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Ejection Fraction/AV & MV Regurgitation
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Ejection Fraction/AV & MV Regurgitation

Hello,

I have an ejection fraction in the low to mid 40s;  my aortic valve is leaking and will require surgery in the near future (I am 79 years old).

I have 2 questions:

1) what does it mean to have an EF in to the mid- to low 40s before surgery (does this make my surgery riskier) and does the EF typlically go down post surgery before it rises again?

2) It looks as though my mitral valve may be leaking also.  I have not had issues w/ this in the past.  Can my mitral valve be leaking bec. of my aortic valve?  Is this common (aotic valve eventually causing mitral to leak)?  If so, is there a good chance that the mitral may NOT have to be replaced if the surgeon goes in and sees no structual issues in the mitral?  What, in your experience, is the chance that the mitral would have to be repaired/replaced?  Also, how much riskier is it to do a double valve operation?

Thank you for your time and answers.    
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242509_tn?1196926198
With aortic regurgitation the ejection fraction can decrease as the ventricle dilates. It is ideal to operate before this occurs, but certainly if it occurs because of the valve then it certainly requires surgery.
If the mitral valve leak is not severe, it may be functional MR from LV dilatation and high end diastolic pressures. These will likely improve after aortic valve surgery, and unless there is a structural abnormality of the valve it will not require replacement or repair.
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