Aortic Valve replacement

[Dale E Petrishe]

We just learned that my 82y/o father is going to need an aortic valve replacement.  He has hypertension (under control with meds) and suffered 2 hemoragic aneryurisms (at approx 55 and again at 65).  With the first incident his body developed an entire 2ndary blood vessel supply to replace the midbrain artery - which is what saved his life with the 2nd incident. He made a full recovery in both instances.

Is he a viable candidate for surgery?  What are the statistics on strokes during/post op?

Are there alternative non-invasive treatments?

What are the advantages/dis-advantages of waiting to have surgery - his Dr. said he can do it now while he is reasonably healthy, or wait until its really bad.

Where can I find further literature/and hospital/doctor referrals for Chicago.

[Cleveland Clinic, MD]

Q: Is he a viable candidate for surgery? What are the statistics on strokes during/post op?
A: The first part of the question he and his doctor will have to decide.  There is no law that people must have surgery and it is a major surgery.  On the other hand if he is active and wants to have this fixed even if it is risky then he should go for it.  Nationally the stroke rate is probably about 1-2%.  It will be higher for him - how much his doctor will have to say.

Q:Are there alternative non-invasive treatments?
A: Not really.

Q:What are the advantages/dis-advantages of waiting to have surgery - his Dr. said he can do it now while he is
reasonably healthy, or wait until its really bad.
A: The timing of valve surgery is more of an art than a science and will have to be determined by his doctor.  One wants to wait some time but not too long either.  It will also have to do with the questions raised in your first question.

Q:Where can I find further literature/and hospital/doctor referrals for Chicago.
A: You could check the local library, friends and family, and national rating surveys such as US News and World report.

[Charles]

What about the Aortic Insufficeincy type murmur ... I have been diagnosed with a mild AI ... I am a 40 year old male
... can you send me info. regarding this type of murmer and any Do's and don't's that I should observe ...

[Cleveland Clinic, MD]

Aortic insufficiency is a leaking of the aortic valve.  If this is not repaired over the long term (years and years - depending on the severity) it can lead to heart failure.  The timing of valve replacement is not always an easy decision and for this reason a person with this condition should have regular follow up with a cardiologist who is knowledgeable in the area of valve surgery.  In general the replacement should be before the onset of any symptoms or heart failure.

Symptoms include shortness of breath with activity, swelling in the lower extremities, chest discomfort and palpitations.    Some medications such as ACE inhibitors (i.e. acupril, vasotec, captopril) decrease the workload of the heart and can help prevent heart failure.  Surgery is however the only cure.

The valve used in surgery may be mechanical,  bioprosthetic (animal valve) or homograft (human cadaver donor).  The only type that requires coumadin is the mechanical.  The advantage of the mechanical is that it will not wear out as opposed to the others which only last 10-15 years.  You and your doctor can discuss which type of valve is right for you when it is time for replacement.  Hope this information helps.  Good luck.  Here are some other sites with AI information:

www.Americanheart.org/Scientific/statements/1998/119803lll.html#B

     www.amhrt.org/Heart_and_Stroke_A_Z_Guide/aorticr.html


     www.inficad.com/~hanky/heart.htm (this is the support group board

[Hank Eyring]

Hello There Dale,

I am writing you to let you know about a list that myself and several other Aortic Valve Replacement patients have going.

I am a 33 year old male who had aortic valve replacement surgery in April of 1999.  I often had questions about stuff like what do other people’s spouses think about their valves clicking, to how do the kids deal with Dad having major surgery.  Also issues about what is involved in approaching surgery, going through surgery and recovering from surgery. We also discuss the use of coumadin since most of us have to take it for the rest of our lives.

If you would like to join a mailing list along with folks who have been through this kind of stuff before and are facing it in the future, just go to the following URL and sign up.

http://frontpage.inficad.com/~hanky/heart.htm

You will find much help with this list and we all learn from each other.

Hope you can join us,

Hank Eyring

[Cleveland Clinic, MD]

Thanks Hank.  We'll pass along the URL as well so it won't be necessary for you to post a reply to every valve replacement question.