"The challenge of valvular heart disease: When is it time to operate?"

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Skeptic 49 - you're right, there are no hard/fast answers, but it does give you an idea for how the doctors think, and the process they generally follow (although every individual's situation may be different). In my situation my cardiologist said "they will operate on you before you see symptoms". I hope he is right, but the reality is that you are never quite sure when symptoms may hit! And it sounds like the post operative complications can increasing once you are symptomatic. I'm going in for my AVR as soon as they will take me! Its definitely not a matter of 'if', but 'when'...
 
I got to know just how my cardio was thinking because over the years, we discussed the timing of my surgery many times, in great detail. I say "discussed" because I am lucky enough to have a cardio who works with me to manage my condition, rather than dictating to me just what to do and when. As we were getting to the place where most of the statistical models would have sent me off to the OR, my cardio said that he could not yet, in clear conscience, recommend surgery. Although some of my statistics were past the usual limits, my quality of life, exercise tolerance and general health were far better than average for my age - with or without the heart condition. Eventually I said "It is time" and we set a date. I'm still seeing the same cardio, as I feel that the easy dialog is of supreme value in management of conditions such as ours.

The article from Cleveland Clinic, for some reason, will not open. But I have seen that sort of information from one or another of the medical or surgical professional organizations. The charts do a lot to help folks understand where they are, how their cardio's will likely evaluate them and what to expect in treatment. In my case, I am lucky enough to have even more - the open communication with my cardio. If you can have both sources of information, make use of them.
 

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