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Mitral Valve Surgery Archive Questions

Below are Dr. Gammie’s answers to Mitral Valve Surgery questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
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Now displaying records 46 to 60 of 74.

Q : 46 11/19/2007	Four years ago I was diagnosed with mitral valve prolapse, but recently my heart seemed more "active" more often, so I had it checked again. I was told I have prolapse and regurgitation, and atrial fibrillation, pulmonary hypertension and tricuspid regurgitation. That was kind of a shock. I'm 54 and otherwise in excellent health (weight, BP, blood work, I walk and work out twice a week). I'm curious how things might have deteriorated so quickly, and how bad this all sounds. Most of all, is this the kind of thing that can be fixed with your less invasive surgery techniques? It seems like perhaps the valve caused the other problems, and so fixing the valve might fix them, too? Have you had a recent echocardiogram performed? Did your cardiologist tell you how severely your mitral valve is leaking (how much regurgitation)? Yes, your atrial fibrillation and pulmonary hypertension may be a result of worsening mitral and tricuspid regurgitation. It is possible to have your mitral valve, tricuspid valve, and atrial fibrillation all operated on minimally invasively with our technique. However we would need to look at your actual studies and records to make this determination. I would be more than happy to assist you. My name is Mary- I'm a physician assistant who works closely with Dr. Gammie. I can be reached at 410-328-5842 or msantos@smail.umaryland.edu.
Q : 47 11/03/2007	I need to know if is possible to transplant the mitral valve with a natural one, and also how possible is it to find one? Also, what is the cost for this this type of surgery? Assuming you have severe enough disease of your mitral valve to warrant surgery, your mitral valve can either be repaired (which is preferable) or replaced. If your mitral valve needs to be replaced, your options are replacement with a tissue valve(cow/bovine or pig/porcine) or mechanical (metal) valve. If you are interested in inquiring about surgery here in the United States as an out-of-pocket expense, please feel free to call me at 410-328-5842. My name is Mary Santos- I'm Dr. Gammie's physician assistant and I would be more than happy to assist you.
Q : 48 10/04/2007	My mother is 82 years old. She has always been very healthy and active. In the last two years she has developed a cough that will not go away, and then this summer her ankles starting swelling. She had a heart catheterization and they said she had mitral valve regurgitation, and one blockage that is 70 percent. How many people in their 80's have surgery to repair this? Is this too risky for someone her age? She basically gets around very well, but she does tire out quicker than she use to. It is very hard to make a decision about this. Can medication help some without the pain of surgery? In regards to your mother's age- no she is not necessarily too old to undergo the type of surgery that she needs. We operate on 80+ year olds a few times a week here! Research has shown that 80+ year olds tolerate heart surgery much better than once expected. You may be quite surprised at how little pain she may have from an operation. I would need to know more about her medical history before stating that she would not be a high risk patient. Based on what you've told me so far, she should fare quite well from an operation. You should, however, make sure that she goes to a hospital that specializes in mitral valve surgery and one that has a large cardiac surgery volume to ensure that they have good experience in operating on people your mother's age. We specialize in this exact type of surgery, and I would be more than happy to guide you and your mother through the process if you would like. My name is Mary, and I'm Dr. Gammie's physician assistant. I can be reached at 410-328-5842 or at msantos@smail.umaryland.edu. I look forward to hearing back from you.
Q : 49 12/08/2006	I have really gained good information by reading the information on your site. If a person opts to get the mitral valve replaced with the pig valve, what happens if it fails? Is it likely that the patient will be able to go into surgery again and get the metal valve, or once the pig valves fails, is it fatal? In the case of my husband, he has had the valve repaired but it is leaking again, and now the option recommended is to replace the valve. Should we be also concerned about a treatment plan that will prevent the valve from leaking again? Your husband could have a re-operation of his mitral vale and have either a metal or tissue valve placed at that time. He could possibly have his valve re-repaired as well. If your husband opts to have his valve replaced with a pig valve, he is likely to require another operation in about 10-15 yrs. It would not necessarily be fatal if his pig valve fails, however having a third operation is going to be much more risky (because of his advanced age and the amount of scar tissue in his chest from his two previous operations). A metal valve, on the other hand, SHOULD last him a lifetime (however there are no guarantees). This would require that he take Coumadin for the rest of his life though. You could discuss optimization of your husbands heart medications with his cardiologist to POSSIBLY help improve the longevity of his new valve by improving his hemodynamics (blood pressure, heart rate, etc).
