MItral Valve Repair

[vitdoc]

Mitral insufficiency is a peculiar problem. Often on echocardiography there may show significant leakage but clinically and on echo other parameters such as ventricular size may remain fairly stable for years. But when there are signs of deterioration then things to repair the problem should be done. One can surgically repair the valve or replace the valve or now possibly clip the valve. Then there is the decision of tissue vs mechanical. I was closely monitored for mitral insufficiency with echos every 6 to 12 months for years with only slow changes noted. Suddenly within a week I deteriorated severely. Going from biking 50 miles to marked shortness of breath going up a single flight of stairs.
I consulted with several top surgeons who both repaired and replaced. Basically repair was not thought to be likely since I already had had 3 open hearts for aortic valve and aneurysm repair. Doing something requiring another open heart should be as permanent as possible so no repair just replacement. But no one was feeling real warm and fuzzy about doing my surgery. They expected marked scarring which would make the surgery not fun.
I was aware of the mitral clip but I thought direct repair might be better.
I was on my way to one of the top mitral centers when I got a call from the head surgeon who surprised me and suggested I pursue getting the clip instead of surgery . I had already been evaluated for the clip and had told them I wanted surgery. But with the surgeon telling me to get the clip I went back to the clip cardiologist and luckily had the procedure done ASAP.
Spectacular results and a piece of cake from my perspective.
Returned to my previous level of fitness and went back on the bike.
I also had been for years been wrestling with AFib. Had three ablations with pretty good initial response for a few years but ultimately went into chronic A.Fib.
About two years after the clip my AFib spontaneously went away and I am in normal sinus rhythm. This maybe due to less strain on the left atrium from the decreased regurgitation . So for me the clip now in about 3 years has been fantastic. I am not sure right now what the specific criteria is for qualifying for the clip. Also it is technically challenging so a physician with a significant track record is important

 

[SHARKY]

How long does a Mitral Val e repair last

I had the heart surgery JUNE/2015 and have been wondering ever since, kind of haunts me a little. that thing in my body, am i bionic now, like the TV million dollar man......LOL [i would think you bionic if there is anything inside that is man made, and just think everyday that does it matter, man made, god made? dont think so, god did make man, yes? so in that thinking, anything manmade is = to god made, right?

 

[SHARKY]

Mitral insufficiency is a peculiar problem. Often on echocardiography there may show significant leakage but clinically and on echo other parameters such as ventricular size may remain fairly stable for years. But when there are signs of deterioration then things to repair the problem should be done. One can surgically repair the valve or replace the valve or now possibly clip the valve. Then there is the decision of tissue vs mechanical. I was closely monitored for mitral insufficiency with echos every 6 to 12 months for years with only slow changes noted. Suddenly within a week I deteriorated severely. Going from biking 50 miles to marked shortness of breath going up a single flight of stairs.
I consulted with several top surgeons who both repaired and replaced. Basically repair was not thought to be likely since I already had had 3 open hearts for aortic valve and aneurysm repair. Doing something requiring another open heart should be as permanent as possible so no repair just replacement. But no one was feeling real warm and fuzzy about doing my surgery. They expected marked scarring which would make the surgery not fun.
I was aware of the mitral clip but I thought direct repair might be better.
I was on my way to one of the top mitral centers when I got a call from the head surgeon who surprised me and suggested I pursue getting the clip instead of surgery . I had already been evaluated for the clip and had told them I wanted surgery. But with the surgeon telling me to get the clip I went back to the clip cardiologist and luckily had the procedure done ASAP.
Spectacular results and a piece of cake from my perspective.
Returned to my previous level of fitness and went back on the bike.
I also had been for years been wrestling with AFib. Had three ablations with pretty good initial response for a few years but ultimately went into chronic A.Fib.
About two years after the clip my AFib spontaneously went away and I am in normal sinus rhythm. This maybe due to less strain on the left atrium from the decreased regurgitation . So for me the clip now in about 3 years has been fantastic. I am not sure right now what the specific criteria is for qualifying for the clip. Also it is technically challenging so a physician with a significant track record is important

there is a bit you left out, when did you have the clip, must have been at least after 1998 or so, because that is when i got the band to try and fix my Mitral Valve, then just now in JUNE/2015 i am the proud owner of a St. Jude Mitral Valve. is there anyone that knows or a good idea how long for a St. Jude mitral valve, etc.?

 

[vitdoc]

there is a bit you left out, when did you have the clip, must have been at least after 1998 or so, because that is when i got the band to try and fix my Mitral Valve, then just now in JUNE/2015 i am the proud owner of a St. Jude Mitral Valve. is there anyone that knows or a good idea how long for a St. Jude mitral valve, etc.?
I had my last open heart in 2006 for an aneurysm and I got the Mitral clip in June 2016.

