Heart valve repair (not replacement)

[Geoff]

Can anyone please tell me where I can read about aortic valve repair, (as opposed to replacement) for regurgitation? Also, is it possible to reinforce a slightly distended aortic root as in Marfan syndrome? Why do we not hear more about this, as it would seem to be a far less invasive approach?

 

[LUVMyBirman]

I have not heard of many Aortic repairs. Actually, one lucky member here on the group that I know of. Pillarpaul. You may wish to send him a PM.

 

[Ross]

Sending to heart talk for more responses.

 

[pillarpaul]

Rare

Rare

Geoff,

Welcome to this site. It is so helpful to talk to the people who have been through the wars, so to speak. As Gina mentioned, I had aortic valve repair - actually three months ago today! I am a major researcher of health problems (especially my own) so I checked numerous resources about valve reapirs and replacments. I had signifcant aortic valve reurgitation like you. When I met with my surgeon for an initial consultation, I asked him about the chances of repairs. He said in thirty years of doing valve surgery, he had only done five aortic valve repairs. He explained to me that the size and location of aortic valves do not lend themselves to repairs, whereas there is a fighting chance with mitral valves. I wasn't crazy about having to take coumadin the rest of my life but I had defintiely resigned myself to getting a mechanical valve. I had also learned from the folks here that coumadin isn't quite the villain I thought it was.

Well, when I woke up from surgery my nurse was happily yelling in my ear that I had a repair, not a replacment. I thought I was still a little loopy from the anesthesia but my wife later confirmed it that day.

When I had my follow-up visit with my surgeon, I happily announced, "Well, now it's six". He knew exactly what I meant. He told me that I had a hole in my valve, probably a congenital problem. He also told me that the hole had a perforation from it. This was probably caused by an angioplasty six years ago. This doc is very skilled and he felt very comfortable repairing it. I feel very lucky as Gina said.

I don't know about your other questions but I hope this helped. By the way, I feel so much better than I did three months and one day ago!

And, Gina, if you read this, did you ever get my PM for the "translation"?

Good luck, Geoff.

Paul

 

[Tom F.]

T. David Procedure

T. David Procedure

On Dec. 20, 2002 I underwent a valve sparing "T. David-5" valve repair procedure. This type of procedure was developed by Dr. Tyronne David, a Canadian. If you do a search on the internet for the term "valve sparing" you will find many articles on the subject. It is a procedure that may be done to repair an ascending aortic aneurysm where the aortic valve is not too badly damaged, and is not otherwise in need of replacement. I had mine done by Dr. Robert March at the Rush Heart Institute in Chicago, and it is also done at many major heart center hospitals. It is a difficult surgery, so local hospitals, even with established cardiac surgical centers, might not have anyone that can do it. I believe that if you look at the personal stories on this site there is one posted by someone that also had this done. There is a risk with it that re-surgery may be needed in the future, but overall the results that have been published have been quite positive. I am told that the key is to find the best surgeon you can, and hope that your valve is not damaged in any way. My results have been pretty good, but I do suffer from a trace amount a regurgitation. My cardio says that is it not significant, not is that a factor in what the future may hold.

If you wish to contact me personally please feel free to E mail me at [email protected], with the subject line "Heart Surgery". I will be happy to answer any questions you might have.

 

[Tom F.]

I just re-read your question again and I would add that the difference between a valve repair and replacement in terms of body trauma and the like is minimal. It is still full "open heart" surgery with the chest wall opened up. I have not heard of anyone doing this with a less invasive procedure. There have been published reports that is has worked with Marfans, even with enlargement of the aorta. The advantages are the avoidance of anti-coagulation drugs, and the good possibility that it is a once-in-a-lifetime fix. But it is major open heart surgery with ll that goes with it.

 

[Nancy]

Dr. Delos Cosgrove at the Cleveland Clinic does valve repair, and also minimally invasive surgery.

Take a look at this link:

http://www.clevelandclinic.org/quality/08-02/08-02c.htm

 

[McCln]

Geoff

Geoff

The others forgot that I also had repair of the aortic valve. Mine was almost 30 years ago. Things were a lot different then. We had zippers and hospital stays were longer then. A lot has happened since then. I was a little 8 year old when I had my repair. I eventually had the valve replaced almost two years ago. But repair will be easy to recover, except for the trauma to the muscles. But you will be fine. Just get all the information you can get. Don't be afraid to ask the cardiologist or your surgeon questions. We are always here to answer what we can here. Thanks for asking. Take care and be good.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve

 

[Geoff]

Heart valve repair

Heart valve repair

Many thanks to all who replied to my question. In particular, I was intrigued to compare the experience of Pillarpaul, whose surgeon had only done 5 repairs in 30 yrs, (you were presumably No 6 - you must have set him a challenge!) with the Cleveland Clinic who always consider repair first and only replace if repair isn't possible. I have yet to find out what the attitude is here in the UK, where we are dependent on the cash-strapped NHS. However, be sure I shall follow it up.

Another aspect which is causing my wife and I some heart-searching is whether/when to go ahead with surgery, at a time when I am virtually symptom free. If I can delay for another 2 - 5 yrs maybe, that could be so much good quality time, during which surgical techniques will undoubtedly advance. On the other hand, I am getting no younger (68 now), and my heart condition will be deteriorating. How do we balance the arguments?