Aortic valve replacement surgery with an enlarged heart

  This is with regard to my father who is 64. He had a mild aortic valve  
  (and still has)leakage detected in 1991. But the doctors decided it was mild enough not
  to require any action.
  Recently he has developed symtoms (symptoms) of congestive heart
  failure. His lungs filled up with fluids, fluids in his legs, shortness of
  breath, fatigue... The doctors prescribed Lanoxin and Lasix. But unfortunately
  they did not inform him of the side effects and hence he did not take any
  potassium supplements. He is in the hosipital now due to high level of
  toxicity in his body. His kidenys seem to be responding. But the bile content
  in his blood has concerned the doctors. It seems that he will be in the
  hospital till he gets back to normal.
  The doctor seems to be of the opinion that a valve replacement surgery at
  this point may not be recommanded as he has an enlarged heart.
  Is is true that an enlarged heart precludes aortic valve replacement ?
  Can non-invasive surgery be done in this case ?
  Also my father lives in India where information is a little hard to get.
  I would be very obliged if you could shed some light on this subject.
  Thank's a ton
  Smitha
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Dear Smitha:
The ideal time to replace a leaky aortic valve is before the heart starts to dilate and becomes dysfunctional.  However, if the heart is already damaged from the leaky valve, this does not preclude surgery, it just makes surgery riskier. If the heart is extremely weakened, the risk of conventional valve replacement surgery may be prohibitive.  High risk surgery could still be performed (at an experienced medical center) with the possibility of artificial device or heart transplant backup.  There are no non-invasive surgical treatments in this situation.  However, there are medicines that can be used in patients with leaky aortic valves that can help the symptoms and keep the damage from progressing.   Your father should definitely be evaluated for surgery at a center that is experienced with high risk valve replacement.  I wish your father the best of luck.
If you wish for your father to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist who specializes in valves at desk F15.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.

[Punkinheart]

This is in regards to my Father who is only 54.  He has a history of heart disease, stnets, triple bypass surgery, as well as, a leaky aortic valve.  His right heart is enlarged and the doctors here at Vanderbilt University Hospital feel that aortic valve replacement is to risky.  He is retaining fluid in his abdomen, legs, and feet, and testicles.  He has had a viral infection that has been cleared up while using Ampicillin for the past 4 weeks.  His vital signs are good, and he is walking and talking...on multiple fluid pills including lasix.  He only has 10% kidney function.  What can we do to preserve his life, he is just to young to let go that easy.  The doctors in our hometown sent him to Vanderbilt after several weeks of hospitalization at there facility. We are willing to travel within the US to save his life....