Posted By CCF CARDIO MD-APS on October 30, 1997 at 10:01:46:
In Reply to: valve replacement surgery posted by D. Piskadlo on October 24, 1997 at 23:48:36:
: Due to Rheumatic Fever as a child, I am being closely monitored for valve replacement surgery. I have echograms every 3 months. I do not fully understand why they are waiting for me to become "symptomatic". Why I don't just have the surgery while I am well. I am 48 years old, and other than a recent episode of Atrial Flutter, I feel fine. They had told me prior to having the atrial flutter that they were concerned it would happen and it did. I was hospitalized for 3 days and am presently taking coumadin and dijoxin. I am scared to death of the surgery. I am always worried about dying
Your concern is understandable, although I can not make a comment as to the actions of your
physicians I can make the following comments. There is no definitive evidence and no consensus
regarding when to replace a valve damaged by rheumatic heart disease. For instance there are
some cardiologists and surgeons who consider atrial fibrillation and flutter a 'symptom' and
would therefore replace or repair the valve as soon as the flutter occurs. Surely there
are not any clear cut advantages to replacing a valve before the patient is symptomatic, especially
given that there are risks inherent in valve replacement surgery in all individuals, even healthy patients.
There are many unanswered questions regarding valve replacement or repair, until there are answers
every patient should be treated individually with discussion of risks and benefits between patient and
physician on a regular basis. It might allay your fears of surgery to find out what surgeon will be doing
your surgery and how many valve replacements he does or has done. If you would like to meet one of the
valve cardiologists here at the Cleveland Clinic just call 1-800-CCF-CARE and ask for an appointment
with one of the imaging staff at Desk F15. Let me just tell you that the risks of not having the valve
replaced on a timely basis are grave, including stroke and death, so as much as I understand anyone's fear of
major surgery, I would hope this would not keep you from having much needed surgery in the future.
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