment of biological valve deterioration, especially the application of “valve-in-valve” TAVR.

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Objective To explore the effectiveness of sequential high temperature humidified high flow nasal cannula （HHFNC）after evacuation of ventilator after cardiac valve replacement. Methods A total of 138 cases transferred to ICU after heart valve replacement in the hospital from February 1，2015 to February 1，2018 were randomly divided into sequential group（68 cases）and traditional oxygen inhalation group（70 cases）. The ICU hospitalization time，mechanical ventilation time，APACHE Ⅱ score，SOFA score，48 h re intubation rate，48 h return to ICU rate，respiratory rate（RR），oxygenation index （OI）and lactate clearance rate（Lac） between the two groups etc.were compared. Results The ICU hospitalization time， APACHE Ⅱ score and SOFA score，the 28 d mortality rate between the two groups compared，the differences were not statistially signifiant（P>0.05），but mechanical ventilation time，48 h reintubation rate，48 h return to ICU rate，respiratory rate，partial pressure of carbon dioxide（PCO2）in the sequential group were lower than in those the traditional oxygen group，the partial pressure（PO2），OI，Lac in the sequential group were higher than that of the traditional oxygen group，the differences were statistically significant（P<0.05）. Conclusion After cardiac valve replacement weaning extubation after sequential application of nasal high flow warming humidification oxygen therapy in patients with mechanical ventilation time shortened，reintubation rate and return to ICU rate were reduced，which can make the patients more safely out of ICU and reduce the incidence of adverse events，has a good application prospect. [ABSTRACT FROM AUTHOR]

Valve replacement is the most common treatment for patients with heart valve disease. Thesurgical trauma, postoperative catheter placement and changes in disease conditionmay contribute to the postoperative complications, especially pulmonary complications. The training on pulmonary function is an key issue of successful surgical treatment, and mainly includes abdominal breathing, pursed lips breathing, blowing up balloons and so on. However, there were few studies of training on pulmonary function in postoperative rehabilitation of patients with heart valve replacement. This paper reviewed related studies and provide reference for further research. [ABSTRACT FROM AUTHOR]