Father - 63

My father just found out that he has a damaged valve (superior vena cava, I believe) due to childhood rhuematic fever and that the heart is severely damaged.  The cardiologist said that the heart is working at 1/5 of what it should be. (due to the valve damage and heaving drinking)  My father is a diabetic (controlled with oral med/diet) and currently taking a high blood pressure med. (but does not have high BP.)  He is an ex-smoker (about 11 or 12 years).  We are currently waiting for his cardiologist to make arrangements for an appointment to come to Cleveland for a second opinion about his condition and possible surgery to repair/replace the valve.  I have 3 questions

1.  What are the chances the valve can be repaired or replaced?

2.  Is he a candidate for heart transplant (which at this point he is against) or can he "maintain" or reverse the damage with a combination of meds and surgery to repair the valve?

3.  When he comes down for an appointment, will he have to go through more tests before it can be determined to have the surgery to repair the value?  If so, how long of a stay can we expect (tests and surgery).

[Cleveland Clinic, MD]

1. What are the chances the valve can be repaired or replaced?

A: Almost all valves can be fixed either through repair or replacement.  The question here is how risky the procedure would be.  If there is a very high risk (there may be) then it may be too dangerous to have the surgery.  We will be able to give him a better estimate of the risk when we see him here.

     2. Is he a candidate for heart transplant (which at this point he is against) or can he "maintain" or reverse the
     damage with a combination of meds and surgery to repair the valve?
A: Very rarely will someone have a transplant for valve problems.  If he is still drinking alcohol he is automatically excluded from transplant.  More than likely the best choice will be some combination of medicine and surgery.


     3. When he comes down for an appointment, will he have to go through more tests before it can be determined to
     have the surgery to repair the value? If so, how long of a stay can we expect (tests and surgery).

A: Depending on what has already been done and the quality of the tests will determine what else needs to done.  Usually some additional tests including echocardiogram and perhaps cath need to be done.  The timing of the surgery will depend on the urgency of the case but in general if it is scheduled before hand will take place within the week of coming to Cleveland.  If it has not been scheduled prior to your visit here it will be scheduled within several weeks of your initial visit.

[Charles McClelland]

I'm a 66 year old male,diabetic (take 10mg glucotrol 2x day and rezulin 400mg 1x day).  Had 4 bi-pass July 98.  Last week went to hospital with flu symtems and right lung full of fluid.  Was given furosemide 40mg 2x day, prinivil 20mg 1x day, Magnesium chloride 64mg 2x day, and potassium 99mg. 1x day.  Since starting to take medication both legs are swelling badly.   Are these medications safe to take together and should I be overly concerned about this excessive swelling.

[sue]

One more question.  The damage to the heart.  It is my understanding that my dad's heart is working at "1/5 of what it should be". (acording to the cardiologist) Can the "working rate" of the heart be improved with  surgery and meds?  The cardiologist did say that dad was "high risk"  10-15% chance of making it through surgery, based on his examination (echocardiogram and heart cath).  If he does nothing dad will only live 1-3 years.  If surgery is possible/successful combined with drugs, will the life expectancy increase?  Dad is definitely following the rules "no more alcohol."  and is trying his best to "cool his jets."  He's always been a very active guy, short winded and all he keeps going.  Almost like the Energizer Bunny....

Thanks for our response.

[kerri]

I was diagnosed with Rhuematic Fever last year.  My doctor said that he had only seen one other rhuematic fever patient.  I have just gotten strepped throat once again and I am nervous that my heart is being damaged.  Is there any doctor on the east coast that might have more experience with rhuematic fever?