 

[sylviayasgur]

Almost 6 months ago, I had my bi-annual cardiologist appointment. My former cardiologist left Ca and went to Jackson, WY. So, he recommended the one I see now.
My echo stated my repaired mitral (2009) is now leaking severely. My doc said it is probably leaking worse than the echo suggests. He said that repairs generally don't last forever, and when I asked about a valve replacement, his preference is to repair again because the mitral valve tends to throw clots more than the aortic. He is interested in the clip through the groin, but he said it would be a long time before it is available. So, I will wait, live my life, walk my dog, and just rest when i feel a bit out of breath. I have always felt that the mitral leakage really affects my aerobic activity when it is leaking mod- severe.
I may see my surgeon again at Stanford, and just get his opinion on it, since he did the repair.

Dr.Gilbert Tang (Mt. Sinai Hospital, NYC) and Dr. Chau (Monterfiore Hospital, NY) are both successfully doing the Mitra-clip. I took my dad for a consult to both two years ago (they must be even more proficient today), but he was not a candidate for it as his heart is so enlarged, his mitral leaflets do not meet and therefore cannot be clipped together. He had a mitral repair done by Dr. Colvin in NYC about 10 years ago. Just FYI, it IS being done.
Be well and pls keep us posted.

 

[tommyv44]

Please have a cardiac MRI before deciding on Surgery even for the clip. The ECHO is NOT the definitive test!

 

[sylviayasgur]

Please have a cardiac MRI before deciding on Surgery even for the clip. The ECHO is NOT the definitive test!

agreed!!! my dad had to do a Cath for detailed look at valve.

 

[CThrock]

Almost 6 months ago, I had my bi-annual cardiologist appointment. My former cardiologist left Ca and went to Jackson, WY. So, he recommended the one I see now.
My echo stated my repaired mitral (2009) is now leaking severely. My doc said it is probably leaking worse than the echo suggests. He said that repairs generally don't last forever, and when I asked about a valve replacement, his preference is to repair again because the mitral valve tends to throw clots more than the aortic. He is interested in the clip through the groin, but he said it would be a long time before it is available. So, I will wait, live my life, walk my dog, and just rest when i feel a bit out of breath. I have always felt that the mitral leakage really affects my aerobic activity when it is leaking mod- severe.
I may see my surgeon again at Stanford, and just get his opinion on it, since he did the repair.

Not true! clips are available I'm having one done I a few days. Going up through the groin. I was told that the clips will last a long time they grow into the layer or skin. The rings don't last but they're not doing rings anymore. Please be investigating before you make no true comments. I have seen three Surgeon's and all have said the same thing.

 

[CThrock]

Please have a cardiac MRI before deciding on Surgery even for the clip. The ECHO is NOT the definitive test!

They do alot more test then an MRI. Never had an MRI for repair or valve replacement.

 

[tommyv44]

It's the best way to determine how severe the leakage is. The Echo is very misleading and I don't know how many people have undergone needless surgery. Look for a study by Dr Stephen Wolff. Google Dr Seth Uretsky too!

Tom

 

[sylviayasgur]

Not true! clips are available I'm having one done I a few days. Going up through the groin. I was told that the clips will last a long time they grow into the layer or skin. The rings don't last but they're not doing rings anymore. Please be investigating before you make no true comments. I have seen three Surgeon's and all have said the same thing.

My dad was looking into the Mitraclip because the ring they had used in precious surgery to repair his mitral valve had stretched along with his heart's increase in size. Ceased to do what it initially had put in to do.

 

[Midpack]

(deleted)

 

[calguy]

Mitral valve question. My wife had a mitral valve replaced in November 2018 and was told by both Doctors that she would fill a lot stronger after the new valve is in. She had it done at Cedars Hospital in Los Angeles by ALferdo Trento who is suppose to be the top Dog there. Since then she has had many test as to why she's tired all the time and tells me she would never have had it done if she knew how she would fill after. Has anyone had this problem? She has has many test to see why, but no answer. So if any of you know anything that might help shoot me a line. Thanks

 

[Thomas]

In my case after mechanical replacement for at least the first year and a bit I was dragged out all the time; zero energy. Part of it was recovery for sure but in the end it turned out it was the beta blocker I was taking Metoprolol. It wasn't a big dose but it was enough to cause severe lethargy. We switched to Biosprolol and it helped.
Best of luck in your search.

 

[catwoman]

Mitral valve question. My wife had a mitral valve replaced in November 2018 and was told by both Doctors that she would fill a lot stronger after the new valve is in. She had it done at Cedars Hospital in Los Angeles by ALferdo Trento who is suppose to be the top Dog there. Since then she has had many test as to why she's tired all the time and tells me she would never have had it done if she knew how she would fill after. Has anyone had this problem? She has has many test to see why, but no answer. So if any of you know anything that might help shoot me a line. Thanks

Calguy,
Has your wife had a consult with doctors at either the Mayo or Cleveland clinic or elsewhere? I believe one of these two has a satellite location in Arizona, but either of these well-respected institutions can handle consultations based on lab and test results.

