When to Replace or Repair?

[sonya489]

Hi,
I was wondering at what stage of regurgitaion of the valves did anyone have there's replaced.

I can see both sides of it doing it early in the process to lessen the complicating factors. As well as waiting until things are somewhat a little worse then doing it..

Is one worse off with 2 valves regurgitating as far as how long it takes for things to get worse if the valves and the aortic and the mitral.....

Thanks,
Sonya

 

[gary]

+ 4 leak, with slight stenosis, and bicuspidity.

+ 4 leak, with slight stenosis, and bicuspidity.

and LV hypertrophy were the combination of factors contributing to eventual Mild CHF and dyspnea that pulled the trigger for me.

EF and regurg gradually worsened as I got 'more mature' with replacement 2.5 years ago, at '8 dog years' old.

In addition my MV has had a +1-2 leak since I was 6 years old and still does.

Regurgitation of +4, with no other factors and asymptomatic, may be tolerable.

Without symptoms, early pre-emptive intervention will likely be dependent on more than a Maximum leak.

 

[sonya489]

Hey,
I have some symptoms I get short of breath,dizziness,a have a bruised feeling in my chest..I have had several occasions of rapid heart beating.


Sonya

 

[alicia]

Sonya, My cardiologist told me when you start getting symptomatic its time to repair or replace the valve. In my case I wish I had of went ahead and had valve replaced instead of repair.

 

[sonya489]

Alicia,
I go back to the cardiologist on Friday to get the rest of my results from the Stress/thallium the only thing they would tell me on the phone was that I DID NOT have CAD.I was more concerend in my case about the heart damage and she wouldn't tell me that ahhh so now I wait..

So why do you say that your wish you had done the replace instead of the repair?

Are you already having problems? Tell me everything about the surgery and the after math....

Thanks,
Sonya

 

[alicia]

Sonya, Dont you just hate the waiting for results? I had repair to mitral valve and now a year and 1/2 later the valve is leaking again and will need surgery to replace anyway but hopefuly not anytime soon. I had roboric repair and they went it thru groin and under right breast. I should have just had standard surgery beause I ended up having problems with the groin area. A week after surgery they had to cut open incision area to the ateries and all. My daughter had to come in 3 times a day for 3 months and pack gauze into this big open incision. I couldnt hardly go anywhere for 3 months becuase its was imposible to cover the area and the incision dripped blood and clear fluids alot! I still dont have all the sensation back in right breast, it feels really weird all the time. My advise is to go ahead and have replacement since eventually you will probably have to have replacement in future and dont use the robot. I also have about 4 port holes in back where tubes were and scars on neck from where tubes were and ended up with a hemotoma. Had two blood transfusions after surgery due to anemia developing. You have to make the decision thats right for you. I felt so much better a few months after surgery up until last Oct when I got really sick and had CHF and diagnosed with cardiomyopathy. Now I just take it one day at a time and since Im felling fair I try to do as much traveling and fun things while I can. I just went to Duke and they told me my heart function was better (EF now at 45%) and leak is not as bad as last year so no surgery for right now!!
yeahh...Talk to you later friend

 

[sonya489]

Well I'm glad Duke seems to think your doing ok! I live near Houston, Texas so we have a lot of specialist at the Heart Institute as well as many other places Houston's medical Center is outstanding and only about a 30 min drive for me.....

I am not a very patient person when it comes to waiting for results.I feel like the reason the stress/thallium was done at all was for family history and my first EKG now I have the 2nd EKG saying the same thing and I have to wait to hear about the heart damage I guess they figure hey it's happened it's in the past so why tell her ahh makes me mad...I will have so many questions for him on Friday......................

Thanks,
Sonya

 

[R0Y]

Sonya,

I don't think there is a simple answer as to when. There are too many factors. I had mitral valve prolapse with severe regurgitation. Fifteen years ago, I developed AV hypertrophy and was experiencing progressive heart enlargement from the condition and my cardiologist suggested that I consider surgery. I sought a second opinion and was told the changes were normal compensation and would probably stabilize. I decided to wait and my condition did stabilize.

I continued to be essentially asymptomatic for 15 years. Then, this past May, I observed the first symptoms of heart failure while cycling. Both my cardiologists agreed I should have surgery and tests confirmed the deterioration in my heart function. It was clearly time and I was fortunate to be able to have the valve repaired.

Selecting the right time is clearly an individual choice. If I had the symptoms you describe and the recommendation of my cardiologist, I would accept that it was time for me.

Wishing you the best.

-- roy --

 

[sonya489]

ROY, What test did you have done to confirm your heart damage?



