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Heart Disease (Expert Forum)
Aortic Valve Stenosis
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Aortic Valve Stenosis
by ifred2000, May 17, 2005 12:00AM
I’m a 62 yo male with a history of heart valve problems. I had a CMV in 1971 and MVR with St. Jude mechanical valve in 1986, since then I’ve been taking blood thinner drugs and diuretics. Now I’ve been diagnosed with aortic valve stenosis (valve area = 0.85 cm2). I feel tired with moderate activities, and the diuretics dose has been increased to help get rid of excess water in the body. The surgeon who performed the MVR operation on me in 1986 considers a new operation a very high risk mainly because the pericardium was closed loosely in that operation, and a weak heart muscle. My EF = 33%, LA = 5.4cm, RV = 3.0cm, I’m healthy otherwise:
1) What is the risk of AVR operation for somebody in my condition.
2) Is minimally invasive surgery an option in this case?
3) Is there a risk in flying in an airplane for long distance?
4) I just read about an AVR surgery for high risk patients at the Maryland Heart Center by Dr. James S. Gammie (www.umm.edu/heart/aortic_high_risk.html) at which “This technique uses a camera and bypasses the aortic valve, adding a new valve from the heart to the aorta and thereby unloading the heart”. Have you heard of the doctor or the procedure?
Thanking you in advance.
1) What is the risk of AVR operation for somebody in my condition.
2) Is minimally invasive surgery an option in this case?
3) Is there a risk in flying in an airplane for long distance?
4) I just read about an AVR surgery for high risk patients at the Maryland Heart Center by Dr. James S. Gammie (www.umm.edu/heart/aortic_high_risk.html) at which “This technique uses a camera and bypasses the aortic valve, adding a new valve from the heart to the aorta and thereby unloading the heart”. Have you heard of the doctor or the procedure?
Thanking you in advance.
Doctor's Answer
by CCF-M.D.-MJM, May 17, 2005 12:00AM
Hi ifred2000,
Sorry to hear about your valve surgeries and recurrent problems.
1) What is the risk of AVR operation for somebody in my condition.
It would take a detailed history and physical examination to assess your risk. It does not sound like your risk is prohibitive of surgery, but I would insist on a high volume cardiology center that does many cardiac surgeries.
2) Is minimally invasive surgery an option in this case?
I doubt it. With multiple previous surgeries you are bound to have scar tissue that would make this surgery more difficult. Plus, at your age you will need a left heart cath to evaluate for coronary artery disease and investigate your current mitral vavle as well.
3) Is minimally invasive surgery an option in this case?
On any long flight or drive, you should change position frequenly and stand to walk when you can. It will decrease your risk of deep vein thrombosis.
4)I just read about an AVR surgery for high risk patients at the Maryland Heart Center by Dr. James S. Gammie (www.umm.edu/heart/aortic_high_risk.html) at which “This technique uses a camera and bypasses the aortic valve, adding a new valve from the heart to the aorta and thereby unloading the heart”. Have you heard of the doctor or the procedure?
I have not heard of this surgery and would not rush to any new surgery that is not proven by time. I honestly believe we have some amazing valve surgeons here. If you are anywhere near the Cleveland Clinic, consider coming for a second opinion.
I hope this answers your questions. Good luck with your surgery.
Sorry to hear about your valve surgeries and recurrent problems.
1) What is the risk of AVR operation for somebody in my condition.
It would take a detailed history and physical examination to assess your risk. It does not sound like your risk is prohibitive of surgery, but I would insist on a high volume cardiology center that does many cardiac surgeries.
2) Is minimally invasive surgery an option in this case?
I doubt it. With multiple previous surgeries you are bound to have scar tissue that would make this surgery more difficult. Plus, at your age you will need a left heart cath to evaluate for coronary artery disease and investigate your current mitral vavle as well.
3) Is minimally invasive surgery an option in this case?
On any long flight or drive, you should change position frequenly and stand to walk when you can. It will decrease your risk of deep vein thrombosis.
4)I just read about an AVR surgery for high risk patients at the Maryland Heart Center by Dr. James S. Gammie (www.umm.edu/heart/aortic_high_risk.html) at which “This technique uses a camera and bypasses the aortic valve, adding a new valve from the heart to the aorta and thereby unloading the heart”. Have you heard of the doctor or the procedure?
I have not heard of this surgery and would not rush to any new surgery that is not proven by time. I honestly believe we have some amazing valve surgeons here. If you are anywhere near the Cleveland Clinic, consider coming for a second opinion.
I hope this answers your questions. Good luck with your surgery.
normal?