Re: Mitral Valve Surgery and Recommendations

[Kirk-]

Posted By Kirk  on April 27, 1999 at 19:35:40
I am 31 years old and have moderate to severe mitral valve regurgitation.  Currently, I am under the care of a cardiologist at Duke University and although I am completely asymptomatic their recommendation is to proceed with a surgical repair of the mitral valve.  Their philosophy appears to be that they can fix a damaged valve but can not fix a damaged heart and if the valve is left untreated the heart may enlarge ultimately leading to heart failure.  This philosophy makes a lot of sense and wanted to know what Cleveland Clinic's position is in this type of situation.  Agree or disagee?  Also Dr. Donald Glower is the surgeon who will perform the surgery and everything I have heard about him is very good and he appears to be an expert in these type of procedures.  Would you concur with this assessment?  Please elaborate with additional info. on Dr. Glower.(In other words, does Dr. Glower meet the Clinic's high standards)
     Your response is greatly appreciated.

[Stan__0]

Posted By Stan on April 28, 1999 at 16:50:41
I've had moderate (3+) mr that's been monitored for the last three years and my cardiologist recommended surgery at the onset.  (The mr was found 3 years ago, although I've probably had it many years).  My heart functions were all normal although I exhibited mild lv dilation.  After a cath and TEE at Dartmouth-Hitchcock Medical Center (NH), the surgical staff recommended no surgery at that time.  I was not yet on their "surgical curve."  A March echo showed my mr had increased to severe, and I am now showing increased dilation in the left ventricle and left atrium.  All my heart functions are still normal, but surgery is now strongly recommended because of the negative changes.  Because no one can predict the often slow progression of mr, I have found the surgeons much more reluctant to operate on early cases than I would have thought.  The debate over what is the "right" time can be quite heated.  Because I am experiencing a degeneration in my valve function, I have scheduled a May 17th date for what will hopefully be a minimally invasive valve repair at Brigham and Women's Hospital in Boston.  (My original May 3rd date has been delayed by a common cold).  I chose Dr. Lawrence Cohn to do my surgery...along with Dr. Cosgrove, one of the best in the field.  I suggest you get the opinion of at least two surgeons to see if you've entered the "curve."  If you choose not to have elective surgery now, make sure you are monitored at least every six months.  I hope my own experience has been of some help.  Good luck.
Stan

[kd__0__0]

Posted By kd on April 28, 1999 at 21:28:42

These are interesting questions.  I have a 3+ mitral valve regurgitation and my CCF cardiologist says no surgery until the heart muscle begins to deteriorate.  Yet, most CCF cardiologists here seem to differ.  I'm really interested to see the answer.  Do either of you have any calcification in the heart (aorta, etc.)?  I wonder if that makes a difference.

[Stan__0]

Posted By Stan on April 29, 1999 at 10:35:54
I show no calcification...just a prolapsed anterior leaflet and a ruptured chord.  Typically, with an otherwise healthy heart, surgery is recommended when something changes for the worse.  Before my mr worsened, the most compelling advice I got was from a cardiac surgeon who said, "..there's a 1 or 2% chance I'll kill you during surgery, and no chance you'll die from your present condition...which odds do you want to go with?"  I chose to wait, and my condition was stable for another two years.  Of course, if I had known then that I would need the surgery in only two years, I might have opted to do it then...but I didn't know and no one else could predict it.  Early intervention versus the risks of surgery is an endless debate and one which you ultimately have to resolve on your own.  Good luck to all of us.
Stan










Follow Ups:


Mitral Valve Surgery and Recommendations CCF CARDIO MD - CRC 4/29/1999
(0)


Mitral Valve Surgery and Recommendations shannon m. 4/29/1999
(7)

Re: Mitral Valve Surgery and Recommendations CCF CARDIO MD - CRC 4/29/1999
(6)

Mitral Valve Surgery and Recommendations Kirk 4/29/1999
(5)

Re: Mitral Valve Surgery and Recommendations CCF CARDIO MD - CRC 4/30/1999
(4)

Mitral Valve Surgery and Recommendations shannon m. 5/01/1999
(3)

Re: Mitral Valve Surgery and Recommendations CCF CARDIO MD - CRC 5/03/1999
(2)

Mitral Valve Surgery and Recommendations Annie 5/17/1999
(1)

Re: Mitral Valve Surgery and Recommendations CCF CARDIO MD - CRC 5/18/1999
(0)