Q : 50 12/05/2006	I read the article on your web site about the success rate of mitral valve repair. My husband had his mitral valve repaired 3 years ago, however it has began to leak again and now the suggestion is to have a valve replacement. Is it possible to repair the valve again verses replacement? Yes, it is possible to re-repair a valve after mitral valve repair has been performed. As you know, Dr. Gammie specializes in the repair of mitral valves and performs about 200 mitral valve surgeries a year. However, in order for us to determine if a repair is a feasible option for your husband, we would need to look at a recent echocardiogram. If you are interested in sending this to us for review, please do not hesitate to call me. My name is Mary Santos, and I'm Dr. Gammie's physician assistant. I would be more than happy to guide you through this process. I can be reached at 410-328-8470.
Q : 51 11/16/2006	My wife has MVP with moderate regurgitation. She has frequent chest pain and is lethargic. The Cardiologist told her that it is all in her head and she should ignore the pain and deal with it. He said that the valve is inoperable because their is some thickening. She is only forty one and in excellent health otherwise. What should we do next? First of all, having a valve that is thickened does not make it inoperable. We perform mitral valve repair surgery on thickened valves on a regular basis. However, only having moderate mitral regurgitation is not an indication for surgery. Has your wife been worked up for her chest pain with a stress test or cardiac catheterization? I am Mary, Dr. Gammie's physician assistant, and I would be more than happy to discuss this with you in more detail. I can be reached at 410-328-8470.
Q : 52 09/14/2006	Six years ago I had open heart surgery resulting in five bypasses and the aortic valve replacement (St. Jude titanium). My cardologist says that my mitral valve is leaking and he is doing an echo every six months. My question is, would I still be a candidate for the minimally invasive mitral valve surgery? My age is 61. You might be a candidate for a "mediumly" invasive approach via the right chest. I would be happy to evaluate your situation. Generally, an operation is reserved for patients with severe mitral regurgitation.
Q : 53 04/29/2006	I'm a 24-year old male with a prolapse of the anterior mitral valve with moderate regurgitation. What do you think of the new Bow-Tie procedure? I like the idea of this as there's no need for stopping the heart or opening of the chest. Does this repair perform well under stress i.e. strenuous exertion? I hope to return to the same level of fitness and participation in various sports. I am strongly opposed to percutaneous "bow tie" repair; this repair has not been adopted by the vast majority of surgeons doing open (ie, direct visualization) surgery. You should have a repair by a high volume mitral valve surgeon with a demonstrated high rate of repair.
Q : 54 04/09/2006	Two years ago I was told at age 64 that I have a "probably congenital" prolapsed mitral valve. Symptoms have been irregular heartbeat and mild dizziness. Am I likely to need valve surgery? It depends how leaky the valve is (as determined by an echocardiogram). If the leak is "severe" then we recommend surgery.
Q : 55 04/04/2006	Does the repair of the mitral valve solve a heart murmur? I have had this condition (heart murmur) for over 40 years. I have been told that the valve will have to be repaired around the age of 70; I am currently 63 years old. Yes; a good repair leaves no mitral regurgitation, and the murmur goes away. The decision to operate is based on the degree of MR as shown by an echocardiogram. Severe regurgitation would warrant an operation.
Q : 56 04/04/2006	In 1973 or 1974, when I was three, I had a mitral valve replaced. I'm not sure if it was a pig valve or a plastic one. Is one better then the other? Also, what is the expected of a plastic one? I am 37 now. You should find a good cardiologist; they should be able to tell based on the echocardiogram. If it is mechanical (metal) you would have needed to be on blood thinners; if it's a pig valve, I would be shocked if it lasted this long. Most likely you had a repair, not a replacement.
Q : 57 02/08/2006	How many minimally invasive mitral valve repairs have you done thus far? How does your rate of success compare to national rates? Approximately 100. We have had very good results.
Q : 58 01/07/2006	How long is the recovery time after this type of surgery? Usually 4-6 weeks for full recovery.
Q : 59 11/07/2005	I have hemophilia A and need mitral valve repair. My hemotologist tells me that I cannot have coumadin which is needed for this surgery. Would I still be able to have the surgery or are there any other options? That is an interesting situation- basically there are two options for dealing with a (i presume leaky/insufficient) mitral valve - repair or replacement. Repair is best because it is durable, and does not require coumadin, only aspirin for life. We strive very hard to fix the valve, rather than replace it, and our repair rate is in excess of 90 percent. If the valve must be replaced, then the two options are a mechanical valve or a tissue (ie, cow) valve; mechanical valve needs coumadin, so that is not an option for you; tissue valve does NOT need coumadin, only aspirin, but it does not last forever, and you would be facing another operation in 12 - 15 years. So - we specialize in mitral valve repair surgery, and would be delighted to help you.
Q : 60 10/13/2005	How many mitral valve repair surgeries are done at the University of Maryland each year? Also, how many MAZE procedures are done each year? We do in excess of 150 mitral valve operations, with a repair rate of greater than 90 percent, and approximately 50 maze operations.

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