Can Valves be repaired

[DuckyCooke]

My dad just started kidney dialysis approx. 3 mo. ago. - 5 1/2 weeks ago he had a mild fainting spell (heart attack ?) and about 3 1/2 weeks ago had a mild stroke - ( talked like elmer fudd for two or three days and had high temp for a few days and great fluctuations in blood pressure 220/110 - 100/40 inbetween dialysis
           They had tried two different fistulas in his arm first before ever started dialysis - and still said wouldn't work / then said he needed to start dialysis so they put a temp connection in at his neck (and would later go back and repair fistulas in arm) - after fainting spell and mild stroke they did alot of tests and said he had a blood infection after they cultured end of temporary dialysis hook up in neck began specific antibiotic treatment - now they said he needs some valves replaced

       Can these be repaired to avoid any extra long term meds.

[Cleveland Clinic]

Im sorry to hear of your fathers ordeal.  I've seen alot of complications with dialysis catheter infections. They really can be a two edged sword. Unfortunately they are a neccessity.

Im assuming your father has endocarditis with valve damage from the infection.  With proper antibiotic treatment often the infection is able to be treated.

The valve repair is usually to repair the damage to the valve from the infection, or if the antibiotic cannot clear the infection from the valve.

After the infection is cleared he should not require long term medications.  He would require antibiotic prophylaxis to prevent recurrent endocarditis.

[DuckyCooke]

They said his blood is now sterile ( clear of infection ?? ) They did a culture on the piece they took out of him and made a specific antibody / if or so this is the case - what are the chances of a recurring stroke

      They want to replace the valves SOON !! - is their time to get a second opinion

is a bad stroke ( or any eminant) they have him on alot of meds - and if they do replace them will their be any extra meds (long term) that he will have to take

   what do you think is the best alternative ?? I am working on copies of some ( few different kinds ) of film that cannot be on CD's other than that i just got copies of everything

[DuckyCooke]

also a Transesophageal Echocardiogram Report (TER coming) - my dad has been sleeping sitting down - says heart burn ?? will this test do that and how long will it last ?

findings of "TER"

-Normal left Ventricular function with left vent. ejection fraction of 60%

-Normal right ventricular function
-There is a mobile echo density(.7by.4cm)on the aortic valve,suggesting vegitation,there is severe aortic regurgitation. no abscess and fistula seen
-There is a small echo density on the anterior mitral leaflet, this could be vegitation, there is moderate to moderately severe mitral regurgitation
-mild tricuspid regurgitation
-No PFO seen by color Doppler or Saline contrast
-Mild to moderate atheroma in the aorta

THESE ARE THE FINDINGS OF MY 63 yr. old dads test - should another be done - how urgent is a procedure for valves and /or should this test be redone since his blood is now "STERILE"

summary of the test and comments is:
-normalleft vent. function w/lft. vent. ejection fraction of 60%
-mobile echo density(.7by.4cm)on the aortic valve,suggesting vegitation w/severe aortic regurgitation
-small mobile echo density(.4by.2cm)on the anterior mitral leaflet,suggesting vegitation with moderate to moderately severe regurgitation
-mild tricuspid regurgitation - THATS IT !! do we have time to send out info for a formal 2nd opinion - AND ANY SUGGESTIONS AND COMMENTS APPRECIATED !!

[Cleveland Clinic]

Ducky,

You could ask to be transferred to another facility, or ask another opinion from a phyiscian at your hospital.

With the presence of a stroke and the findings on echo, valve replacement would be a logical next step. Timing is a difficult issue not knowing your fathers full history.  

At some point you will need to trust the physician performing the procedure.

[DuckyCooke]

I appreciate your "frankness" and i do understand that - i was just curious as to the pros and cons of getting pig valves as compared to any and all of his other options - with his continuous kidney dialysis - I do think the surgeon group is excellent (only 2 docs 1 male and one female and we have some mutual friends)

i didn't know why some places repair valves more than others and why some places replace valves - some at 90%-10% and vice versa ratios respectively.

I do not know the 10 yr. advantages and disadvantages - and i also hear of just drug/medication procedure treatments ?

                         Thanks Doc