Thanks,
Sonya

 

[R0Y]

Sonya,

Actually, it was a pair of tests: a dopler echo caridogram and a heart catheterzation (as part of an angiogram) to measure internal heart pressures. The tests were really a final confirmation after the shortness of breath, sudden fluid retention, and dramatic increase in blood pressure.

-- roy --

 

[sonya489]

Roy,
I just completed a stress/thallium so I am waiting until Friday for those results to see if I have heart damage and if so how much....I hate to wait for results.......I'm so scared if it does show the damage that the catherization will be what I have to do next!


Sonya

 

[R0Y]

Sonya,

I can tell you that the catheterization went very smoothly. It is not something to fear. In fact, mine turned out to be unexpectedly beneficial. The only discomfort during the procedure was a brief flushed feeling when they injected the dye for the angiogram. It was interesting to watch on the monitors. The angiogram turned out to be very significant. It showed a 90% blockage at the base of the left coronary artery. This had been completely silent but posed a clear danger of a massive heart attack. I never was in the high risk category for coronary artery disease so this was a complete surprise. I feel very fortunate that it was caught in time. This may literally have been a life saver.

-- roy --

 

[sonya489]

That is so good they found that in time ahh I know you were suprised when they found it. I think it's just hought of the test.
I mean I have had a echo,ekg,another ekg, and a stree/thallium I know these were a breeze other than vomiting after the thallium test then taking a 2 hour nap.....I mean basically I know if the thallium showed the heart damage then heart cath. would be next..Every other one has already been ran....I will post whenI find out on Friday!

Thanks,
Sonya

 

[sonya489]

Sorry I haven't updated this:
I went for Thallium results and they were fine I had no blockages,no clogged arteries, no heart muscle damage.
He said not to worry about the EKG's although they are puzzling to me. He made the comment about a electrical problem to the heart could be causing this.Whatever that means. He is going to re-echo in January.
No meds at this time so thats good. He said regular echos ar important....

Has anyone had the new test thats out the heart ct profile
i's new and suppose to be good insurance doesen't cover it though? If so what did you think abou the test!

Thanks,
Sonya

 

[Sully77]

Sonya,

The results of the test sound great and regular echos are important, I have one every six months even a year and a half after surgery. No meds is also a plus. My advise on repair or replace is to just go ahead and replace. My problem could not be repaired so I did not have a choice but if you have read Alicia's posts you know what can happen. Wait until you have your echo in Jan. and see what that says.

Good luck and keep in touch.

Jay

 

[sonya489]

Thanks to everyone on this board yall are great!

Sonya

 

[Junebug]

Hi Sonja,
I'm going through the same thing you are right now...only I guess I'm a step ahead. I have one group of cardiologists saying it's time to replace the valve and another saying it's not. I'm trying to get an appointment at Mayo clinic for a 3rd opinion.

My angio of last year showed my Pulmonary valve was leaking (moderate to severe) and the echo this year showed it was worsening. This time around I'm starting to have symptoms....shortness of breath, "sighing" alot, fatigue easily. Also, I feel like my neck is a bit swollen, mostly on my left side. Sometimes it subsides, but I'm aware of it. I'm not sure if it's coincidental to the other symptoms or if it's part of it. I had some blood work done this week & am waiting for the results to see if anything can be ruled out...like anemia.

By the way, I thought I'd share the info/process regarding Mayo (maybe it's just the cardiologists)....they won't even SCHEDULE an appointment until they have had time to review your previous records. At first I was a little put off by this then realized it makes tons of sense since if you're making the trip out there you need to know how long to expect to stay (for tests & stuff).

I'm waiting for my info to reach the cardiologist (don't we all hate waiting !!)

Please let us know what you find out. Also, one question I'm going to ask Mayo is: if it's not "time" with these symptoms, how will I know it's time, i.e., to what degree to the symptoms have to worsen? Maybe you can ask your docs the same thing.

 

[Nancy]

Junebug-

Here's a link for the various heart valve problems and their attending symptoms. I found it very interesting. I made a post to your other post regarding fluid retention, congestive heart failure, CHF, which my husband has.

http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/23659.html

 

[Herb M]

There is somewhat of a tradeoff in deciding when to get a valve replaced. New technology appears frequently enough to consider waiting until you really need a replacement, but there is always the risk if you wait too long there could be damage to your heart. Your cardiologist should be able to determine when your symtoms are at a level to justify not waiting any longer.

 

[Junebug]

Nancy,
Thanks for your reply & direction to the website....it is VERY informative. Sometimes I feel like I'm going crazy while I'm waiting.

I really appreciate all of you "being there" and your advice as well as reading other people's "adventures".