Surgery

Posted By Barry Townsend on May 09, 1998 at 00:29:28:







Thank you for providing this forum.
In 1994 a family physician noticed a heart murmur during a routine physical and referred me to a cardiologist who subsequently diagnosed me with mitral regurgitation due to mitral valve prolapse. He recommended annual echocardiograms. On April 1, 1998 I got another echocardiogram and, this time, was recommended for valve surgery within the next year.
This last echo revealed severe mitral regurgitation, myxomatous leaflet abnormalities, severe mitral valve prolapse, left ventricle and left atrium enlargement (mild), and trace tricuspid regurgitation. This news has been somewhat of a shock because I did not expect to have this surgery so soon after the initial diagnosis in 1994. I also have had no history of heart problems (I am 35).
I am confused because the cardiologist and surgeon seem to have differing opinions on the optimal timing for this type of surgery. I am also confused because, if I opted for the surgery, it seems the surgeon would do a valve replacement using traditional open heart surgery. Evidently, there is only one cardiac surgeon in the area and he has done only 15 valve surgeries (but has performed over 200 other open heart surgeries) in the past year. This concerns me.
My question(s) are: What is the optimal timing for mitral valve replacement in the case of severe regurgitation? Is repair an option for myxomatous valve degeneration? Does a repair last long or will it begin to degenerate again? Does it make sense to undergo an open heart operation if places like the Cleveland Clinic do minimally invasive procedures? Are my choices really limited by my HMO or can I pay less and volunteer as a research patient in a place like the Cleveland Clinic?
Thanks so much.
Barry Townsend