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Mitral Valve surgery
I am an 81 year old woman who has been blessed with excellent health all of my life. Many years ago I was diagnosed with Mitral Valve Prolapse with little or no noticeable problems. Recently, however, an Echocardiogram revealed an increase in the valve leakage and the doctor has recommended a Transesophageal Echocardiogram. My question to you is: What is the percentage used to denote normal heart function? I believe the Dr. said the percentage of heart function I had had decreased from 60% to 50% and he has mentioned minimally invasive heart valve surgery. When I researched "Minimally Invasive..." it seems to be not minimally at all, since it involves heart bypass and a long recovery period. I find myself more fatigued than usual, but after all I am 81 years old. I would be reluctant to take the risk of diminished quality of life. What, in your opinion, would be my chance of having the quality of life I now have if I did not have the surgery? Thank you for your professional and very valued opinion.
When you read the post, it appears the poster has done research and now asks specific questions regarding left ventricle functionality and minimal invasive surgery for the MVR. Poster's research has led to an erroneous conclusion regarding minimal invasive heart procedure, and before she can weigh the options a better understanding of the procedure is necessary.
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Dorie, I identify with your dilemma. My mitral valve regurgitation is/has been moderate to severe for at least the last 5 years, but I have some artery occlusions and would not be an appropriate candidate for minimal invasion valve operation due to artery blockages...surgeon would want to do an open heart surgery and bypass vessels at the same time. It is my understanding minimal invasive surgery is not recommended if there is CAD.
I am asymptomatic so the doctor, and I agree to watch and wait. If you just have fatigue as a symptom, and it seems to me as you said it is not unexpected as one ages.
For a better understanding and weigh your options: Minimally invasive heart valve surgeries are surgeries that use smaller incisions than the ones typically used to operate on the heart valves. During a minimally invasive heart valve surgery, the breastbone is not completely divided and retracted. Rather, surgeons use a variety of smaller incisions to gain access to the heart.
There are a number of advantages to minimally invasive heart surgery. Chief among them are limited blood loss during surgery, fewer side effects associated with large incisions, a reduced stay in the hospital and superior cosmetic results as patients are spared the large incisions and scars typically associated with open-heart surgery. Also, there can be memory loss with a by-pass as well as a larger loss of blood.
However, these surgeries may take longer and often require a surgeon with a higher level of surgical skill. Not all people are good candidates for this type of surgery. For example, people may not be eligible if they have atherosclerosis (hardening of the arteries) or obesity. I'm not obese, but arteries are that of a person who didn't take care of his health...you are blessed with excellant health!
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Dorie, I identify with your dilemma. My mitral valve regurgitation is/has been moderate to severe for at least the last 5 years, but I have some artery occlusions and would not be an appropriate candidate for minimal invasion valve operation due to artery blockages...surgeon would want to do an open heart surgery and bypass vessels at the same time. It is my understanding minimal invasive surgery is not recommended if there is CAD.
I am asymptomatic so the doctor, and I agree to watch and wait. If you just have fatigue as a symptom, and it seems to me as you said it is not unexpected as one ages.
For a better understanding and weigh your options: Minimally invasive heart valve surgeries are surgeries that use smaller incisions than the ones typically used to operate on the heart valves. During a minimally invasive heart valve surgery, the breastbone is not completely divided and retracted. Rather, surgeons use a variety of smaller incisions to gain access to the heart.
There are a number of advantages to minimally invasive heart surgery. Chief among them are limited blood loss during surgery, fewer side effects associated with large incisions, a reduced stay in the hospital and superior cosmetic results as patients are spared the large incisions and scars typically associated with open-heart surgery. Also, there can be memory loss with a by-pass as well as a larger loss of blood.
However, these surgeries may take longer and often require a surgeon with a higher level of surgical skill. Not all people are good candidates for this type of surgery. For example, people may not be eligible if they have atherosclerosis (hardening of the arteries) or obesity. I'm not obese, but arteries are that of a person who didn't take care of his health...you are blessed with excellant health!
.
Definitely do your research first. Sometimes valves get better on their own. There is a risk. Healing is a problem when we get older along with other unforeseen complications. Unless you are feeling really miserable now, I would definitely way the options.
