Mitral and Aortic valve Replacement

[xinxin]

Hello All,

My mom is 63 years old, and she has been experiencing shortness breath, tiredness, and chest tightness since last December, and the Echo shows that she has the mitral stenosis. 1/6/2012, she had her TEE, and the results showed that her Aortic valve has moderate regurgitation with the mildly thickened leaflets. And her mitral valve is moderate to severe stenosis with mild regurgitation. Pressure half-time is 188ms, and the valve area is 1.17cm^2. We are living in Cincinnati, Ohio, and we saw a local surgeon today, we were told she needs to have her two valves replaced in next three month, and valve repair is not an option at this time, and also the minimal invasive procedure is also not possible because she has two valves, we are very scared. The doctor recommended her to have Mechanical valve (on-X), and when we asked about tissue valve, he said tissue valve only can last about 15 years, and then she may need another surgery.

I’ve been doing some researches on this site for a while, and known that Cleveland Clinic is one of the best hospitals to have this kind of surgery. We don’t know how to choose a surgeon, because my mom will need to replace two valves at the same time, I am not sure which surgeon is best for her. Do we choose surgeon by ourselves, or by hospital? Do you have any suggestions?

Thanks very much!

 

[Greg a]

I just wanted to drop in and welcome you to this great site of street wise not book wise individuals ....I am Canadian and our health system is TOTALY different so I cant answer but do want to welcome you ....there will be loys of feedback soon so stay tuned

 

[Mentu]

Welcome to VR. Selecting valve type is an issue that you need to discuss when you speak with your Mother's surgeon. How you select a surgeon really depends upon your health insurance. Some health plans limit where surgery can be performed or give you an incentive to use local surgeons and hospitals. I would be more concerned about finding a surgeon with experience performing multiple valve surgeries on patients similar to your Mother. If the Cleveland Clinic is an option for you, it is certainly the best known hospital for heart surgery in the United States. Local hospitals, however, can also provide excellent care with the benefit that they are closer to your home.

Larry

 

[Mom2izzy]

I haven't had any contact with the Cleveland Clinic, so I don't have first hand knowledge, but I've been told that at CC you don't "pick" your surgeon. You pick the facility and they tell you who your surgeon will be. If that is true and you do choose CC, it takes the decision making pressure off. Again, this is only hearsay, but I did hear it from the first surgeon I spoke with who trained at CC. He had referred me to the University of Michigan, and I asked if he thought CC would be better, he didn't think it would be for my particular issue. I asked the question again at U of M, and they told me basically the same thing, about CC choosing the surgeon for you.

A woman who worked for me had a parent with heart issues similar to your mom's which was also complicated by the fact that he was diabetic and older (late 70s). The local surgeons wouldn't touch him, but they went to The Fred and Lena Heart Center in Grand Rapids, Michigan to try to get included in the clinical trials for percutaneous (sp?) valve replacement. He ended up needing more than one valve replaced, so they did the surgery as a standard Open Heart surgery. He is doing fabulously! I'm not necessarily trying to recommend that facility, just letting you know that when one hospital turns you down due to the complexity, there is probably one out there...you just need to be persistent. You may also find other surgeons will have different opinions about repair vs. replacement and tissue vs. mechanical.

My surgeon has a YouTube video indicating that research shows the more experience they are with repairs, the more likely they are to recommend a repair over the replacement. He specializes in mitral valves, but generally would at least try to do a repair before resorting to replacement (not in 2 separate surgeries...the decision is made on the table). He gives patients the pros and cons about mechanical vs tissue and let's them choose. I'm only 40, and I chose tiissue (if the repair doesn't work)...I got the feeling that would have been his recommendation anyway...In his opinion, 15 years from now we will probably be doing replacements percutaneously anyway.

 

[xinxin]

Thanks for the reply. I will check my mom's health insurance, and I believe it should be OK for her to go to CC, but I will check it. I didn't know we don't "pick" the surgeon, so anyone here who can share his/her "story" about choosing a surgeon at CC?

Thanks

 

[Lynlw]

Thanks for the reply. I will check my mom's health insurance, and I believe it should be OK for her to go to CC, but I will check it. I didn't know we don't "pick" the surgeon, so anyone here who can share his/her "story" about choosing a surgeon at CC?

Thanks

From what I understand at ccf and some of the other larger centers that have a few surgeons often some surgeons are better , have more experience with certain surgeries and others are they experts in other surgeries. usually they will refer you to a surgeon that specializes in what you need done, especially since most people don't know the different surgeons and who has the most experience in what they need, type of thing