How long can you have severe MR w/ no ill effects?

[jonkep]

I was a healthy Air Force Pilot with no history of heart trouble (flight physical every year).  I got SBE (Actinomyces viscosus - unknown portal of entry and NO dental work prior) and after a difficult diagnosis was treated with IV Penicillin (PIC line) for 8 weeks and oral amoxicillin for 12 months.  I got better but it left me w/ a 1-2 mm hole in the base of the anterior leaflet of the mitral valve and severe MR, grade 5.  That was in 1994.  I am now 45 years old and still healthy.  I run, work out, swim, etc.  I get can echo every six months and have remained about the same:  EF: 65-70%  LA 4.2-4.5.  Every time I get a new doctor they can't believe I have so much MR for so long with no symptoms.  My question is, how long can this go on?  Is it possible I could have a normal lifespan and never need a valve repair?
Thank you for a great forum.

[BillC]

Same deal with me - cycling and triathlon despite severe leakage and perforated valve leaflet (endocarditis) - but progressive leakage and heart enlargement.  I went through a few cardiologists w/ very different opinions, but finally made up my mind to have the surgery earlier v. later after reading ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease. You can download the PDF at:

http://www.acc.org/clinical/guidelines/valvular/3205p149.pdf

[NgottMV]

I also am being monitored every 6-9 months for my Mitral Valve.
I've been taking Accupril 20mg and Atenonol 50mg 1 x a day as well as an Ecotrin 325mg a day.  I had a incident of a mini stroke about 1 1/2 year ago.  I'm 42 years old.  How long is too long?  Why have surgery now if it can wait 5 to 10 years?
Your not alone.

[jonkep]

I don't know how they determined it to be a 1-2 mm hole.  I have had 3 TEE's and a couple of MRI's.  I would guess that was how they imaged it.

The MR is a grade 5 on a 1 to 5 scale.  I don't know the name of the scale - but all the Doctors I have had have used it.  I have never heard of PISA, sorry.

My Doctor says that as long as I don't have symptoms, and the LA is in the normal range, he recommends against surgery.    I guess if you're having symptoms, its a whole different game.
JKK

[thomass]

Would you be so kind to mention
how they detected the 1-2 mm hole
in your anterior leaflet?
regards
Thomas

[thomass]

I have moderate mitral regurgitation with symptoms
but the scale for PISA regurgitation measure is supposedly
from 0 to 4. When its value get to be equal to  3 then they dircet you to surgery.
SO it is kind of important that you know which protocole or measure they used to determine the regurgitation PISA or something else ??????

[debra21784]

The trick with valve repairs is to have it done electively rather than as an emergency.With signs of enlargement you run the risk of arrythmias and heart failure.Now a days you can have a minimally invasive procedure and be back home in 5 days or less .Don't delay get a cardiac consult after having a TEE .bEEN THERE AND DONE THAT

[CCF-M.D.-CRC]

Dear jonkep,
The timing of mitral valve surgery is more art than science.  It is interesting that you have made it thus far without needing surgery however, I would not delay too long either.  Your atrium is starting to show signs of enlargement and the ejection fraction although high is due to the unloading of the regurgitation.  If one waits too long permanent damage to the heart may occur.  

Given the high success rate of valve repair at our institution and the low risk we are sending people earlier to surgery.  We do not wait for symptoms to develop.  In fact once symptoms start to occur it is an indication that damage has already taken place.  If you would like to be evaluated here for mitral valve repair I would suggest seeing Dr. Griffin, Grimm or Stewart.  You can make an appointment with one of them by calling 800-223-2273 and asking for cardiology appointments.