past medical history: significant for: 1. aortic stenosis. 2. anxiety. 3. chronic anemia. 4. left frozen shoulder. past surgical history: significant for: 1. dilatation and curettage times two. 2. rhinoplasty. 3. cardiac catheterization. medications on admission: 1. celebrex 200 mg p.o. twice a day. 2. ativan 0.25 mg p.o. p.r.n. 3. aciphex 20 mg p.o. twice a day. 4. multivitamin. allergies: no known drug allergies. physical examination: she was afebrile with stable vital signs. she was in no apparent distress and sitting comfortably. her lungs were clear. her heart was regular with holosystolic murmur. her abdomen was soft, nontender, nondistended, bowel sounds were present. extremities were warm and well perfused. laboratory data: her laboratories were all within normal limits. ho course: the patient was evaluated by dr. and it was decided that she would go to the operating room. she was taken to the operating room on , for an aortic valve replacement through a mini sternotomy. please see operative report for further details. the patient was transferred to the csru postoperatively and had an uneventful course. she was fully weaned from the ventilator and extubated. she was kept on some blood pressure supporting medications and was able to be weaned off those medications. she was began on lasix diuresis. on postoperative day number two, she was transferred out to the floor. she continued to improve. her foley catheter was removed and she continued to do well and was able to void. the patient was extubated. physical therapy was consulted in order to assess her ambulation and her deconditioning. it was decided prior to discharge that the patient was doing well, was able to match her previous function and the patient was safe to be discharged home. the patient's chest tube was removed on postoperative day number three. she continued to do well. her diet was advanced and she was tolerating regular diet and her pain was well controlled using naprosyn and ibuprofen. the patient was discharged to home on postoperative day number four tolerating a regular diet and doing well. die instructions: the patient was instructed to follow-up with dr. in three to four weeks and follow-up with her primary care physician in one to two weeks. she was also instructed to do no heavy lifting of her upper extremities and protect her sternum. she had no other restrictions. medications on discharge: 1. aspirin 325 mg p.o. once daily. 2. lasix 20 mg p.o. twice a day. 3. colace 100 mg p.o. twice a day. 4. protonix 40 mg p.o. once daily. 5. lopressor 12.5 mg p.o. twice a day. 6. naprosyn one to two tablets p.o. q4hours p.r.n. for pain. 7. compazine 10 mg p.o. q6hours p.r.n. for nausea. 8. motrin 600 mg p.o. q6hours p.r.n. follow-up: the patient was instructed to follow-up with her primary care physician for adjustment of these medications, specifically, the stopping of her lasix diuresis. discharge diagnoses: 1. aortic stenosis, now status post aortic valve replacement through a mini sternotomy. 2. anxiety. 3. chronic anemia. 4. left frozen shoulder. 5. status post dilatation and curettage times two. 6. status post rhinoplasty. 7. status post cardiac catheterization. condition on discharge: the patient was discharged in stable condition. , m.d. dictated by: medquist36 Procedure: Extracorporeal circulation auxiliary to open heart surgery Reopening of recent thoracotomy site Open and other replacement of aortic valve with tissue graft Other incision of pleura Monitoring of cardiac output by other technique Transfusion of packed cells Transfusion of other serum Transfusion of platelets Diagnoses: Unspecified pleural effusion Aortic valve disorders Hemorrhage complicating a procedure Anxiety state, unspecified Surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation Migraine, unspecified, without mention of intractable migraine without mention of status migrainosus