An echocardiogram estimates the amount of blood pumped into circulation with each heartbeat. The estimate is referred to as the EF (ejection fraction) and normal would be an EF of 55 to 75%. A decrease in EF can result from heart muscle damage and/or mitral valve regurgitation as some blood is lost to the backflow of blood (regurgitation) and less blood gets into circulation with each stroke. This stresses the heart to work harder and the result can be an enlarged left ventricle that weakens contractions.
Minimally invasive approach is becoming the standard approach. Currently, for all mitral valve surgeries, this is the favored approach for everyone, . The only exception is for those who need other surgery at the same time (i.e., a coronary artery bypass). You mention a bypass in your post? Are there other problems that would require a bypass? Bypass requires (usually) the incision of the breastbone, but minimally invasive needs small 2-3 inch incision, etc.
Dr. Gammie says there are many advantages to the minimally invasive approach, including the major advantage of less pain after surgery and earlier rehabiliation, recovery, and return to work and daily activities. "We also think there's less blood loss and a lower likelihood of receiving a blood transfusion," Dr. Gammie said
According to the latest guidelines from American Heart Association and American College of Cardiology, select patients qualify for early surgical intervention to treat mitral valve regurgitation. At the Cleveland Clinic, a recognized leader in treatment of valvular heart disease, surgeons are able to repair more than 99% of mitral valve prolapse using da Vinci Mitral Valve Repair, a minimally invasive, sternum-sparing procedure. The procedure is performed using the da Vinci Surgical System, the world's only commercially available robotic platform for complex, minimally invasive surgery.
"Robotically assisted mitral valve repair is the best and least invasive treatment for the majority of patients with a leaky mitral valve," said Dr. Mihaljevic. "Compared to valve replacement, mitral valve repair provides better long-term survival, better preservation of heart function, lower risk of complications, and usually avoids the need for long-term use of blood thinners (anticoagulation)."
In patients who have mitral valve prolapse, the tissue of the mitral valve leaflets and chordae are abnormally stretchy, so that as the heart beats to circulate blood, the mitral valve bows or flops back into the left atrium. Many patients with mitral valve disease are asymptomatic (have no symptoms), even with a leak that is severe. When symptoms develop, they include shortness of breath, fatigue, loss of energy, swelling of the ankles and palpitations (extra or skipped heart beats).
Minimally invasive approach is becoming the standard approach. Currently, for all mitral valve surgeries, this is the favored approach for everyone, . The only exception is for those who need other surgery at the same time (i.e., a coronary artery bypass). You mention a bypass in your post? Are there other problems that would require a bypass? Bypass requires (usually) the incision of the breastbone, but minimally invasive needs small 2-3 inch incision, etc.
Dr. Gammie says there are many advantages to the minimally invasive approach, including the major advantage of less pain after surgery and earlier rehabiliation, recovery, and return to work and daily activities. "We also think there's less blood loss and a lower likelihood of receiving a blood transfusion," Dr. Gammie said
According to the latest guidelines from American Heart Association and American College of Cardiology, select patients qualify for early surgical intervention to treat mitral valve regurgitation. At the Cleveland Clinic, a recognized leader in treatment of valvular heart disease, surgeons are able to repair more than 99% of mitral valve prolapse using da Vinci Mitral Valve Repair, a minimally invasive, sternum-sparing procedure. The procedure is performed using the da Vinci Surgical System, the world's only commercially available robotic platform for complex, minimally invasive surgery.
"Robotically assisted mitral valve repair is the best and least invasive treatment for the majority of patients with a leaky mitral valve," said Dr. Mihaljevic. "Compared to valve replacement, mitral valve repair provides better long-term survival, better preservation of heart function, lower risk of complications, and usually avoids the need for long-term use of blood thinners (anticoagulation)."
In patients who have mitral valve prolapse, the tissue of the mitral valve leaflets and chordae are abnormally stretchy, so that as the heart beats to circulate blood, the mitral valve bows or flops back into the left atrium. Many patients with mitral valve disease are asymptomatic (have no symptoms), even with a leak that is severe. When symptoms develop, they include shortness of breath, fatigue, loss of energy, swelling of the ankles and palpitations (extra or skipped heart beats).
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