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When to consider mitral valve repair?
    I have a cardiologist who tells me I might someday need a repair my my mitral valve, but I would like an independent 2nd opinion.  I am old enough I wonder whether I should obtain heart sugery sooner (in terms of number of years) than an younger person.  At what age would I be to old to operate on?   I'll give you more background:
     I am 69 years old with a completely normal carotid ultra sound test.  That is, I have no sign of heart disease.   I'm in excellent health but have a lifelong history of heart murmur which turned out to be mitral valve prolapse.  I am slender, and I don't smoke or drink alcohol, and I eat very carefully, no sugar, very little animal fat, .  I tap dance 20 minutes every day, plus do a dozen push-ups from the knees.  I'm still productive, regularly publishing articles and book chapters in my field.
    I scarcely noticed my palpitations until I was about 50.  When I did notice it I gradually eliminated caffeine, etc.  I now drink no caffeine, not even decaf teas, eat no chocolate, and began avoiding medications with an adrenaline like effect such as sudafed.  
    Nevertheless,my last holter found 5,231 PVCs, up from about 3,000 two years before that and 2,000 one year prior still.  My echocardiogram found that my left ventricle was mild to moderately increased when compared to my prior echo dated 01/31/05.  Overall ejection fraction is estimated to be 60 to 65%.  I was diagnosed as having mild (grade 1) impairment of ventricular relaxation with normal left ventricular filling pressure for my age.
    Mitral valve apparatus is abnormally thickened and superiorly displaced consistent with myxomatous degeneration with moderate prolapse of both leaflets and mild-to moderate regurgitation.
    My other valves are structurally normal, but there is some regurgitation of the tricuspid valve, indicating a peak right ventricular pressure of 16.0 mmHg above the right atrial pressure.
    There is no apparent change in the left ventricular systolic function compared to the 2005 echo.  The severity of the mitral insufficiency appears to have a mild increase since the last study.  The left ventricle has increased in size from 5.42 to 5.87.

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