On-X Aortic Heart Valves: Safer with Less Warfarin On-X Aortic Heart Valves: Safer with Less Warfarin



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Mitral valve repair/replacement for those over 80

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  • Mitral valve repair/replacement for those over 80

    Hello everyone,

    My name is Sabine and my mother-in-law (age 84) is trying to decide whether or not to have mitral valve surgery. Her cardiologist says they will try to repair the valve first, but if that's not possible will opt for replacement. She is at Kaiser San Rafael; recommended surgeon is Dr. Hon Lee at Kaiser Santa Clara. Surgery at Mercy General in Sacramento may also be a possibility.

    Any suggestions? Did anyone out there have mitral valve surgery over 80 (or know someone that did)?

    Thank you very much,

  • #2
    Hi Sabine and welcome to the insane asylum. There have been a few people over 80 that have had valve replacement in here, most represented by a significant other such as yourself. Give them time to respond. If they don't, from what I remember they all did well, though one had a difficult recovery.

    The question would be, how good of physical condition is mom in law currently?


    • #3
      Hello Ross,

      Great quotes :-).

      She's in excellent health, doesn't smoke and has walked a lot most of her life since she's never gotten her driver's license. She's under a lot of stress because she's the primary caregiver for her husband who has progressive dementia/Alzheimer's.

      Thank you,


      • #4
        I had an aunt who had aortic valve surgery at about 88 and did very well. She died at 95 of other causes.
        Mitral valve repair & maze procedure - October 20, 2005 - Montreal Heart Institute
        A-Fib - August 2005
        Endocarditis - 2004


        • #5
          Has she had a cardiac catheterization? I would ask if she would be a candidate for mitral valve repair using the da Vinci robot. It's the most minimally invasive surgery, with just a few keyhole size incisions. I just took a peek at Mercy's Web site; it said mitral valve repair with the da Vinci is "coming soon." Thought I had read some of the KP hospitals were using it. A quick look showed KP Santa Clara using it for urological surgery, not sure about heart.


          • #6
            When I was in ICU, I watched people in their 80's leave long before I did. Kind of upset me that they were doing so well and I wasn't.


            • #7
              Susie, I shared the ward with a guy that was 87 when he had an AVR.
              He left hospital more quickly than I did and I was only 41 at the time.
              He was in good condition before surgery, I was in class IV heart failure.

              "The only thing we have to fear is fear itself." FDR


              • #8
                Barbara Bush had VR surgery at 83, and she's doing fine. Barbara Walters had AVR surgery at age 80. If she's relatively healthy now, she will probably do fine.


                • #9
                  Hello Luana,

                  I've heard that minimally invasive mitral valve repair with an experienced surgeon, without the da Vinci robot, is generally preferable in older patients as use of the robot increases cardiopulmonary bypass time.

                  Thanks for all the comments. I've been hearing a lot of positive information that should help my mother-in-law make her decision. The big question is if she decides to have surgery, how do we find the best surgeon for her?



                  • #10
                    Hi Sabine,
                    Sounds like she's a member of Kaiser-Permanente's Senior plan? If so, she'd have to have a KP doctor.


                    • #11
                      Hello Luana and everyone,

                      I've heard it's sometimes possible to go outside of Kaiser, if for example the head of cardiology O.K.s it. Also, in some places Kaiser has no thoracic surgeons on staff - for example, in Sacramento Kaiser contracts with Mercy General Hospital for thoracic surgeries for their members.



                      • #12
                        Hi Sabine, I just wanted to let you know that my father had an aortic valve replacement a year ago May at the age of 87. He had suffered a heart attack and while they were in doing 6 or 7 bypasses (can't recall the exact number) they replaced his aortic valve. He was out of the hospital and back home a week after surgery. He is the primary caregiver for my mom who will be 90 in November. She suffers from dementia. He does have a nurse's aide that comes in 4 days a week now. But that was at our insistence. He went back to cutting grass four months after his surgery. And he just finished waxing his car this past week. He did a little at a time over the past month. He's doing great! He also takes Coumadin for atrial fibrillation and is doing fine with it. LINDA
                        mitral valve repair 1974
                        mitral valve replacement with St. Jude Mechanical 1981
                        pacemaker dependent


                        • #13
                          I think the best surgeon is one who does a lot of valves. Valve surgery is about 20% of total cardiac surgeries, so some surgeons do whole lot more CABGs than they do valves. If you're able to go out of the area, Stanford would be a great place to go in northern Cal. I think we've had a couple people have surgery there. Bill B?


                          • #14
                            One of our common recommendations is to find a Surgeon who does a LOT of the specific procedures the patient will need.
                            In your mother-in-law's case, that would be someone who does a lot of Mitral Valve Repairs AND has experience doing them on elderly patients.

                            That said, one of the Top Surgeons in Northern California is Dr. Craig Miller at Stanford.
                            There are also other good surgeons at Stanford whose names I don't recall.

                            In Southern California, Dr. Hillel Laks at UCLA is another Top Surgeon with an excellent reputation world wide.

                            'AL Capshaw'


                            • #15
                              Dr Hon Lee did my surgery in Kaiser Santa Clara Homestead - he came highly recommended for Mitral Valve replacement/repair. Unfortunately cannot comment on the over 80 part.
                              [FONT="Comic Sans MS"][I]Smile and the whole world smiles with you[/I][/FONT]

                              Minimal Invasive Thoracotomy MVR with On-X Mechanical valve and Modified Maze procedure on 06/24/2008
                              Successfully Cardioverted on 08/14/2008 for AF