Mitral Valve Replacement & post op percardial tamponade

Posted by Gina on May 23, 1999 at 00:22:46
History: I am a 30 year old female who recenty had a Medtronic Hall mitral valve replacement. The initial surgery was sucessful. Three (3) weeks post op I was urgently rushed to the hospital and diagnoised with Percardial Tamponade. My INR was 14 when I reached the ER. It is belived that the Coumadin does I was given and told to stay on for two weeks and come back for a PT test was too much. I was given 3 pints of fresh frozen plaza & 1 pin of whole blood before/after the drainage.

I had an echocardiogram this week and it showed a small ring leak on the medial site of the valve. MVA by pressure halftime is 2.1 cm sq. How serious is this? In your experience is this something that will
deterioate?
I also just obtained my records from the day of the percardial drainage. April 6th, That echcardiogram states that my Tricuspid valve is reguirgitating mildly and structuraly normal, with the right atrial chamber enlarged. The echo I had this week and the three previous state that the Tricusbid valve in normal as well as the right Atrium. Could the fluid around the heart at the time of that echo given off a false reading?
I had a cath in January and Tricusbib reguirg was not noted. Very confusing. I also have a mild but long A/V Block.
Any input that could be offered would be appreciated. I am very much considering coming to your clinic for an evaluation.
Thank you. Gina Metzger, ***@****

Posted by CCF CARDIO MD - DLB on May 23, 1999 at 11:11:35
Dear Gina
The tricuspid regurgitation, if mild, will probably not be a problem. A mild degree of tricuspid regurgitation can come and go on an echo, depending on the circumstances in which it was done. I do not think the tamponade had anything to do with the tricuspid valve.
The leakage around the mitral valve may be a problem, depending on the amount and the exact location of the leak, as determined by the echocardiogram. A mild degree of leakage through the valve would not be as concerning, but if the leakage is around the valve, that may indicate it is prone to deteriorate. I can't really say without looking at the echo tape. You would be welcome to come here and see one of our valve specialists.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Posted by Roxane Crawford on June 09, 1999 at 09:09:25
I am writing in regards to my mother,she is 72 years old. She was just told she now has a leaking mitral valve and will need open heart to correct this. My question is ,is there any other option besides open heart to correct this?We have been hearing alot about the key hole surgery.Is this a possibilty to replace a mitral valve?My mother had a major heart attack in 1994 and also had a massive stroke in 1995,which she has fully recovered from,due to her strong
positive will to live.I would appreciate any info you could give me.

Posted by roxane crawford on June 30, 1999 at 07:47:40
i really need an answer to my question..as my mother is going for the surgery soon

Posted by CCF CARDIO MD - DLB on July 02, 1999 at 14:17:16
Dear Roxanne
The only treatment for severe mitral valve leakiness is surgery. There is a minimally invasive option to do the surgery, but this is not the keyhole surgery to which you refer. The minimally invasive mitral valve surgery is done with a smaller incision than standard open heart surgery, but it is still major surgery.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.