Met with cardiologist and cardiac surgeon today and they said mitral stenosis has become severe and symptomatic (shortness of breath, afib, TIA) and it is time for surgery, probably in the next month. They offered the option of trying another valvuloplasty, but it has a guarantee of worsening regurgitation by at least one level, leaving me with worse regurgitation instead of stenosis, and if the current regurgitation is moderate (which it may be, echo results have varied) they will not even attempt it. Plus if it goes badly that means emergency replacement. It is also unlikely to last more than 5-10 years (I was extraordinarily lucky to get 22 years out of the last one) and then I would need OHS anyway and be older. So I think I am just going to bite the bullet and do the replacement now.
Surgeon said I would definitely be getting a mechanical due to my age (56) and having rheumatic heart disease -- said I might only get 3-4 years out of a tissue valve because of these factors. As for repair, he said "Anyone who thinks they can repair that valve and give a durable result is lying to you." He said their practice usually uses the On-X because there's some evidence it's more resistant to pannus, plus they're just used to it. The INR is going to need to be high regardless, because it is a mitral valve.
They will also do an ablation while they are in there.
Lots to do -- see the dentist and maybe get a loose tooth pulled, TEE, cardiac cath to check out the blood vessels feeding the heart, sign the will and POAs that we luckily just updated recently, check out all the pre-op and post-op tips on these boards so that I'm prepared.
Weirdly I feel much better now since there's a plan.
Surgeon said I would definitely be getting a mechanical due to my age (56) and having rheumatic heart disease -- said I might only get 3-4 years out of a tissue valve because of these factors. As for repair, he said "Anyone who thinks they can repair that valve and give a durable result is lying to you." He said their practice usually uses the On-X because there's some evidence it's more resistant to pannus, plus they're just used to it. The INR is going to need to be high regardless, because it is a mitral valve.
They will also do an ablation while they are in there.
Lots to do -- see the dentist and maybe get a loose tooth pulled, TEE, cardiac cath to check out the blood vessels feeding the heart, sign the will and POAs that we luckily just updated recently, check out all the pre-op and post-op tips on these boards so that I'm prepared.
Weirdly I feel much better now since there's a plan.
