My Mother is an active 61 years old. She has been diagnosed with the following details :
Severe aortic stenosis , Peak gradient of 105 mmhg with a mean of 52 mmhg. Moderate to severe AR, Severe MR
Severe pulmonary hypertension, estimated PASP of 62 mmhg.
Global LV hypokinesia with severe LV systolic dysfunction, estimated EF 25-30%
Type 2 DM
Mild, non obstructive coronary atheroma on coronary angio
What is the best treatment for her ?
Thanks a lot
Based on the test results you listed in your question, it appears your mother has severe aortic stenosis (narrowing of the aortic valve), severe mitral regurgitation (leaking of the mitral valve causing increased pressure in the lungs), aortic insufficiency (leaking of the aortic valve), and left ventricular dysfunction (weak heart muscle).
I would recommend consulting a cardiologist and a cardiothoracic surgeon to consider surgery on the aortic and mitral valves. The cardiologist and cardiothoracic surgeon will be able to look at all of the details of the case and come up with a good plan that is individualized to your mother as I do not have access to all of the clinical variables used to make those decisions.
There are pros and cons of both strategies. Without having the ability to read through your mother's history it is difficult to say. The use of a metallic valve requires the long-term use of anticoagulation without ever stopping. Those valves tend to last longer. Tissue valves do not require long-term anticoagulation but have a limited lifespan (typically 10-15 years).
Most of the patient's I see end up getting a tissue valve because of the anticoagulation issue. Also, if a new valve is required in the future, percutanous options will likely be available while that will not be an option with a mechanical valve.
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