Q
: 1
11/25/2009 |
I am a cyclist who was recently diagnosed with mitral valve prolapse and moderate to severe regurgitation. The only symptoms I currently have are decreased stamina, feeling light headed after my heart rate gets above 180 and a cough after exercise. My cardiologist is suggesting we wait before considering treatment. When is a symptom a symptom? I do not have the classic text book symptoms, but am not excited to wait for them to appear. Could my athletic performance improve if the regurgitation is corrected? What is the durability of repair?
Typical symptoms of severe mitral valve regurgitation include shortness of breath when climbing stairs/inclines/hills or when bending over to tie shoes, decreased stamina, increased fatigue, decreased exercise tolerance, and sometimes a dry cough. Once you are diagnosed with severe mitral valve regurgitation, surgery is usually indicated (regardless of the presence or absence of symptoms). Dr. Maurice Enriquez-Sarano at the Mayo Clinic provides some good evidence-based medicine regarding timing of mitral valve (repair) surgery. You may want to do a literature search on some of his publications. Yes, your athletic performance should improve after the operation. Regarding durability- research has shown that less than 10% will require a re-operation after 20 years (so pretty durable). Your main focus should be on having your valve REPAIRED (versus replaced) and sooner rather than later. Mary- Dr. Gammie's physician assistant.
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Q
: 2
10/25/2009 |
I am a 51 year old female, and have had mitral valve prolapse and moderate regurgitation for many years. I had an echo last week, and my numbers have gotten worse. My doctor recommends repair of the mitral valve. I am having heart catheterization next Friday, will this determine which way they will approach the surgery?
Yes, the cardiac catheterization will determine if you have any blockages in your coronary arteries. If you do have significant blockages, you would not be able to have minimally invasive surgery since you would also need coronary artery bypass grafting surgery, which can only be performed through a sternotomy. However, to get a better look at the mitral valve and how to approach repair of this valve, an echocardiogram (specifically a TEE- transesophageal echo) should be performed. Mary- Dr. Gammie's physician assistant.
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Q
: 3
09/22/2009 |
What would be the reason a person would opt for traditional open heart surgery to replace a mitral valve instead of going with the robotically-assisted heart surgery? I don't see any benefits in choosing traditional surgery. Is there something that could cause someone to be ineligible for the robotically-assisted surgery?
Not everyone is a candidate for the minimally invasive mitral valve surgery. Factors such as being older than 75yrs old, having coronary artery disease, having a very low ejection fraction, having other significant valvular disease besides mitral valve disease, and being obese could make someone ineligible for the minimally invasive approach. If you have further questions, please do not hesitate to contact me. Mary- Dr. Gammie's physician assistant.
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Q
: 4
08/06/2009 |
Can you have a mitral valve replacement using minimally invasive techniques or do you have to have open heart surgery?
Yes, it is possible to both repair AND replace your mitral valve minimally invasively. Dr. Gammie specializes in both mitral valve repair surgery and minimally invasive mitral valve surgery. I would be more than happy to answer any other questions that you may have regarding your mitral valve. My name is Mary- I'm Dr. Gammie's physician assistant. I can be reached at 410-328-5842.
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Q
: 5
08/03/2009 |
I have a mitral valve lapse. Sometimes I can feel it when it begins to regurgitate. How do I know if it needs to get repaired?
An echocardiogram will quantify the amount of mitral valve leakage/regurgitation (mild, moderate, severe). Surgery is only indicated for those who have a severe amount of leakage of their mitral valve (severe mitral valve regurgitation). If you have any further questions, please do not hesitate to contact me. My name is Mary- I'm Dr. Gammie's physician assistant. I can be reached at 410-328-5842.
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Q
: 6
07/29/2009 |
How long is the hospital stay for patients who have had mitral valve repair?
The length of hospital stay following mitral valve repair depends on several factors, including your age, medical comorbidities, and presence or absence of complications following surgery. The average length of stay (assuming no complications) is about 4 days.
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Q
: 7
07/22/2009 |
What is the area of the mitral valve in square centimeters for people who have healthy hearts?
The ranges for the area of the mitral valve are as follows: Normal- 4-5 sq cm. Mild Mitral stenosis- 1.5-2 sq cm. Moderate Mitral stenosis- 1-1.5 sq cm. Severe Mitral stenosis- less than 1.0 sq cm.
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Q
: 8
06/14/2009 |
At the end of June I will undergo surgery because of a mitral prolapse. If the valve cannot be repaired, very soon I need to tell the surgeon the type of replacement valve that I want.
What criteria can I use to help me in this decision? I have no symptoms, but the valve has severe regurgitation, my left atrium is severely enlarged, and my left ventricle is enlarged. In two months I will be 60 years old. I am in good health, a bit overweight. I do not practice sports, besides walking about a total of 3 hours a week. I am disciplined with my medications.
