Re: Valve Replacement

Posted By CCF CARDIO MD - MTR on August 19, 1998 at 10:02:05:

In Reply to: Valve Replacement posted by Scott A. Kudler on August 16, 1998 at 04:12:45:






My grandfather is 82 years old and has been advised that he needs a heart valve replacement. I would like to know if it is advisable at his age to have this surgery and are there any new techniques or procedures with a valve replacement. Also, he lives in Las Vegas, NV and I would like to know if you there are any heart surgeons there that you can recommend for this surgery.
Thank you for your time,

Scott












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Dear Scott, thank you for your question.  Valve replacement surgery has progressed quite a bit in the last 10 years and elderly patients certainly can do well after such a surgery.  In your grandfather's age category, the most common valve replacement surgery involves replacing the aortic valve which can calcify and become stenotic with age.  So, I'll assume that your grandfather has aortic stenosis and that his cardiologist has determined that he needs valve replacement surgery.  Traditional aortic valve replacement (AVR) involved opening the entire sternum to expose the heart, but newer minimally invasive techniques have been developed to perform the surgery through a 4-5 inch incision.  Minimally invasive valve replacement is associated with a shorter recuperation period and a shorter hospital stay postoperatively.  However, not all cardiothoracic surgeons are skilled at performing this type of surgery.  The main risks of AVR are stroke from having to be put on cardiopulmonary bypass (heart-lung machine), death, and bleeding.  Octogenarians are at higher risk for any open heart surgery procedure, but only a cardiothoracic surgeon could quote you an accurate risk assessment for your grandfather.  However, with aortic stenosis, the valve obstruction progresses and if not treated, can eventually be fatal.  Thus, I suggest that you speak with your grandfather and his cardiologist about the risks and benefits of surgery vs. continued medical therapy and pay special attention to your grandfather's quality of life and life expectancy with his present condition.  I was able to find the name of a cardiothoracic surgeon who trained at Cleveland Clinic and is now practicing in Las Vegas, NV - Dr. George Merino: Phone: [phone].  But, most cardiologists have certain cardiothoracic surgeons with whom they work with extensively so I suggest you speak to your grandfather's cardiologist before speaking directly with a surgeon.  I hope you find this information useful.
Information provided in the heart forum is for general purposes only.   Specific diagnoses and therapies can only be provided by your physician.