Looks like mom has to have mitral valve replaced - sorry this is kind of long

[kfay]

Yeah, don't dwell on things that you can't control. Obviously, those nerves that control your heart rhythm run through your heart and they are cutting into your heart. They know where they are for the most part, and do there best to miss them and almost always do, but sometimes, someone will need a pacemaker. Even someone very young. When you see her in ICU, she will have two, temporary pacer wires sticking out of her chest. They will leave those in until they are positive the need for a permanent pacer is no longer necessary.

 

[watson524]

Yeah I've seen some pictures of people in the ICU right out of surgery and almost fell off my chair.... When I was young, she had pneumonia and my dad took me into her hospital room. She had an O2 mask on and I said "that's not my mommy" and turned around and walked out. This time I just have to remember, it's all to help her and they will come out. Didn't even realize some of those wires were for pacing. Huh.

 

[yotphix]

I'm 30 years younger than your mother and had an aortic valve replacement last year. They did a maze too while they were in there. I had periodic AF and when the Maze was offered up by the valve surgeon I asked friend of a friend who happens to be head of cardiology at a large urban hospital what he recommended. His response was 'absolutely, the Maze has a very high success rate and very low risk of adverse effects or complications.' (He quoted stats I don't quite recall but both numbers were in the very high 90's, sucessful and problem free.) I had a little more AF in the couple of weeks after the surgery and haven't had any more in the 16 months since.

 

[Bear72]

It sounds like they are doing more and more aortic valve replacements through catheter but I hadn't heard about this being studied for mitral valves (though it only makes sense I suppose). Our main concern really is to only have this done once. Obviously there's no guarantees either way but....

The list I compiled I got from going to their website and putting in the main campus and "mitral valve replacement" in the main search box. While they all do that, I can't figure out how to find ones that specialize more in MV vs say AV replacement.

There are a few different groups studying valve replacement in the mitral position via catheter. Here's one www.endovalve.com .

In regards to isolated mitral valve surgery at the Cleveland Clinic, you may want to look into Gillinov, Petterson or Mihaljevic.

 

[Michelle D]

I love the Cleveland clinic. The entire staff is awesome. I also think Dr. gillinov is amazing. No surgeon I've seen in Florida, even at the Cleveland clinic in Florida felt they could repair my valve. Only Dr. Gillnov and Dr. Mahalavic would try. I should never have a mitral valve problem again. I don't know what reasons they have not to do MAZE. You do choose your surgeon. I was scheduled with Dr. Majalevich but had to have it done as an emergency while he was on vacation so I lucked out with Gillinov.

Six days after surgery i rode to Toledo and back to see where my husband grew up. I had no problem and only got out once. I was fine, just get one if those neck pillows.

 

[Michelle D]

Hmmm ok that's interesting... and wasn't something I was aware was a risk with this surgery since I was thinking it was "just" go in, take out bad valve, put in shiny new valve, check for working of valve and move on. Didn't know that might mess with electrical signals. Not that I'm going to dwell on it... everything WILL be fine. I'm going to be positive!

Do stay positive, another good thing is because of get age it should be less painful. I'm 28 and I'm 12 weeks from my ohs, the nerves coming back are something else I must say. It definetly does things to the rhythm, I never had a-fib until after my surgery. The risks of not coming out of this surgery are extremely low at the CC but there are less serious complications that you'll want to be aware of. I suggest during the work week hours chat with a CC nurse on their website. They are quite helpful in answering questions.

 

[watson524]

Thanks for the tips! I didn't know they had online chats with nurses from there, I will definitely look into it. Those 3 doctors you mentioned were among the top on my list, along with Lytle so I know I'm on the right track at least.... just have to wait and see what we get to do as far as picking given how this is being set up and all.... I talked to my mom tonite about the porcine valve and also having a Maze done. She said as far as she remembers, she was never on meds to stop the a-fib but as soon as I said that someone mentioned she might have more energy if she got out of a-fib, her eyes lit up. Frankly, she has more energy and "get up and go" than I can deal with now and she has 38 years on me, I can't imagine what she'd do with MORE energy but hey, it's a good attitude to have I think.

 

[ALCapshaw2]

I'm confused and surprised that more Doctors do NOT prescribe SOTALOL (generic form of BetaPace) for Atrial Fibrilation. There are several members of VR who have found that Sotalol controls and/or prevents episodes of A-Fib with few or negligible side effects once their body adjusts to the medication. Some Doctors will work with their patients to find the minimum dose needed to maintain / minimize A-Fib events.

