why

[twj]

why do they not want to do surgery on a valve that is leaking where is that blood going i feel if it is tore sew it then your symptons are gone ?


This discussion is related to Mitral Valve � Tricuspid Valve Leakage.

[ed34]

it depends on now much the valve is leaking. The blood is basically staying in your arteries or the heart and it just means the blood isnt being pushed out of the heart as efficiently as it could. Lots of people have leaking valves, millions in the US. Is your
leak mild, moderate or severe? if mild/moderate it is likely they will try to control your symptoms with medication. Severe will require repair surgery or replacement.

[kenkeith]

The blood should pass through a one direction flow through the heart and out into the circulatory system.  Where does the blood go?  Blood normally moves in a forward flow, but back flows into the heart chambers when there is a leakage.  If serious,  the reduced blood flow into circulation can cause heart problems from enlarging to heart failure, etc.

[skydnsr]

As Ed34 comments, your doctor's advice about surgery will depend on how badly the valve is leaking.  Lots of people have a trivial or mild leak, and they never even know it.  As long as symptoms are absent or mild, you can live for a long time like that.  

There are risks associated with valve surgery.  When the health risks of the leak become greater than the risks of surgery, then you will be advised that it is time for an operation.  

Postponing the operation as long as reasonably possible is a good thing.  You avoid unnecessary surgical risks by doing that.  A few people actually die during heart surgery.  It's not like having your tonsils out.  It's a lot more major than that.  It's not something to jump into, just to "get it over with."

Also, if you can postpone your operation, you may be able to take advantage of advanced surgical technology later on.  If you have the valve replaced now, you are stuck with the artificial valves and surgical techniques that are available now.  The technology is getting better all the time.  

You probably have been advised that you need to be monitored by a cardiologist from now on.  Keep your appointments, so you will know when it is truly time.  

You may also have been advised to take prophylactic antibiotics (usually ampicillin, unless you are allergic to it) for certain medical procedures.  This is a cheap medication that reduces your risk of getting an infection inside your heart.  When the valve leaflets are abnormal, they are more prone to getting infected.  If you have any unexplained fevers, you should be checked for bacterial endocarditis.

If you want a second opinion about the need for surgery, schedule a consultation with a cardiothoracic surgeon.  Sometimes surgeons advise operating sooner than cardiologists do.  

[kenkeith]

QUOTE: "Postponing the operation as long as reasonably possible is a good thing.  You avoid unnecessary surgical risks by doing that.  A few people actually die during heart surgery.  It's not like having your tonsils out.  It's a lot more major than that.  It's not something to jump into, just to "get it over with."

The comments are not necessarily true.  Wating too long may/will increase the surgical risk. Postponing as long as ressonably possible is not a good thing as the disorder will almost nevrer get better.  The risk of waiting too long and basing a surgical decision on symptoms (such as heart failure) puts surgery at a higher risk.  How can that be a good thing?

[skydnsr]

My words were, as long as reasonably possible.  Waiting too long is not reasonable, by definition.  

Yes,people who wait too long can have irreversible heart damage.  It is also very true that patients who are moribund are not good surgical candidates.  That is why pre-surgical valve patients need to be monitored.  In my post, I did state the need for continued follow-up, as well as the option of seeking a second opinion.  

I stand by my comments.  It is simply not the case that everyone with valve disease needs immediate surgery.  

[skydnsr]

I do want to correct one thing in my original post.  It is amoxicillin that I was thinking of, not ampicillin.