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Questions posted in the
Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: 3rd open heart surgery My wife is having her 3rd open heart surgery. A brief history, she had rheumatic fever as a child that progressed to St. Vitus dance. After she led a normal life till 1988 when she was 32 years old she went for a balloon valvuloplasty for severe mitral stenosis. There was a problem and the balloon ruptured the backside of her heart. A year later she had her mitral and tricuspid valves replaced. Recent ekg showed her aorta valve leaking and her heart was extremely slow. She is going to have a pacemaker put in and they are going to fix her leaking aorta. There is some concern among the doctors about the pacemaker and her tricuspid valve being a trickey placement. She has St. Jude valves in her mitral and tricuspids. Can you explain what problems there are, and is this as uncommon as the doctors make it sound? Thank you, T. Dave
Dear David The St. Jude's valve in the tricuspid position will make transvenous placement of a pacemaker problematic. However, your wife could have the pacemaker leads attached at the time of surgery to the outer surface of the heart. This gets very technical and very tricky. I would suggest that someone very experienced in cardiac electrophysiology be consulted. I hope this has been useful. I wish you the best of luck. Feel free to write back. Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
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