Arotic Valve Replacement

[Pat]

Recently my mother was diagnosed with arotic valve disease.  This was during a routine physical.  My mother is 78 years old, in excellent health, 5' 100 lbs., walks 2-3 miles a day and appears to have no symptoms.  She has normal to low blood pressure, and has never had any type of heart disease.  Her doctor referred her to the Heart Clinic, Sarasota, FLorida, where my parents are living.  My father's doctor who is a cardiolgist, due to his heart disease history, gave my mother a series of tests, echocardiography and discovered the arotic valve is completely shot and will need replacing.  Her tests were read by a another heart doctor of the Sarasota Heart Center who confirmed the need to replace the valve. She is now waiting for an appointment to determine size and type of valve replacement.
I live in Minneapolis, and have several questions before someone decides to perform major open heart surgery on my mother who is in excellent health.  Shouldn't we get a second opinion?  Should she be referred to the Mayo Clinic in Rochester, close to my home? How do I make sure this is the best solution for my mother and there are not other alternatives?  What happens if she doesn't have this surgery?
PCP

[Kim G. Christensen]

I will need an aortic valve rather sooner than expected, Listen to my families case history. All the men in my family have bad aortic valves. My grandfather, father, my father's brother and my two brothers. The experiences with "tissue valves" have not been good. My dads threw a clot and caused a stroke, it lasted 7 yrs. He died 7 yrs from the surgery. My brother had it replaced 3 times. Tissue valve first, then a "ball and cage" (the poorest design ever) then he had a "button on a hook" he died a little over a yr ago.It has been my personal feelings that a tissue valve is just a stop gap meassure as if you live more than 7-10 yrs you will need another one. Since I will be having the procedure, I will insist on the latest design with hopes that they will not have to go in again. Anyone looking towards the replacement you have all my best wishes. Kim

[Gail]

I am a 43 year old women who was recently told by my heart doctor that I have a narrowing of the arotic valve.Echograms were done.My Question: What can I expect in the future? My blood presure is up one day and down the next.I have been told they plan to watch this.

[Paul Sanjiv K.]

I am 40 years old and 1 1/2 years back I had to go in for replacement of Arotic Valve Replacement.

In the opinion of my Doctor, the usual cause for this AVR is Rheumatic heart disease.

Is this the only possible cause or there could be some other reasons also.

Further the doctor says the rheumatic heart disease occurs either in childhood or in adolecant age.

Is this a fact? Because I never had any such disease either in childhood or at adolecant age.

Kindly reply to my E-mail: ***@****  OR

***@****

[Paul Sanjiv K.]

I am 40 years old and 1 1/2 years back I had to go in for replacement of Arotic Valve Replacement.

In the opinion of my Doctor, the usual cause for this AVR is Rheumatic heart disease.

Is this the only possible cause or there could be some other reasons also.

Further the doctor says the rheumatic heart disease occurs either in childhood or in adolecant age.

Is this a fact? Because I never had any such disease either in childhood or at adolecant age.

Kindly reply to my E-mail: ***@****  OR

***@****

[[email protected]]

How is laser used in heart treatment?

[Roy N.]

Dear Pat,

Hope you read this in time, I just saw your Post today (Feb. 8, 2000).
My 85 year old mother had an aortic valve replacement surgery in 1996, so I am a bit of an 'expert' in this one specific area: AVRs in elderly women.  My mom was also in overall excellent condition (still vigorous, independent homemaker at 85), 5ft.3 inches, 115 lbs.   She did have one symptom - she had briefly fainted twice (0nce at 84, second time at 85), but she recovered almost instantly from both faints, with no side effects, etc,.

Please feel free to Email me at ***@****; I would be delighted to exchange info with you and give you my 'advice' for whatever it is worth.

But before you do anything else-- YES, DEFINITELY GET A 2ND AND EVEN 3RD OPINION.  Do NOT consent to elective open heart surgery for 78 year old without getting at least 2-3 different experts agreeing it is needed.

Feel free to contact me.
Best,
Roy

[Pat]

I am 54 and facing the same surgery with no symptoms really either... other than a shot aortic valve.. I know how hard it is to have them do this to you when you don't think you are in danger..
My feeling is that if her valve is that bad and especially at her age.. she ought to have it replaced with a tissue valve.. the chances are pretty good it would last the rest of her life..

The tough part is to know when.. I think you ought to have at least 2 opinions and then you and or her decide what needs to be done.. the real kicker is that sometimes with this valve.. the first symptom can be death... I am going to do it soon myself and am really not completely convinced that I should yet..

2 doctors tell me yes and one says maybe not..

???

good luck

Ted

[Pat]

I am 54 and facing the same surgery with no symptoms really either... other than a shot aortic valve.. I know how hard it is to have them do this to you when you don't think you are in danger..
My feeling is that if her valve is that bad and especially at her age.. she ought to have it replaced with a tissue valve.. the chances are pretty good it would last the rest of her life..

The tough part is to know when.. I think you ought to have at least 2 opinions and then you and or her decide what needs to be done.. the real kicker is that sometimes with this valve.. the first symptom can be death... I am going to do it soon myself and am really not completely convinced that I should yet..

2 doctors tell me yes and one says maybe not..

???

good luck

Ted

[Cleveland Clinic, MD]

Thanks for your comments Susan.

[Susan]

Pat, I thought I would just comment for the "whatever it is worth" department.  I live in FL in the Tampa Bay area and know that the Sarasota Heart Clinic is very good and the doctors are really great.  I am about 30 years younger than your mom but had my valve replaced last February here locally (St. Judes mechanical).  I could not be happier with the results and had a terrific doctor and surgeon from the St. Pete Heart Center group.  Because of the proliferation of elderly in this area (& FL in general), the medical services are as top notch as any of the notables such as Mayo, especially for the more routine procedures like valve replacement.  I know it is hard being apart and will be tougher on you, but so much easier on your Mom to be close to her own home and surroundings.  I can tell you from experience, I am glad I was.  Plus she will have the added benefit of still being near the doctors who "did the deed".  That is comforting to a heart patient and I can speak with some authority on that!  As well as I did, the thought of having to travel home from a far away place is no picnic.  The weather is a real consideration as well because the sooner she is up and walking, walking, walking, the faster she will heal.  That is much easier to do in sunny FL than the snowy and cold north (I assume this is something to be done immediately.)  If there is anything else you would like to know, I will see what I can find out for you, but your Mom will do just fine in Sarasota and in the long run probably better than the aggravation of a long hard trip both before and after the surgery.  Good luck!

[Cleveland Clinic, MD]

Dear Pat,

I know it can be frustrating living far from elderly parents and helping them with health care decisions.  Without knowing the specifics of this case I can't really comment on the need for surgery or a second opinion.  I would suggest calling her doctor and setting up a time to discuss the issue with him.  Mayo is a good institution but she may be fine in Flordia also.