My first decision has to be between mechanical or biological.
A tissue valve replacement lasts approximately 10-15 years and does not require the need to take Coumadin (blood thinning medication) and a mechanical valve lasts your lifetime and will not require for you to have another surgery but you will need to take Coumadin for the rest of your life. These are the pros and cons of both types of valves. If you choose the tissue valve you will most likely require another operation in your lifetime. This does not mean that this is not a good option but just something to consider. Stacy Walsh, Nurse Practitioner, Cardiac Surgery
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Q
: 9
06/02/2009 |
I have very symtomatic symptoms from mitral valve regurgitation and I am wondering if I should have the repair done even if my cardiologist doesn't believe so?
It depends on the degree of mitral regurgitation that has been determined by a Transthoracic Echocardiogram and by a Transesophageal Echocardiogram whether or not mitral valve surgery would be recommended. If the degree of mitral regurgitation is moderate or severe than you should consider being evaluated by a cardiac surgeon to determine if surgery would be appropriate. Dr. Gammie specializes in Mitral Valve Repair and Replacement and if the mitral valve is repairable it is always a better option to have it repaired if it can be than to have it replaced. Please feel free to contact us at: 410-328-5842. Stacy Walsh, Cardiac Surgery Nurse Practitioner
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Q
: 10
05/31/2009 |
Are patients that undergo mitral valve repair put on a heart/lung bypass machine? Do you have to stop the heart in order to work on it?
Yes, Patients that undergo mitral valve repair or replacement are placed on a heart/lung bypass machine and the heart is stopped for a specific period of time but not for the whole operation. Stacy Walsh, Nurse Practitioner, Cardiac Surgery
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Q
: 11
04/26/2009 |
I was told I have a leak on the left side of my heart. However, I am not having chest pains or shortness of breath, so my doctor told me that he would do another Echocardiogram in a year. Is this the standard treatment for this problem?
It is normal to have repeat Echocardiograms yearly if the degree of regurgitation (leaking) is a small amount and if you are not having symptoms like shortness of breath, fatigue, etc. Make sure if you begin to develop any symptoms that you contact your Doctor so he can determine if an Echocardiogram is warranted sooner.
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Q
: 12
03/14/2009 |
If you have mitral valve repair how long do you have to stay in the hospital? Can you climb stairs immediately after going home?
The average length of stay in the hospital is about 4 days (assuming no complications). Yes, you should be able to climb stairs immediately after returning home (assuming you were climbing stairs before surgery!). Have you been diagnosed with severe mitral valve disease? Is your doctor recommending surgery for you? I would be more than happy to help guide you through the process of being evaluated for the (minimally invasive) mitral valve repair surgery that Dr. Gammie performs here at the University of Maryland Medical Center. My name is Mary- I'm Dr. Gammie's physician assistant. Please do not hesitate to call me. I can be reached at 410-328-5842.
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Q
: 13
12/05/2008 |
Im still a teenager and was wondering what the chances are of my minor leaking valve to get worse? Is there any way of preventing this from happening?
I assume you're speaking of your mitral valve? The likelihood is low that your mitral valve leakage/regurgitation will progress to a serious (SEVERE) degree. Surgery is only indicated in those with SEVERE mitral valve regurgitation. However, you should follow up with your cardiologist to monitor your mitral valve leakage with an echocardiogram(s). The great majority of those with mitral valve regurgitation (even those with up to MODERATE mitral valve regurgitation) will never require surgery in their lifetime. There is really no way to prevent your mitral valve regurgiation from progressing. If you start to develop symptoms of shortness of breath, increased fatigue, heart palpitations, or chest pain contact your cardiologist for evaluation.
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Q
: 14
07/17/2008 |
When is the right time to have a mitral valve repair performed?
There are many things to take into consideration when answering your question. Do you have mitral valve stenosis or regurgitation? How severe is the disease of your valve? Have you had a recent echo performed (within the past year)? Surgery is usually indicated when you have SEVERE disease of your mitral valve. I would be more than happy to discuss this with you in more detail. My name is Mary- I'm Dr. Gammie's physician assistant. I can be reached at 410-328-5842 or by email at msantos@smail.umaryland.edu
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Q
: 15
07/16/2008 |
I have mitral valve replacement 15 years ago. I always had to pre-medicate for the dentist Now they say that is no longer necessary is this true?
The American Heart Association recently changed their guidelines for preventive antibiotics prior to dental work. They now only recommend antibiotics for those with artificial heart valves (like yourself), a history of infective endocarditis, certain forms of congenital heart disease, and cardiac valve abnormalities following a heart transplant. Ultimately, it will be up to your cardiologist to make this determination though.
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