Re: Mitral Stenosis

Posted By CCF CARDIO MD - CRC on January 14, 1999 at 09:29:37:

In Reply to: Mitral Stenosis posted by Ram  on January 13, 1999 at 15:31:38:






Hi,
My elder brother (who lives in India) has been diagonosed Mild Mitral Stenosis.
The impression noted by the cardiologist are as follows:
Reumatic Heart Disease
  i) Mild Mitral Stenosis
     [ MV area by planimetry & by doppler = 1.3 & 1.3 cm2
       peak and mead gradients of Mv = 8 & 5 mm Hg ]
  ii) No Mitral Regurgitation
  iii) Normal Aortic valve
  iv) No Pulmonary hypertension
  v) Left atrium is mildly dilated
The fact that this disease is "news" to our family [ no background history],
we are looking for second opinion on this. The doctor has suggested that
for the time being no aggresive (aggressive) treatment is required. However, he said
that in future some sort valve treatment (replacement) would be essential.
To this regards, I have following questions:
How do we know when it's right time for surgery, valve replacement and
what is involved in a repair or replacement of this type.
What is  minimally invasive surgery that is available. What is the
difference between invasive and the "regular" surgery?
What kind of prognosis is there after the surgery? Which are the key
centers ( USA, India) that handle such cases. Any recommedation in
India and US, etc. What kind of preventive measure/ medication that
one should take, at this stage. I further would like to refer this
report to someexpert in USA and seek second opinion, any recommedation
would be useful.
Thanks
Regards
--ram
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Dear Ram,
Thank you for your question.  From the information you have given me I would agree with his doctor's assessment.
Q: How do we know when it's right time for surgery, valve replacement and
what is involved in a repair or replacement of this type?
A: Timing of surgery is not always an easy task but in general if he were to develop any symptoms it would be time.  Repair is not always possible with mitral stenosis and usually replacement is needed.
Q: What is minimally invasive surgery that is available. What is the
difference between invasive and the "regular" surgery?
A: Minimally invasive valve surgery is done through a smaller incision on the left side of the chest.  The recovery time is slightly better but this type of surgery can not be done in everyone.
Q: What kind of prognosis is there after the surgery?
A: Generally very good.
Q: Which are the key centers ( USA, India) that handle such cases.
A: I don't know about India but the Cleveland Clinic is probably the top center in the US for mitral valve surgery.  Dr. Cosgrove is one of the best surgeons in the world for this type of surgery.
Good Luck and let us know if we can be of any further assistance.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
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.