mitral regurge

[zyzyx3]

i had a bypass 10yrs . ago..my heart  EF is 38%..my heart echo shows vdilated left ventricle, segmental wall motion abnormalities impaired oerall systolic funtion....severe mitral regurge, dilated left atrium....mild airtic regrge, no significant systolic gradient...a small sized thromus is attached to  the apex...ischemic cardiomyopathy...this is my case i get difficult breathing facilities every now & then.. what do i need to do..do i need an operation to replace my mitral regurge...will my heart survuve that operation or their is another way to spare me from that operation...thnx

[kenkeith]

A renown heart surgeon from Mayo Clinic (Rochester) has stated the biggist problem he sees are patients who have waited too long for MV operation.  He recommends an operation with enough lead time to adequately preserve LV functionality.  This a surgeon's point of view and a cardiologist may have different view?!  

From what I have read and my own experience, a heart enlargement and an EF below 29% places the patient at a high risk, and unless absolutely necessary surgery is not a very good option.  You should be treated medically as I have been to reduce the dilated LV (if possible) and that treatment should increase your EF as well.  You will need an operation for severe MVR as it will not get any better and waiting is not a very good option.

[Momto3]

The general rule of thumb is to surgically repair, or replace, the faulty valve when the patient is symptomatic or shows signs of declining cardiac funtion.  That said, it's just a general guideline and each patient should be evaluated by their own physicians.

Have you seen your cardiologist recently?  What is his/her recommendation?  Any chance you could go to Cleveland Clinic or Mayo?  They are exceptionally well versed in handling more difficult cases and have a great deal of experience in treating patients such as yourself.