MVP with Severe Regurgitation

[barry70]

Hi,

I am 34 years old and have MVP with severe Regurg. I am aspymptomatic. Here are my echo results from last year. I know I will need repair surgery one day. The controversial issue is when?? My cardio thinks not anytime soon, since my heart is handling things fine so far. Surgeons think otherwise and seem to be more aggressive to operate on young asymptomatic patients.

Also, I live in NYC. If there referrals for surgeons, I'd love to hear about that too. Any other thoughts/feedback would be appreciated! Many thanks in advance.

Left Atrium - 36.1mm
Aortic Root - 39.5mm
%LV Dimention - 46%
Septum - 12mm
LV Free Wall - 11.2 mm
LV Dimention Diastole - 46.4mm
LV Dimention Systole - 24.9mm (this is good I think).
LV Ejection Fraction 65%

Severe MR
No Tricuspid Regurg. or Atrial Septal Defect
Normal Mitral Valve inflow pattern

MVP on both leaflets
Borderline LV Hypertrophy
Normal LV Wall motion
Normal RV
No Pericardial effusion

 

[Nan]

Hi Barry, and welcome. Yes, that is a tough call. If you go to the "reference " section of the forum, you will find information from the American College of Cardiology about when (in their opinion) surgery should be performed for various valves.....

It is still a personal call, made with the best input you can get from one or more surgeons.

In NYC you have Columbia Presbyterian/Weil Cornell. They have a good reputation for heart surgery.

I know other folks with more expertise from this site will jump in and give you more info.

Lots of luck.

 

[Ross]

Cardiologist always like to wait until things are very bad. Surgeons want in there before that and before lasting damage is done. I'll take the surgeons side any day over the Cardio. If we all waited until prime for the Cardiologists liking, most of us may never have recovered.

The echo, being this old now, is pretty much worthless. You'd need a brand new current echo to really review. Right here is why the surgeons want to go now-Borderline LV Hypertrophy!

 

[barry70]

Next echo scheduled for a few weeks from now. Thanks for the input so far.

 

[Karlynn]

I will echo what Ross said. Cardios tend to err on the side of caution and may sometimes end up waiting until too much damage is done to allow for a quick, optimum recovery.

I was 32 when I had my mitral valve replaced. I was very symptomatic. Looking back, I know we waited too long. It took me a long time to recover and I am not 100% normal.

Being asymptomatic can be an illusion. When changes take place slowly, our minds and bodies adjust to the debilitation. You may find out after recovering from a repair or replacement (they won't know until they actually get in there) that you had been dealing with symptoms but had adjusted to them and were lulled into thinking you were asymptomatic. We've had many members say they thought they were asymptomatic, but after surgery found that their energy levels were higher and their breathing was better than before surgery.

With a severe regurge your heart is working under stress and having to work harder to do it's job, so it has to be taking it's toll in someway on your heart. I will be surprised if your measurements and report on your echo shows no change from last year. But I'm certainly not wishing worse numbers on you.

Welcome to our family here. You will find this site enormously informative, welcoming and a bit wacky.

 

[KathyH]

Karlynn is right about not noticing the changes, or blaming them on something else. I was turning 50 and have a few extra pounds on me. I was thinking I was lazy or my diabetes caused me to be so tired after work, plus I was getting old... right.... WRONG! I feel so much better now. Lucky I listened to Ross and AL and not my cardiologist.They were the ones that made me decide to see a surgeon. I didn't have any heart damage before and that helped my recovery. Good Luck, let us know your next echo results.
KathyH

 

[MichyB]

HI Barry. I'm a NYC'er too. Before my situation got a little more complicated (I had a pulmonary hypertension scare that turned out to be unfounded) I was interested in being followed at NYU. They have a fantastic cardio surgery dept. there (some of the surgeons names that come to mind are Ribacove and Colvin) and do things like minimally invasive surgery etc. But, my situation got pretty complicated and I wound up at Columbia Presbyterian in the Bronx to r/o ph. I had a fairly positive experience at Columbia and will probably continue to be followed there. Good luck.

 

[BillCobit]

I was also asymptomatic, but ACC guidelines indicated it was time for surgery. My cardiologist wanted to wait, I wanted to get it taken care...so I opted for surgery. No regrets, though you never know in advance how things will turn out.

 

[MitralMan]

Barry, I'm 3 weeks post-op from a mitral valve repair at NYU

Barry, I'm 3 weeks post-op from a mitral valve repair at NYU

Colvin is the head of cardiothoracic surgery there, and he is supposed to be the best mitral valve repair guy in NY. If my post-op experience is any indication, I'd highly recommend him.

I was asymptomatic for years -- or now I think I can write, THOUGHT I was asymptomatic for years. Turns out I just didn't know what a really well-functioning heart was supposed to feel like or do.

I had a little shortness of breath over the last couple of months, and went in to see my cardio at Cornell -- absolutely GREAT guy who basically said "gee, we thought it would be 10 or 20 years before you'd need a repair, but forget that -- you need one in 3- 6 months."

Went to Colvin, who said, "3-6 weeks." I opted to get it done immediately. I just knew.

Turns out between my first visit to the cardio and my surgery three weeks later, my heart had enlarged AGAIN.

All else being equal, you want a REPAIR, not a replacement.

Further, NYu specializes in "minimally invasive" MVR. 'course, that's in the eye of the beholder, and I felt like I'd been hit by a truck for several weeks (still look like it), but they do NOT crack open your sternum. Some docs scoff at this and call it a gimmick. In my book, it means I heal faster. End of story.

Best of luck to you. You can private message me if you want more details.

Cheers,

MitralMan

 

[barry70]

Thanks

Thanks

Thanks for the responses. I plan to see Colvin after my next Echo next month. Your heart was showing signs of enlargement, right? Did you ever here of Dr. Mehmet Oz at Cornell? Thanks.

 

[PapaHappyStar]

I had surgery at the Columbia Presbyterian recently. I think Dr. Oz works at the Columbia Presbyterian, but the two hospitals are affiliated. Columbia has a higher volume, has more varied expertise and is probably a better choice if you have a complicated condition or surgery. It may not be as friendly as a smaller/community hospital.

I would decide on a surgeon before considering the hospital though -- top notch surgeons dont usually work at mediocre hospitals.

 

[Nan]

Hi, yes, I know of Dr. Oz. In fact I had a consultation with him (he recommended a re-surgery for my aortic st. Jude's as it is so small and causing problems- I decided not to do it). He is very highly regarded at Columbia Presbyterian. While debating the possibility of surgery, I asked some friends who were on the faculty there, and they couldn't say enough good about him. Also, he performed aortic valve surgery on an aquaintance of mine who also had all kinds of good things to say about him.

Dr. Oz is also involved with alternative healing as well as being a surgeon. I believe that his surgery specialty is actually heart transplants, but he clearly also does valves!

Couldn't hurt to talk to him!

Let us know.