Q
: 1
03/12/2008 |
I have a 13-year-old son who was recently diagnosed with mild aortic root dilation-measuring 28 mm. He also has trace aortic and mitral regurgitation. He's healthy and active, 69.5"tall and 125 lbs. He also has a solitary kidney. Elevated ASO level of 280 (previously was in the low 300s). History of repeated strep throat. Tonsills were removed. Past rheumatic fever is a possibility. He being evaluated by a geneticist at the end of March to rule out Marfan Syndrome. He does not present with any of the Marfan characteristics, except aortic root dilation, height, and myopia.
What would you recommend the course of treatment be for aortic root dilation of 28mm?
As you know by now your son's aortic root is rather large for his age. For what you describe (aortic root dilation,height, and myopia) he does have traits of Marfan syndrome which will (or not) be confirmed by the genetic testing. If he is Marfan positive I would recommend close follow up on the root dilatation and early treatment if it seems to continue to dilate or if aortic insufficiency is worst. Treatment is achieved by root replacement (open heart surgery).
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Q
: 2
03/07/2008 |
I read your news release about this surgery (http://www.umm.edu/news/releases/rare_aortic_valve_surgery.htm). Is it possible to perform this surgery on high cholesterol children?
That surgery is only for high risk (older) patients. An aortic valve in a child or young adult can be changed or repair with very low risk. Having a high cholesterol, although bad for health in general, does not represent a higher risk for heart surgery. In other words, the chances of dying during or immediately after heart surgery or not higher if you have high cholesterol.
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Q
: 3
07/18/2006 |
I am 35 weeks pregnant and my unborn baby has been diagnosed with an abnormal tricuspid valve. There is a severe leak and the right atrium is extremly dilated and the ductus is slightly narrowed. I have been given two very different explainations as to what will happen to the baby after birth. Could you tell me what you have seen happen most often in a case like mine? I know that you can't give me exacts without seeing the fetal echos but I am just trying to get as much info as possible so that I can be informed.
It is very likely that based on what you describe your baby may have Ebstein malformation of the tricuspid valve. If this is the case most likely your baby will need some type of treatment, probably surgical at some point in life.
The only cases in which heart surgery for Ebstein malformation is needed in a newborn is when the tricuspid inisufficiency is combined with pulmonic stenosis. This is extremely rare, although we have performed surgery in 3 newborns with this disease over the last 12 years.
Please let us know if we can be of any further assistance.
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Q
: 4
06/21/2006 |
My 4-year-old son has been born with a bicuspid heart valve. He is fine right now. Can you tell me if he would eventually have problems?
I'm assuming this is a bicuspid aortic valve. In general most people have a normal life, so much that many if not most are never diagnosed. In a few cases, bicuspid aortic valve predisposes the person to have infection (endocarditis) of the valve. One way to prevent this problem is to use antibiotics at the time of invasive procedures. As an example, every time your child is seen by a dentist, he/she should be aware of your child heart condition so antibiotics can be given.
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Q
: 5
05/05/2006 |
My 4-year-old daughter was diagnosed an an asymptotic ALCAPA patient and has subsequently gone through an open heart surgery 10 months ago. She was also diagnosed with severe MR. A mitral valve repair was performed using 5-0 goretex suture as neo chordae. Annuloplasty was done using 4mm goretex tube and 5-0 interrupted site. Now she is okay.
As an annuloplasty has been done using a ring, as her heart grows how can it cope? Is a reoperation necessary? If so, at what age?
In general annuloplasties are performed with C shaped rings, not full circle rings. That way, her mitral valve can keep up with growth.
It seems to me that your child had the operation we would do for similar cases. Reoperations soome times are needed to change the mitral valve if the valve continues or increases the amount of insufficiency (leak) I can't tell you when or if she will need surgery.
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Q
: 6
04/28/2006 |
My son, who is 2 1/2 years old, has been diagnosed with congenital mitral valve stenosis. According to the echo cardiography done on April 20, 2006, the child is diagnosed to have a significantly abnormal mitral valve - parachute mitral valve with severe mitral stenosis. Due to the abnormal mitral valve, pulmonary arterial pressure is significantly high. It seems that only a single papillary muscle is working. He has been advised to have surgery in the next four to five weeks. We are hoping the valve can be repaired. Do you have any advice?
I'm afraid valve replacement is the only option. Parachute mitral valve can't be fixed in 99.99% of the cases.
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Q
: 7
04/20/2006 |
My 11-year-old daughter has AS leaky and ASD. She needs repair of the valve and ASD closure. What is the possibility of intervention by catheter.?
ASD in general can be closed by catheter intervention. Aortic leaks (or insufficiency) cannot. The most important thing is to determine how much leak the aortic valve has. Your daughter may need the ASD closed now and be okay.
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Q
: 8
03/16/2006 |
My 15-year old son needs both his aortic and mitral valves replaced due to rheumatic or congenital heart disease (diagnosis is uncertain). Surgery is recommended due to
enlarged left ventricle. Regurgitation is moderate to severe in the aortic valve and moderate in the mitral valve. The surgeon recommends two mechanical valves.
We would like to avoid long-term anticoagulation therapy. What additional information would be needed to determine if mitral valve repair (vs. replacement) is an option?
And if the mitral valve could be repaired, would the Ross procedure be an option for replacement of the aortic
valve?
In order to decide whether a mitral valvuloplasty is doable a very good quality echocardiogram is needed, sometimes in older patients. Only a trans-esophageal one will have enough resolution to accurately judge the problem. Regarding the combination of Ross and Mitral plasty, of course it would prevent anticoagulation but in your son's case he seems to have an important degree of aortic insufficiency which has poor medium term results when treated with a Ross procedure. I'm afraid your surgeon has given you the most practical solution with the lowest surgical mortality and the best long term result.
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Q
: 9
01/07/2006 |
How fast should a normal heart rate be for a 4 1/2-year -old girl?
It depends on the time of the day. During normal activity near 80-90 beats a minute, running and playing much higher (120-150). While sleeping it could be as low as 60 beats per minute.
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Q
: 10
12/28/2005 |
My 18 year old son had a VSD at birth. He had a repair of the VSD, removal of double muscle chamber and aortic valve repair at age 5. His aortic repair did not hold. His last stress echo three weeks ago showed his EF went from 70% to 55%. He also had runs of VT (10 - 15) beats which he not had last year. He had a cardiac cath and TEE last week. We've seen two surgeons. Both seem to agree that one leaflet of the valve is severely "stretched" but that the rest of the valve seems to be intact. One wants to do the Ross procedure. The other wants to repair it. My son is very active physically. We want to do what's best for him in the long run and whatever would have the longest term effect. We need help on which way to go. Is there a way to see someone at your facility to help us make a decision?
Both surgeons gave you good advice. Ideally it would be nice just to repair the valve, but realistically, since it was already repaired it may not be doable. The Ross Procedure is great for young people, but he had two surgeries already and the Ross may require a future surgery to revise/replace the pulmonary valve that is used to replace the aortic one.
I would be happy to review the echo and the cath and then give you some advice.
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Q
: 11
12/05/2005 |
Why does ASD cause frequent respiratory infections?
Atrial Septal Defects allow blood that has already been through the lungs to go back to them. That creates a condition by wich lungs are wet and full of extra blood not needed for their normal function. Wet lungs are ideal for bacteria and viruses to grow, especially during the winter months.
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