Re: Leaky Aortic Valve and Valve Replacement

Posted By CCF CARDIO MD-APS on February 05, 1999 at 08:50:57:

In Reply to: Leaky Aortic Valve and Valve Replacement posted by Jason on January 31, 1999 at 20:43:37:






I am 21 and recently diagnosed with 2 leaky valves rated as moderate to severe.  One is the aortic valve.  My doctor does not want to do surgery until I become very weak and have extreme shortness of breath.  Currently, I lose consciouness several times per day and can be out for as much as a hour.  This is causing me to stay home more and more as I never know where I will be when this occurs.  People are always frightened and upset by these episodes, and I am embarrased.  Why can't I have surgery now while I am young and strong?  Why must I wait until I become sicker and maybe not as able to withstand the rigors of surgery?  My doctor has not answered that question.



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Dear Jason,
Gone are the days when valve replacement was avoided until the patient was symptomatic
from their "leaky" valve.  We now have a technique called repair that can be attempted
prior to replacement that is only done in major cardiac centers.
REGARDLESS, your "passing out spells" are concerning and may qualify as symptoms
that warrant surgery soon, not later.  Also, you should know that the heart muscle
makes compensation for the leaky valves that eventually is detrimental to your
health, and often it is too late to repair and or replace at that point, which means the patient
ends up with heart failure and that carrries a very poor prognosis.
Your best bet is to seek a second opinion, if not treatment of your fainting spells
which are very limiting from what you say. Your second opinion would best be at a university hospital
that is well known for its valve surgery and has cardiologists that specialize in the treatment of
valvular disorders.  The Cleveland Clinic is one of these hospitals.
Remember that for valve repair to be considered (this is where the valve is fixed and there is no artificial valve needed)
it must be addressed NOW, certainly not when you develop symptoms.  The likelihood of repair is better for the mitral valve than for the aortic.
I can not stress to you the importance of your seeking a second opinion in the very near future.
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.  The names of some of our valve cardiologists are Drs. Asher, Griffin, Stewart, Grimm, Isada, and Mayer-Sabik.
Our Chairman of Cardiothoracic surgery, Dr. Cosgrove, is one of the pioneers of valve repair.