surgery

  My 80 year old mother has progressed from mild mitral valve leakage to severe leakage.  She has been advised by her cardiologist that if she were younger, immediate surgery would be recommended.  But because of her age, she needs to make her own decision.  Her health otherwise is great - good blood pressure, non alcoholic drinker, non smoker.  She is active and has very little in the way of symptoms.  My question is whether or not she would be a candidate for the minimally invasive surgery.  We have been looking at her options, and this looks good to her.  But are there any age limits, or other things we need to consider?  Thank you for your help.

[CCF Cardio MD - MTR]

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Dear Barb, thank you for your question.  It sounds like your mother is faced
with a difficult dilemna.  If she were younger, mitral valve repair would be
recommended to fix the mitral regurgitation (MR).  But, at age 80, the risks
of open heart surgery are greater even though she's in excellent health otherwise.
Your mother sounds physically active and certainly is not at the end of her
lifespan.  Minimally invasive mitral valve repair may be a viable option for
your mother since the recuperation after surgery is improved with this technique.
The biggest factor involved in the risks of such an operation is the cardiac
surgeon's experience with the technique.  Our cardiac surgeons at Cleveland
Clinic have been the pioneers of minimally invasive valve surgery and have a
very good track record with minimally invasive mitral valve repair.  However,
whether your mother would be a candidate for a mitral valve repair depends on
the morphology of her valve leaflets and whether the leaflets technically can
be repaired and whether she has coexisting coronary artery disease.  If coronary
disease is present on a cardiac catheterization, then she would need bypass
surgery and valve repair which couldn't be done via a minimally invasive approach.
For these reasons, all elderly patients who are being evaluated for valvular
sugery need to have a cardiac catheterization to rule out coronary disease.  The
valve leaflets can be examined with an echocardiogram (which I presume she's already
had done).  If the MR is left untreated, she could develop left ventricular
dysfunction and heart failure within a few years.  We would be happy to evaluate
your mother here at Cleveland Clinic.  If you would like her to be seen here,
then please call 1-800-CCF-CARE and ask for an appointment with a cardiologist
at Desk F-15.  If you can't come to Cleveland, then I recommend that you have
her evaluated at a tertiary, academic medical center where minimally invasive
cardiac surgery is commonly performed.  I hope you find this information
useful.
Information provided in the heart forum is for general purposes only.  Specific
diagnoses and therapies can only be provided by your physician.