mitral valve repair indications

[ddavey]

my daughter is 21yrs old, mentally impaired and has dilated cardiomyopathy, diagnosed in march 05  previous history of accessory mitral valve tissue and aneurysmal dilation of anterior mitral leaflet near mitral-aortic junction present since birth.
echo done 9/12/06 shows mitral regurgitation 3+++
tricuspid regurgitation 2++
LV EF 45%  MV E/A=1.4  MV DT=239 (EF was 35-38% in 3/05)

LV mass index 110   (was 104 in echo of 3/05)

what are the indications of mitral valve repair here.  in march 05 there was only mild mitral regurgitation and no tricuspid regurg. she is presently on coreg 25mgs 2x day and vasotec 2.5mgs 2x day and will be having cardiac mri

also  what does dP/dT mean on echo   hers is 727

any help would be greatly appreciated   thanks

[Cleveland Clinic]

ddavey,

there are comprehensive guidelines for valvular heart disease that can be found at http://americanheart.org/.  With respect to the mitral valve repair/replacement is often decided based on the amount and mechanisms of regurgitation, the presence of other valvular or coronary disease, the amount of cardiac dysfunction and the presence or absence of symptoms.

With the fact that your daughters EF is low and the regurgitation is progressing, I would be concerned. It is impossible to tell what that means exactly without seeing her though.

dP/dT is one aspect of echocardiography that explains how well the heart is squeezing.  It is not routinely used, but had been correlated to progression of CHF and mitral regurgitation. I dont have a chart handy to explain the specific numbers, and it is really impossible to explain the finding without being able to review the echo itself.

Perhaps a second opinion would help ease you mind and the current course of treatment.

good luck

[ddavey]

thank you very much for taking the time to answer my question.
i am waiting now for the results of the cardiac scan and what her cardiologist recommends, thank you so much for your input