Post mitral valve replacement recovery

  I have been an active runner and biker for 15 to 20 years, in 1994 was diagnosed with mitral valve reguritation (severe).  This was from having had bacterial endocarditius in 1980.  I went into Emory Clinic in Atlanta in November 1996, they say the valve was beyond repair, as that was the original intent.  They expressed amazement that I had continued being able to run 5 to 6 miles a day leading into surgery.  I resumed  running 4 months after surgery.  I have a mechanical value now (carbomedics prosthetic , model  700 size 33).  I believed after surgery and after rehabilitation I would be able to fully regain my active life and previous abilities.  I am doing 45 to 50 minutes a day of exercise, from running to bikeing, yoga, lifting light weights.  But  I seem unable to return to my former abilites.  Now it is all I can do to run an ll minute mile verses the 8 minute miles I used to be able to do effortlessly.  As a result  I push myself all the harder and go through cycles of extreme fatigue and depression.  How can I learn and figure out what I can expect out of my body now?  How can I continue my life at the best of physical condition I am capable of achieving?  I am on coumadin, does this affect me in any way as to  exercising? Help!  I get so frustrated and depressed!!

[CCF Cardio MD-SGM]

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Dear Jo,
Although most people experience a significant improvement in symptoms and exercise capacity following a mitral valve replacement surgery, some patients-especially those who were asymptomatic prior to the operation-may not notice any improvement in their quality of life.   In any case,  full recovery should be the rule.  The coumadin should not affect your exercise capacity, or have any impact on your quality of life.  
I recommend that you discuss this issue further with your cardiologist.  It may be necessary to reimage the valve and the heart using and echocardiogram (possibly a transesophageal echocardiogram) to ensure that the valve is functioning properly.  If there is no significant abnormality with the heart or the valve, I would expect that you should be able to achieve the exercise levels you had enjoyed preoperatively.  However, you should know that severe mitral regurgitation can sometimes lead to occult (unrecognized) dysfunction of the main pumping chamber of the heart-the left ventricle.  Sometimes, after surgery to replace or repair the valve, the ventricle will demonstrate varying degrees of dysfunction.  Again, this possibility should be discussed with your physician, and may be a cause for your exercise limitations.
I hope I have helped to clarify this issue.  Information in the Heart Forum is for general purposes.  Specific diagnoses and therapies can only be provided by your physician.