I assume that her primary care doctor has run tests to rule out endocrine and other types of disorders. My sister has lupus, fibromyalgia, rheumatoid arthritis, non-Hodgkins lymphoma and other auto-immune disorders. It wasn’t easy to get diagnosed at the beginning, which followed a freak fall in 1998 at home that shattered her right hip. She just wasn’t healing like she knew she should, being an RN. It took several tests before an ANA (anti-nuclear antibodies test) was positive. One by one, the other disorders popped up. She does not have the stamina she should. She is 63 now.

My MV replacement was in June 2003 at age 52. I was in congestive heart failure because of the failing valve. I could tell the difference in heart function within 24 hours. My surgeon did not order cardiac rehab — said I just needed to do a little more each day — and I believe that was a factor in a more lengthy recovery than I expected. It was early March 2004 before I felt consistently better each day. I had a few very exhausting days that almost sent me to an ER. I went back to work part-time at about 6-7 weeks and full-time 4 weeks later. I was also showing cats and resumed several fly-to shows, spaced well apart. But it was just hard. Today I am fine and I will be 70 in 2 months.

After 18 months, your wife should be feeling much better. Get copies of all her test results so you know what was done and what doctors were trying to rule out. Get copies of the doctor’s notes. Pursue a second opinion to find out why she feels so badly.

 

[dornole]

I agree that she should be feeling better. In my case after mitral valve repair (which was not open heart so very easy on my body to recover from the procedure itself) I felt better close to immediately. The beta blocker made me feel half dead, once they stopped that after a couple weeks (my blood pressure and heart rate are naturally very low anyway) I was good.

 

[kevanndo]

Mitral valve question. My wife had a mitral valve replaced in November 2018 and was told by both Doctors that she would fill a lot stronger after the new valve is in. She had it done at Cedars Hospital in Los Angeles by ALferdo Trento who is suppose to be the top Dog there. Since then she has had many test as to why she's tired all the time and tells me she would never have had it done if she knew how she would fill after. Has anyone had this problem? She has has many test to see why, but no answer. So if any of you know anything that might help shoot me a line. Thanks

My 15 year old daughter has had three open-hearts surgeries (3 weeks, 6 years and 9 years). When she was six years old, she had a repair to correct a severely leaking mitral valve, and the surgeon told us the same thing--that she would have much more energy after the surgery and would seem like a new person. So I was very surprised when not only did she NOT seem more energetic post-surgery, she actually seemed worse than before the surgery. She was pale, yellowy looking, and tired all the time, but I thought I was just being a paranoid mom. I kept telling my husband that something was wrong, but I didn't know what. About a month after surgery I took her into the pediatrician's office to look at what I thought might be an infection at the incision site on her chest. The nurse practitioner's first words were: "Oh my gosh, she looks terrible!" As strange as this might sound, I was actually relieved to hear those words because they validated what I had been suspecting, that something was not right. To make a long story short, she was suffering from a somewhat rare condition that had been caused by the surgery--hemolytic anemia. The regurgitant jet caused by her newly 'repaired' valve was actually shearing/destroying the red blood cells as they passed through. This resulted in her hemoglobin dropping to 6.4 and her reticulocyte count becoming extremely elevated (11.6). Basically, her bone marrow production of new red blood cells could not keep up with the destruction of her existing cells caused by the valve. Hemolytic anemia is very rare in repairs if there is no prosthetic device involved, as was the case with my daughter. However, it is much more likely to occur with a valve replacement. If the cardiologist has not done so already, I would strongly suggest that you request that they do a reticulocyte count and a blood smear. A hematologist can look at the blood smear to determine what type of destruction, if any, of blood cells is taking place that could be contributing to your wife's condition. My daughter ended up having to go for blood transfusions every 3-7 days for two months until her condition stabilized. Unfortunately, the hemolysis continued until she had her mitral valve replaced at 9 years of age.

 

[calguy]

Thank you all for your input. I'm taking my wife to Dr today and will bring up what you have told me. I am so thankful that there are people out there that help . Again thank you all AL

 

[Protimenow]

In my experience, I also had to change beta blockers. Metropolol made me very lethargic. Bisoprolol has fewer side effects, and worked better for me. I'm on a diffrent bata blocker now - partially because it was avavlable in a 2.5 mg pill.

I've heard the 'feel like a new man/woman' talk, and this isn't always the case. I felt good after my AVR - not so much after my ablation. But it also takes time to recover from some of these.

I hope your wife's issue(s) are easily detected and easily resolved.

I'm sure that you'll keep us updated.

 

[Thomas]

In my experience, I also had to change beta blockers. Metropolol made me very lethargic. Bisoprolol has fewer side effects, and worked better for me. I'm on a diffrent bata blocker now - partially because it was avavlable in a 2.5 mg pill.

What's the new one you're on now? I have the same issue with the 2.5mg limitation of the Bisoprolol and I'd like to discuss it with my cardio. Thanks