Severe Mitral Valve Reguritation w/ Symptoms/Refractory Hypertension

[dee1015]

I'm a 34 year old female w/ a dual chamber pacemaker implanted less than a year ago for sinus node dysfunction and I've also been suffering for over a year with refractory hypertension (175/100 - 225/128). Despite seeing a Hypertension Specialist from the University of Michigan, my blood pressure STILL remains high. Last year I had an echo that indicated mild to moderate regurgitation in three valves. Recently my Dr ordered an echo due to a fairly pronounced heart murmur and symptoms (shortness of breath from exertion and while lying down, chest discomfort, fatigue, palpatations, edema in feet, ankles and legs) which indicated Severe Mitral Regurgitation w/ thicked anterior leaflet and restricted posterior leaflet and Moderate to Significant Aortic Regurgitation. My question is could the uncontrolled BP made the regurg worse and is surgery indicated at this point? Thus far nothing has been able to control BP and all tests done for secondary causes have turned up negative. My Dr referred me to a Cardiac Surgeon at U of M...what questions should I ask? What can I except? Also, does U of M have a reputable program for valvular repair/replacement? Would they operate on both the Mitral and Aortic Valve or wait until the Aortic valve became severe? What affects will the BP have on this? Would it be worth a trip to CC to be evaluated?
Thank you so much for your response?

[Cleveland Clinic]

Yes the poorly controlled blood pressure could have made your aorta dilate and worsen your aortic regurgitation, and increase LV afterload and cause worsening of your mitral regurgitation as well. You absolutely need to get the blood pressure under control; if this is still not well controlled after 1 year of trying I suggest that you obtain a new specialist in this condition. Even if it requires a brief hospital admission for workup for secondary causes of hypertension.
I don't know how experienced the surgeons at U of M are with double valve surgeries. I would ask the surgeon how many cases similar to your he has performed and what his rate of complications is, at least compared with the national average. If the numbers are not in the 50% percentile then I would ask for an evaluation elsewhere. At our institution the mortality for many varied open heart surgery cases is half what it is at the average centers. so being careful where your operation is performed is VERY important.