Re: Aortic valve replacement

Posted By CCF CARDIO MD-APS on February 08, 1999 at 07:19:27:

In Reply to: Aortic valve replacement posted by Asad on February 07, 1999 at 13:04:16:






Hi
My mother is 83 years old, and has a sever classified aortic stenosis with mild+
aortic insufficiency and mild mitral insufficiency. We are getting several conflict
recommendation on how and where to do the operation. Doctors in kuwait recommended
that a replacement to the Aortic valve is a must. Therefore, we need an advice, for
someone at her age what wold be the best thing to do for her.
Thank you




Dear Asad,
Your best advice is from a place like the Cleveland Clinic because this is where
valves are assessed and replaced on a daily basis in patients of all ages.
When an aortic valve is severly stenosed, the literature states that the patient should
have surgical replacement or risk a 50% chance of death in the next 3-5 years, depending on
his/her symptoms.  If the Left ventricle (main pump of the heart) is in good shape (ejection fraction about 50% or
greater) than the person will do very well with the new valve.  An 83 year old patient has a small risk of death or stroke
just from the surgery itself, and this risk would increase if the patient has any other disease like diabetes, coronary artery disease,
etc. but it would unlikely reach that 50% risk of not doing surgery.
Regardless, because elderly patients (anyone older than 65) are at slightly increased risk when undergoing open heart surgery due to
their age, they especially should seek care at centers where the surgical teams are skilled at valve surgeries in elderly patients, i.e. at
an experienced center.
I hope this information is useful. Information provided in the heart forum is for
general purposes only. Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
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. Valve cardiologists at the Cleveland Clinic are many and they work out of
Desk F15: Drs.Griffin, Mayer-Sabik, Asher, Garcia, Isada, and Stewart.  The surgeons are Drs. Smedira, Sabik, Cosgrove, and Lytle.