valve problems

[elarabi]

My Echo shows the following results: LVEDD 6.9 cm; LVESD 5.2 cm; SWT 1.1 cm; PWT 1.1cm; FS 29%; RV 1.6cm;LA 5.3 cm; Ao root 3.3 cm- MITRAL VALVE disease with moderate to severe mitral incompetence (RA of 9.9 cm2) and MVA of 1.7 cm2.
I also suffer from AF and have 5 stents implanted.
Iam on Marevan,Concor, Digoxin,Asprin.
What is youe evaluation and is it safe in my case to have a surgery.
Thanks in advance

[kenkeith]

Thank you for your response, and it is interesting your doctor wants to wait for sympoms...it does indicate differing opinions (but not unexpected) from the professional medical community.  Just curious was it a surgeon that suggested going ahead with an operation?

Ken

[elarabi]

Thank you so much for your reply and help,I consulted 3 Heart Doctors ,one said I should have a surgery but the other two said do not go for surgery since you have no symptoms.My EF is normal and I exercise for 45 minutes daily by walking in treadmill.
I think I will wait and do not go for surgery at the present time.
Thank you for your interest and accept my regards from Egypt.

Take good care of yourself.

Elarabi

[kenkeith]

I've had moderate to servere MVR for more than 7 years.  At the time of the diagnosis my left ventricle was enlarged and I did have occluded vessels as well.  The surgeon did not want to do an operation on the valve because of the enlarged LV and low EF. Is your EF normal?  When the heart is enlarged and a lower than normal EF, the risk is the heart may not recover very well.

With medication my heart has returned to normal size and pumping adequately.  However, my new cardiologist believes it would be better to wait and watch, and if I have any symptoms (shortness of breath) then  surgery would be recommended. Personally, I am not sure that is the correct approach. I feel well, and with an operation there is the risk of
of complications and ill health going forward...it is an age issue for me.

My information from an article written by a successful surgeon associated with the Mayo Clinic states the biggest problem he has with heart valves is the patient waited too long...
Your left ventricle is slightly enlarged based on the fraction shortening (FS) and that may be a consideration, and a good surgeon that you trust should be the source for an opinion.  It is my understanding the moderate to severe MV disorder will not regress and at best there can be no progression, but the heart would remain under an increased burden to meet the system's demand for oxygenated blood and that can continue to keep you left ventricle enlarged and possibly progressing larger.  That will lead to heart failure and there is a risk of an arrhythmia as well.

I hope this provides a perspective for you, and information to help you with consultation with a surgeon.  Thanks for sharing. Take care,

Ken