Can this valve be repaired?

[kayl]

I am a forty-nine year old female who had rheumatic fever at age 12.  I had damage to most of my heart valves, the mitral valve was damaged the most. I had a mitral commissurotomy, in 1973.  I had open heart repair of the mitral valve in 1987.  When I had the open heart surgery in 1987, I was told that the aortic valve would probably need replacing at some point.  My Mitral valve was replaced in 1990 with a St. Jude prosthetic valve.  I am on coumadin.  I began having atrial fibrillation in 1995.  I took an assortment of heart medications to control the fibrillation, but none were successful.  The side effects were sometimes worse than the pounding heart.  In 1998 I had a mild heart attack.  In 1999 I had an AV node ablation with placement of a Med Tronic pacemaker.  I am pacemaker dependent.  All was terrific until about 3-4 months ago I began having left arm pain, chest pain. I I consulted my cardiologist, my heart rate is back up slightly  between 110-120 bpm.  My blood pressure is slightly elevated at 155/90.  My echocardiogram showed moderate aortic regurgitation and mitral regurgitation.  My question is, if the aortic valve has to be replaced, can it be done after an AV node ablation with pacemaker dependence?  If the valve can be replaced, approximately how long before replacement is necessary?

[CCF-M.D.-RCJ]

kayl,

Sorry to read of your ordeal.

The AV node ablation and pacemaker dependence do not alter the ability of a surgeon to perform an aortic valve replacement.  It would be unlikely that the valve will be repairable -- rheumatic aortic valves are not often repairable.

The timing of surgery depends on factors that you have not provided, most importantly the heart function and size parameters.

Given that the next open heart surgery for you would be your third, I would strongly recommend that you come to the Cleveland Clinic for an opinion.  There are only a handful of surgical teams in the world that specialize in re-do valve surgeries, and none do them better than here.

Good luck.

[eileneee]

your situation sounds like an instant replay of mine with the exception that i did not have ablation.  i would like to chat with you if you want and compare statistics, etc.  i have had two open heart surgeries for valve repair and then valve replacement necessary from damage from rheumatic fever at age 12.
i am awaiting the 3rd open heart surgery.  i am 56 years old, female.  my email is ***@****