reoperation

[lifefruit]

Dear Sir/Madam,

My dad just had a MitralValve surgery on 24 of May, and after a week of the repair, the doctor repeated the echo and he has found tat there is still a significant amount of leakage on the heart.
My question is:
Isn't it after the surgery before the doctor close the patient heart then need to recheck the heart function ?
Is this case due to the doctor negligence or it is natural thing to occurs? I am not going to sue the doctor or anything, but if this is due the negligence, I am considering of trying to go to another doctor.

Regards,

Aswan Jaya

[kenkeith]

QUOTE: Isn't it after the surgery before the doctor close the patient heart then need to recheck the heart function ?

Once the repair is complete, there should be an assessment of the function of the valve by echocardiography before the sternum is closed.  This procedure would allow the surgeon to evaluate the function of the heart when it is actually beating and filled with blood.  The statistics show about 95% of the valves are fully repaired, and an echo would assure the repair is scuccessful before closing the heart.  A small number of patients may show abnormal blood flow through the valve. About 6% will have an unsuccessful valve repair.

You should ask if there was an echo prior to closing the sternum.  It is difficult to believe if there was an assurance of valve functionality prior to closing, the valve would leak within a few days!  You should talk to another surgeon, because if the subject surgeon, and/or his team, skipped that procedure it has caused unnecessary complications.
Hope this provides a perspective for the expectation of a valve repair . Thank you for sharing your father's experience.

[lifefruit]

dear ed34,

Thanks for your response. According to the Dr, the tested it after the surgery, and it was perfect. But a week later he said, there is still a significant amount of leak which might not detectable by stethoscope, but it is detectable in echo.

If it is done few hours before the surgery then, I am not sure, cause my father push to operating theater quite early. but the one I am sure he had is echo and angiogram.

My father oxygen level is quite good, which around 97-98% without apparatus to help him breathing. but he experience irregular heart beat, (faster). so far, the dr suspect it is because of the furosemide, due of lacking potassium. and he try to adjust the potassium level, and would like to start warfarin.

so could I said the OP was successful, as the oxygen level is high, but there is still a leakage base on the echo read?

Regards,

Aswan Jaya

[ed34]

This is actually quite rare, valve repairs generally have a very good success rate and so I would also be asking questions as to why it was not successful. The valve is not actually tested during surgery, it is a visual thing during repair. Once the heart is closed and restarted, they can see by the monitors if there is a good blood flow, generally by the oxygen level in your blood around the body. Did they do a TEE scan at any time before surgery or was it just a standard echo? In most cases they usually perform a TEE which involved swallowing a tiny scanning device to get closer to the heart, for a more detailed image and diagnosis. This is when the decision is made between valve repair or valve replacement.