Can't do valve job, ejection fraction to low

[Old Hippie]

Had a bunch of preliminary test done; heart cath, echo cardiogram, etc. Went to check into the hospital on Monday for mitral valve replacement on Tuesday and surgeon said he can?t do it. Said he had overlooked my ejection fraction and it was to low. He put the survivability of the surgery at 50/50.

Any alternatives to this surgery?

Atrial Fibrillation
ICD 2 years
Coumadin

 

[EireCara]

Hi there and welcome. Im afraid I dont have an answers to your question, but Im sure somebody will be along soon with some helpful advice for you. (It can be a bit slow at the weekend so hold tight). Best Wishes.

 

[Phyllis]

What about the bypasses that need doing too? I have no suggestions other than getting another opinion from a large heart center like Cleveland, Mayo, Brigham or Mass General, but I am sure others will be along to weigh in. What was the number on the ejection fraction?

 

[Bina]

Just last week I was thinking....what ever happened to our Hippie?
It might be a good thing that this surgery hasn't happened yet, I would be kind of concerned that the doc could "overlook" something as important as the ejection fraction. You need another opinion!!!

 

[Computec]

I second that !

I second that !

Old Hippie...

Another opinion is definitely called for. While you're at it go to a different institution entirely. Sounds like these people are incompetent.

Jerry

 

[WayneGM]

Sorry, Old Hippie. I don't have an answer other than agreeing with the others.....you should definitely get a second opinion. Best wishes and good luck.

 

[Nancy]

You cannot cave to this opinion. You have to get a second opinion. It's WAY too important! Please, consult with one of the large centers.

 

[tobagotwo]

I agree with the other folks here on this one. Did the fellow tell you what the outcome would be if you didn't have surgery to replace the valve? How long the decline would take, and what it would be like to experience?

I assume your EF is mostly the result of damage from your five heart attacks, mixed with the coronary inefficiency caused by your AFib. Maybe an ablation session needs to take place first, to try to curb the AFib, or a MAZE procedure during the surgery. If you have current blockages, stenting might also help your EF.

If you are really in trouble, you may be able to find and get into a percutaneous valve implantation trial, where the valve is replaced with a special one introduced through a catheter. They are less common for mitral use, but I have read of a couple of trials that were completed in the last year.

Best wishes,

 

[Karlynn]

What about the bypasses that need doing too? I have no suggestions other than getting another opinion from a large heart center like Cleveland, Mayo, Brigham or Mass General, but I am sure others will be along to weigh in. What was the number on the ejection fraction?

Mayo and CC are well-known for doing successful surgeries on people that no one else will touch.

I agree - don't give in to this opinion. There was an article in our local paper over the weekend about a 7 year-old girl who had successful brain surgery to remove a tumor that was too close to her carotid artery. 27 doctors refused to operate on her. She is now tumor free and is showing signs of an excellent recovery.

As Nancy always says "Never give in and never give up."

 

[hensylee]

find a teaching hospital or a Cleveland Clinic and check with them. Don't let it go.

Been wondrin where you have been. Nice to see you again. Please stay in touch and keep us informed. Look at all the encouragement you have just received. We'll hang with you.

 

[Rebecca]

I would get a 2nd opinion. This month at my cardiologist office my yearly echo was giving me estimated EF at 40-45%. My cardiologist refers me to Emory Heart Center and my EF rate at Emory University Hospital was at 60%. Emory University Hospital in Atlanta has the top of the line echo with 3 D and is rated at #16. My first phone call was that there was a one month wait list. My second call after I explain that my cardiologist refer me they give me appointment in five days. The doctor that I saw at Emory was Stephen Clements. Duke University Medical Center in Durham, N.C. is rated at # 8. May God bless you!

 

[Tom F.]

I agree with the others, go to a major teaching heart center hospital and get a second opinion. There is a guy at University of Chicago Hospital who specializes in the really tough surgeries, Valluvan Jeevanandam, MD. He may be your guy.

 

[gadgetman]

Old Hippie,

Based on the records my Cardio had forwarded, Dr. McGiffin gave me less than a 20 per cent chance of coming thru this without some complications, but when compared to 0 per cent without it, he didn?t even blink when he said it. My records indicated my heart/lung pressures were too high and Dr. McGiffin wanted to get them down before we operated. They immediately put me in CICU (from his office to CICU in a wheelchair) and started working on reducing the pressures.

You have been given some great advice here. Mine was at a teaching hospital, University of Alabama at Birmingham.

Good Luck and May God Bless,

Danny

 

[Blanche]

Old hippie:
I couldn't find a listing of the top 50 hospitals for Heart and Heart Surgery from the July 2007 issue of U. S. News & World Report. But, I just happen to have a copy of that magazine...So, here goes...

