Optimum Timing of Mitral Valve Replacement Surgery

[Sarah]

Hi, I am new to the forum. I am 47 years young, and was diagnosed with Rheumatic Heart Disease (RHD), Mitral Stenosis , at age 19.

At age 31, I have OHS to repair the valve.(the opening was enlarged from 1.2 to 2.5 sq cm)

I have been complaining of fatigue, and joint pains(Hip, lower back, SI, Knee, Foot) for the last 5 years to my cardiologist. He subsequently referred me a Rheumatologist who concluded that I have Benign Joint Hypermobility Syndrome with myofascial pain.

In Dec 2003, I had breathing difficulities; the lung specialist attributed it to post-pneumonia infection asthmatic cough, while the cardio think it's mild chest congestive failure. (Note I have never been asthamatic all my life except for this episode)

My Cardio always said that my heart condition is not that bad, and doesn't think it's time for valve replacement surgery. However, in my recent appointment, I told him I want to have a better quality of life. He then said he would not object to the surgery, but caution me that I am trading one set of problems for another.(pl give me some of your views)

I also have a long history of drug allergy; the doctors have confirmed that I am allergic to Ampicillin, Erythromycin, Vancomycin, I am also unable to tolerate Atenolol 25 mg -it will trigger wheezing, after the pneumonia episode; unable to tolerate lovastatin 20 mg - it causes muscle ache especially on the shoulders, upper back and arms.

I am currently on the following medication: Digoxin 0.125 mg, hydrochlorothiazide 25mg, ezetimibe 10mg, penicillin injection 1.2 mega u IM every 3 weeks.

I hope to hear from you all as to at which point of my life should I go my the valve replacement surgery - by the way, the cardio said that biological/tissue value is not an option for me because my current valve is both flail and calcified due to the RHD.

 

[Harrybaby666]

Hi There Sarah...Welcome To This Awesome Site!!!

Hi There Sarah...Welcome To This Awesome Site!!!

Hi Sarah,
I am so glad that you posted, because I read your post and found alot of simularities between you and I as far as health goes.

First, let me tell you, I have asthma, and I was on atenolol and Toprol XL and they both bothered my asthma very badly, so now I am on Coreg which makes the heart pump better (I have Cardiomyopathy, Valve Leakage and Congestive Heart Failure) .

Second, Although I have not yet had valve replacement surgery, I have had ALOT, AND I DO MEAN ALOT of support from these wonderful people. I also know that there is a condition called Cardiac Asthma, which if I am not mistaken, my grandmother has (she is on an inhaler twice a day) This is something you might want to ask your cardiologist.

Third, I am also on a Statin drug (Lipitor) and let me tell you...the pain from it is absolutely horrible, and when you combine it with arthritis....LOOK OUT!!
You might want to ask your doc if there is another med you can take...I also take Lopid because of my high triglycerides. I know its not much, but I hope it helps you feel better and points out some possibilities to ask your doctor about. I understand your pain completely, and I hope it goes away as I know its not fun...Take Care Harrybaby666

 

[Yaps]

Did they say

Did they say

Anything about regurgitation with your mitral?One of the symptons of regurg is almost chronic pnemonia, I know ..I had it 4-6 times a year until mitral replacement.
There are drawbacks to surgery , the heal-up time usually 12 weeks.
If you have a mechanical valve, you must be on blood thinners forever, which complicate your life further due to certain foods and supplements effect the drug, must have blood checked frequently.
You still have to be aware with endocardinitis, take antibiotics before dental work, must take blood thickening agents before any surgery, then lovenox or similiar products to thin it in recovery(St Judes can block easily from clotting).
Perhaps this answer's your questions as to what Dr meant by 'drawbacks' , in my case I hadnt a choice... lol..cause it sure beats dying..lol btw; lol we are the same age..shhh..dont tell anyone
Love Yaps

 

[JimL]

Hi Sarah, and welcome!

A general principle that many of us have observed is that cardiologists seem to want to postpone surgery, while surgeons generally recommend surgery much sooner. You could get a second opinion from a surgeon.

The shortness of breath that comes as the valve is less and less functional is no fun at all. It is possible for the valve to head south rapidly.

Coumadin, as most who are on it will tell you, is no problem. I've had a couple minor surgeries while on coumadin with no trouble. I cut my hands all over on thorns and such yesterday with no bleeding problems whatsoever.

 

[Marty]

If your echo and your murmur show significant regurg, and your left atrium is dilated ,surgery sooner rather than later is indicated.

 

[ALCapshaw2]

Welcome aboard Sarah !

I believe you are our first member from Singapore. Amazing!

With all of your complications, I would seek recommendations to some very experienced heart surgeons for their opinions on how to best treat your condition.

The American Heart Association has a list of anti-biotic protocols for people who are allergic to Amoxicillin. I take 500 mg of Azithromycin (2 tablets from a Z-pak) before each Dental Procedure to prevent endocarditis. Clyndamycin is another option.

Good Luck in your quest for knowledge and treatment.

'AL'

 

[Sarah]

Thank you to each and every one of you who responded.

I do have MR after the OHS, but the MR is very mild compared to the MS - due to restenosis - as the value opening is narrowing again. My LV (left ventricle) has been slightly enlarged since the last OHS.

I will be going for another echo on 8 Nov 2004
And then my cardio will fix an appointment for me see to a surgeon, as I last indicate to him I wish to have the valve replacement surgery after 1 Dec 2004. My heart rate is on the high side and they have caught my palpitation on ECG before- the cause of it was AF.

With my present condition I can't even do an hour of slow walk on level ground. I can only do my walking exercise in the swimming pool (1.4 m deep) and for only half an hour.

I hope that the "fatigue" and the "cardiac asthma" will go away after the surgery. I love to travel and I want to camp in the mountains and hike in the forests.