Valve Replacement (I have reposted this, b/c of no answers)

  Hello,
  My mom is 60 and is told that she will need a mitral and aorta
  valve replacement in the near future. Her mitral valve is
  already mechanical, she had that replaced when she was 33 years
  old. Her damage to her heart was due to having rheumatic fever
  six times between the ages of 13 - 28. Her heart is also enlarged.
  Her surgeon is out of Aultman Hospital in Canton, Ohio. He
  also wanted to test her carotid artery, is that usual? Also,
  she of course will have a heart catheter test done, and she's
  nervous because when she had one before her first surgery, it
  was very painful, and she doesn't complain about anything. Has
  procedures changed in the last 27 years to make it more comfortable?
  She has bad veins. Also, she's been on coumadin for the past 27
  years and she's in excellent health, except for her heart. I have
  two other main questions though:
  1 - Her heartbeat races sometimes, and it doesn't settle very easily,
  2 years ago, she had to be hospitalized because of it and they
  gave her a heart shock. Now, her doctors are trying to control
  it by medication, but it still races sometimes. Why does this
  happen and is there anything she can do, besides rest, to make
  it slow down? It can happen anytime, even if she is only resting.
  2 - Her surgeon made it sound like the double valve replacement
  surgery is very risky because she has a lot of scar tissue. He
  is not sure when he wants to operate and says that she should
  try to enjoy life now and not operate until it's a life or
  death situation. But she's in excellent health and we want her
  around for a long time. Could you give me any percentages of
  risk that would be a range for her situation and operation.
  Any information would be very much appreciated. The more that I
  know, the less I'm nervous about this. Thank you very much.
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Dear Marie:
I apologize for the lack of a response to your previous question.  Repeat heart surgery with double valve replacement is a relatively high risk surgery.  This sort of surgery should only be performed in a major medical center that does lots of valve surgery.  It is reasonable to examine the carotid arteries with an ultrasound to see if there are any blockages that might necessitate surgery.  Cardiac catheterization has been refined over the past several years, and patients find it more tolerable than in the past.  Cardiac catheterization requires entering an artery, not a vein, so "bad veins" are not directly a problem.  Many patients with rheumatic heart disease have fast, irregular heart rates.  This can be treated by different types of medications; if one medication does not work, others can be substituted.  There are potentially other invasive procedures that can be done to treat fast, irregular heart rates.  These procedures are best done by cardiac electrophysiologists, cardiologists who specialize in heart rate problems.  
Information provided here is for general purposes only.  Only your doctor can provide specific diagnoses and treatments.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment at Desk F15 with a cardiologist who specializes in heart valves.