'AL Capshaw'

 

[Michelle D]

I'm on sotalol, but still have some a-flutter often but just for 15 seconds and I can't really tell I'm having them. The sotalol took about two weeks to get accustomed to but I don't feel any side effects anymore.

Chat with nurses, get to the heart center page on the CC website first and there should be a link on there, that way you are talking to a heart center nurse.

 

[watson524]

I'll have to try to get more info about the a-fib. The only thing I can think of right now is that hers doesn't come and go, it's constant and they've always said going in and out and in and out of rhythm vs always being out.

For my own knowledge, how could not being in a-fib give her more energy? I just thought a-fib messed with the rhythms but maybe the more consistent pumping got things going for all around better feelings. She doesn't feel her a-fib at all, just the echo that tells her she has it I guess.

Michelle (by the way, my name is Michele too, just spelled differently) - thanks for the tip about the online chat with the nurses. I didn't know they did that!

 

[Adrienne]

For my own knowledge, how could not being in a-fib give her more energy? I just thought a-fib messed with the rhythms but maybe the more consistent pumping got things going for all around better feelings. She doesn't feel her a-fib at all, just the echo that tells her she has it I guess.

When a heart is in a-fib, the atrium fibrillates rather than pumps, so it doesn't send the blood into the left ventricle which is the main pumping chamber and pumps blood throughout the body. It is even worse when a person with a-fib is lying down because when standing, at least gravity brings some of the blood down to the ventricle. In any case, because the atrium is not pumping the incoming blood down to the ventricle, the ventricle does not have enough blood to pump to the body and that is why people with a-fib have less energy.

 

[watson524]

Wow, thanks for the info! I thought that the lack of blood flow was because of the regurgitation and didn't realize the a-fib also contributes. So she's almost got a double whammy. Seriously, if she had more energy... wow. There'd be no way to keep up.

 

[ALCapshaw2]

My (NON-professional) understanding is that when the heart is in Atrial Fibrilation, it's pumping effeciency is compromised, i.e. less blood is 'pushed out' into the body.

Do you have access to her Echocardiogram?

It would be interesting to know her Ejection Fraction while in A-Fib.

It would also be interesting to know her Blood Pressure (is it Low?)

'AL Capshaw'

 

[watson524]

Her echo report (don't have it in front of ne but I think I'm remembering right) says the ejection fraction is at least 60.

And hope, her bp isn't low. Generally in the 120-130 / 75-80 range. (she's on a med to help keep it down)

 

[Eva]

Her echo report (don't have it in front of ne but I think I'm remembering right) says the ejection fraction is at least 60.

And hope, her bp isn't low. Generally in the 120-130 / 75-80 range. (she's on a med to help keep it down)

Michele, These numbers look good to me and are a good indication about your mom's heart's muscle.

 

[watson524]

well that's good to hear. maybe the lotensin and atenolol did something to "preserve" all these years.

 

[Adrienne]

Exactly - a double whammy

Exactly - a double whammy

:biggrin2:

Wow, thanks for the info! I thought that the lack of blood flow was because of the regurgitation and didn't realize the a-fib also contributes. So she's almost got a double whammy. Seriously, if she had more energy... wow. There'd be no way to keep up.

Actually, this is exactly what happened to me right before I had my surgery. I already had severe mitral regurgitation, but the heart was compensating by dilating the atrium so it could pump better. However, the greatly dilated atrium is what caused the A-Fib. In any case, I started going into CHF (congestive heart failure) because the blood was backing up to my lungs!:eek2: Luckily, since my mitral valve repair, things have been great!!:thumbup::biggrin2:

 

[watson524]

Glad to hear you had a positive outcome!

Her cardio did mention CHF when we were there but said other than slight shortness of breathe when walking up an incline and stuff, she is at a point where he thinks things are about as bad as they'd get withOUT being in CHF. (i.e. no leg swelling - except in humidity, which who doesn't get sometimes) etc. That's why he really thinks this time is the point where it needs to be done.

 

[heartdoc]

Hi - Your Mom might be a great candidate for a minimally invasive mitral valve replacement and maybe an ablation/Maze procedure to control her atrial fibrillation for good. That would get her back to her active life faster than she could expect. See link about this type of surgery with lots of pictures and explanations: www.bigappleheartsurgery.com/page18.php

Best Wishes,

Heartdoc
www.bigappleheartsurgery.com