1. Cleveland Clinic
2. Mayo Clinic, Rochester, Minn
3. Brigham and Women's Hospital, Boston
4. Johns Hopkins Hospital, Baltimore
5. Massachussets General Hospital, Boston
6. New York Presbyterian Univ. Hospital of Columbia and Cornwall
7. Texas Heart Institute at St. Luke's Episcopal Hospital, Houston
8. Duke University Medical Center, Durham, N. C.
9. Stanford Hospital and Clinics, Stanford, California
10. Barnes Jewish Hospital/ Washington U., St. Louis
11. UCLA Medical Center, Los Angeles
12. William beaumont Hospital, Royal Oak Michigan
13. NYU Medical Center, New York
14. Cedars-Sinai Medical Center, Los Angeles
15. Lenox Hill Hospital, New York
16. Emory University Hospital, Atlanta
17. Washington Hospital Center, Washington DC
18. St Francis Hospital, Roslyn, N. Y.
19. Hospital of the University of Pennsylvania, Philadelphia
20. University of California, San Francisco Medical Center
21. Vanderbilt University Medical Center, Nashville
22. University of Michigan Hospitals and Health Centers, Ann Arbor
23. University of Chicago Medical Center
24. Christ Hospital, Cincinnati
25. Inova Fairfax Hospital, Falls Church, VA
26. Robert Wood Johnson Univ Hospital, New Brunswick, N. J.
27. Banner Good Samaritan Medical Center, Phoenix
28. Abbott Northwestern Hospital, Minneapolis
29. University Medical Center, Tucson Arizona
30. University of Kansas Hospital, Kansas City
31. University of Minnesota Medical Center, Minnesota
32. Hackensack University Medical Center, N. J.
33. Sentara Norfolk Hosp.-Sentra Heart Hosp., Norfolk, VA
34. St Luke's Hospital, Kansas City, Mo
35. Shands at the University of Florida, Gainesville
36. Lehigh Valley Hospital, Allentown, PA
37. Methodist Hospital, Houston
38. Northwestern Hospital, Chicago
39. Scripps Memorial Hospital, La Jolla, Calif.
40. Clarian Heath Partners, Indianapolis
41. Jewish Hospital, Louisville Ky.
42. Yale-New Haven Hospital, New Haven Conn.
43. Henry Ford Hospital, Detroit
44. Loyola University Medical Center, Maywood, Ill
45. Riverside Methodist Hospital-Ohio Health, Columbus
46. University of Maryland Medical Center, Baltimore
47. Beth Isreal Deaconess Medical Center, Boston
48. Rush University Medical Center, Chicago
49 Hahnemann University Hospital, Philadelphia
50. Maine Medical Center, Portland
-30-

Kind regards,
Blanche

 

[Ross]

Most certainly seek help elsewhere, this place has just written you off.

 

[Old Hippie]

Sorry, I left a lot out of original post. The surgeon said he would confer with others and get back with me. Sure enough, they called today and scheduled another cath next week that would more accurately determine my ejection fraction. He said they did not do something on the previous cath a month ago because of my kidney problems and not using as much dye. As before, rather than the cath being same day surgery, I have to check in the day before and check out the day after so they can flush my kidneys of the dye as a precaution.

I’ve had many, many test and procedures done over the last few months and years and the surgeon saw an ejection fraction of 40 somewhere in my records when the valve replacement was scheduled. He was reviewing my pictures and records on last Monday prior to the scheduled Tuesday valve replacement and saw another more recent ejection fraction of 22, hence him refusing to do it at what the said, a 50/50 survivability.

I do have two stints that are 80% and 100% clogged. He was to bypass those while he was "in there".

I paid a doctor referral company for a report on this surgeon and he has a stellar record. He is highly rated as a Cardiothoracic Vascular Surgeon, rated 9 out of 10 and the report said "Above National Average - Cardiothoracic Surgeons" "Exceptionally Good - Thoracic Surgery". He was on the staff at West Virginia University School of Medicine, his almamata, as a Professor of Surgery before he came to the VA last year. He did his Internship and Fellowship Training at Duke.

 

[Karlynn]

I'm glad he has a good rating, but I wouldn't let that stop me from getting other opinions from well-known surgeons, if he tells you he wouldn't do it.

 

[Lynlw]

I would also suggest getting a 2nd or 3rd opinion at some of the leading centers, I personally would go to one of the ones that have Adult with Congenital Heart Defect Centers, since the cardiologists and surgeons there have alot of experience dealing with heart that have alot of problems and had many surgeries, it certainly wouldn't hurt to get opinions. Usually you can just send copies of the cath and echo cds and not have to go in person to get 2nd opinions. I'm not sure what your kidney problems are of if you have any other issues, but would you be a candidate for a heart transplant?
This must be a very scarey time, I will keep you in my prayers, Lyn

 

[Poppy]

Ejection Fraction??????

Ejection Fraction??????

Sorry About My Naivitivity But I Am Still New To All This,,,,what Is Ejection Fraction Please???i Have Never Come Accross It And Its Never Been Mentioned During My Consults......may I Also Ask What Are The Complications Of Being Diabetic And H.v.r. My Cardio Has Never Mentioned It Just That I Have Pressures That He Is Worried About...my Fault I Didnt Ask I Was Too Scared At The Time.....i Trust You All And Do Take Your Advise But There Again I Am Not Scared Of You....blessings Poppy Uk

 

[Curtsmum]

Wishing you all the best, hope everything goes well for you, take care.