Question about post mitral valve repair and still having regurgitation...

[tsanjose]

Hi all. So I just went in for my 3 month (ended up close to 4 mos after scheduling it) last week. I was super stoked to come in and talk to my cardio about my latest echo done on 2/28. When I got there, he told me everything looked great. My EF went up from 52% after my surgery to 56% now. He did tell me that I have trace to mild regurgitation and I was pretty bummed.

I thought repairs are suppose to fix this? Does anyone post repair still have any regurgitation? If so, to what degree?

 

[JulienDu]

When I was 9 I had a valve repair, I went from severe to mild. Very common for repair. Not all repair end up being 100 percent repair but you could stay like that for a long time, mine barely moved. Went from mild to mild/moderate in 20 years. Surgeon ( the one that just operated me ) that look at the repair done 20 years ago by another surgeon he did not even know told me the repair was a success. And with a mild regurgitation I have still done among the toughest jobs.

 

[tsanjose]

good to hear julien! was your repair on your mitral or aortic?

 

[JulienDu]

yeah my bad should have mentioned that mine was aortic

 

[dornole]

I had mitral repair (via balloon) in 2002. It was chiefly to repair stenosis. It fixed the stenosis but I was left with moderate regurgitation instead, which I have lived with just fine for 13 years now, doing anything I want to do and just taking aspirin. It is now moderate-severe and some of the stenosis is coming back also. (I have rheumatic heart disease). I always knew it was unlikely to be a permanent solution but since it was a much easier procedure than OHS, it's been a decent outcome.

I think mild is a pretty good outcome and I wouldn't be too bummed or concerned. Follow up with your visits faithfully to keep an eye on things.

 

[tsanjose]

thanks for the words of encouragement. yeah i was feeling a bit down cause the thought of having to do another surgery bums me out. i was also thinking that needing a full on replacement would kind of suck too so i can use some insight/input from people with repairs and how long they last.

 

[dornole]

In my case my cardiologist told me to expect 10-15 years out of the repair and I am on year 13. But I think it is extremely variable. Especially for mitral valve since it's so complex. Some types of problems seem to be SUPER successful and durable when repaired, others not. Mine is one of the not so easy ones and the procedure used is not as reliable as a surgeon actually getting in there and repairing.

If you really only have trace to mild regurgitation and you followed my trajectory of one "level" of regurg per decade or so (trace to mild, mild to mild/mod, mild/mod to mod, mod to mod/severe), it would take you 40-50 years to get to where I am now, still in the waiting room. Not to say that's what'll happen, but maybe it gives you some perspective.

What did your surgeon say about durability of your repair?

 

[Zoltania]

I found this study stating that the 10-year freedom from reoperation for mitral valve repair was over 94%:

http://aats.org/annualmeeting/Program-Books/2014/7.cgi​

The study was not large but it is quite recent, unlike most studies I've found.

 

[tsanjose]

my surgeon told me he was very satisfied with the repair. he said it should last my entire lifetime and no further need of repair. i'm not sure if he's saying this cause my chords ruptured and other than this, there is no other evidence of degeneration or damage. i was in a car accident when i was younger and we think maybe it was due to this. or he could just be saying this cause they want us all to get back to our normal daily routine without worrying about future surgeries.

eitherway, i'm still worried, lol. heart surgery is just about as serious as it gets. i just don't want to discount any symptoms.

zoltania, did i ask you if you still had regurgitation after your repair?

 

[Zoltania]

tsanjose, you hadn't asked before, but my echo after surgery showed that I now have no mitral regurgitation. Before the surgery my chords had ruptured too.

 

[dornole]

Thanks for posting that article Zoltania, it was super helpful and encouraged me that surgical repair vs. replacement be an option for me even as a rheumatic patient. . . I only wish their data went more than 10 years. Not sure why they picked that number since plenty of us patients would like to live many more years than that. : )

tsanjose, I'd try to take that warranty and run with it as much as you can! (For contrast, my cardiologist directly told my husband "Well, that went about as bad as it could have gone" and seemed dejected. So at least some of them will tell you the truth!) Perhaps if you have a few more good checkups you will feel less worried over time. How great would that be to be heart-surgery free the rest of your life. That's my hope for you!!

 

[Zoltania]

Here's another article, from 2015, with encouraging numbers about occurrence of regurgitation and need for re-operation after minimally invasive mitral valve repair:

http://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-015-0390-y
​

Highlights:

• "[R]ate of freedom from reoperation after mitral valve repair was 98.9 ± 0.3 % at 1 year, 96.4 ± 0.8 % at 5 years and 95.4. ± 1.1 % at 10 years."
• "Freedom from recurrent mitral regurgitation was 99 ± 0.4 % at 1 year, 95 % ± 1.3 % at 5 years and 86.6 % ± 3.8 [at 10 years]."

 

[chaidell]

tsanjose - I had/have trace regurgitation after my surgery. It's actually quite normal as most with even healthy valves have trace regurgitation and never know. If you're closer to mild, depending on your age, you may need one more surgery down the line, but that would be in like 20+ years. No one wants to have OHS, but I'm glad there is an option for us.

After about a year Post-Op, you'll be out of the lemon law period. Your confidence in your repair will strengthen and life will be back to normal!


We're like German cars...high maintenance!