Possible Mitral Valve Surgery Needed?

[V__]

I wonder if you're presupposing a valve replacement with a mechanical valve here and meaning compliance to ACT long term?

You are correct. My statement was too cryptic and had these assumptions. Depending on age or other circumstances, one could choose a bio-prosthetic valve too.

That's probably a point to bring up with the surgeon - which prosthetic valve to use, if it comes down to it. (In my case it was straightforward, and the replacement was not needed. So I glossed over this choice.)

 

[pellicle]

My statement was too cryptic and had these assumptions.

I'm just trying to head off any potential misunderstandings I see burgeoning ...

in my case it was straightforward, and the replacement was not needed. So I glossed over this choice

I thought that the implication of a redo was a good point in that above. Thinking about that would make one wonder if kicking the can was worth it...

 

[V__]

I thought that the implication of a redo was a good point in that above. Thinking about that would make one wonder if kicking the can was worth it...

I think it's just counting the probabilities and optimizing the outcome. The repair has a certain risk and outcome, and a fraction of people will later need a redo, which has a certain risk/outcome balance. The replacement has a certain risk and outcome, and some people will need a redo, etc. I doubt the difference is big in the end, but it seems the repair is preferred.

 

[pellicle]

The repair has a certain risk and outcome, and a fraction of people will later need a redo, which has a certain risk/outcome balance.

interestingly I faced a similar dilemma on my 1992 OHS when I went with a cryopreserved viable homograft. At that time nobody was sure how long they'd last. So turned out to be 20 years.

I'm pretty happy with that decision (which was basically led by my surgeon) because:

1. I didn't mind being a lab rat on data gathering because they'd already saved my life when I was 10
2. it seemed that it might be a chance at no further surgeries
3. it was mentioned "we don't want to see you on warfarin just yet" (suggesting that may be undesirable and that the valve wasn't a dead certainty for being "done")

In the mean time ACT point of care technology arrived and I've had it easy since then.

Today is my measure and decide day, so INR was 2.5, decision was "continue previous dose".

Pretty simple and I don't really see what all of the fuss is about. So far I've not cut myself shaving

Nor have the monsters got me.

Best Wishes

 

[Zoltania]

The aspect of "pulling the ribs back" resembles a "minimally invasive" method of surgery. Which would be a real surgery, just not the frequent "sternotomy" way, when they cut the breastbone. The minimally invasive method may or may not be robotically assisted. As long as the surgeon has sufficient experience with it, it should work well. (The techniques are different from the sternotomy-based access.)

The catheter might be something else... perhaps a pre-op check of the heart arteries?

The "catheter" might actually be a "port," which from my understanding is a rigid tube that is temporarily placed from the incision to the heart and through which the instruments are inserted. As was said, this could be robotic or not (in my case, it was not robotic).

 

[V__]

The "catheter" might actually be a "port," which from my understanding is a rigid tube that is temporarily placed from the incision to the heart and through which the instruments are inserted. As was said, this could be robotic or not (in my case, it was not robotic).

That makes sense. I do remember seeing "port access" phrase in my medical papers for the minimally invasive surgery.