Want mine repaired

[oopsyadaisy]

I went to a marysville site and actually watched a video of this guy get a mininmal invasive surgery done on his valve and they repa ired it not replaced it. They said that over 80 per cent of valves CAN be repaired. Why doctors are so quick to stick in all these other valves is most likely because you will be back and you need to come back so they will get paid. If I lived in the states I would have gone to marysville just so I could get mine dealt with.

 

[Nancy]

Lots of members here have gotten their valves repaired. Different surgeons have different skills in this area, so you will have to first find a surgeon who likes to repair. Then the other obstacle is that not every problem can be fixed with a repair. Some valves or hearts are just too damaged to repair. Then a shiny new valve is the way to go.

As with ANY valve surgery whether a repair, a tissue valve, or a mechanical valve, there are NO guarantees that you won't have to have repeat surgery. So much depends on the overall condition of your heart, your health, and what caused the problem to begin with. Each person is unique.

You will have lots of questions for your surgeon.

 

[tobagotwo]

It is much more frequent for a mitral valve to be repairable than an aortic valve. Successful mitral valve repairs happen all the time. Not every mitral valve is a candidate for repair, but most surgeons will repair a mitral valve if they feel that they can, and only replace it if necessary.

While it has happened, very few aortic valves are successfully repaired. Nearly all aortic valves that require surgery are replacements. Unless there is a very unusual issue with an aortic valve in the first place, one should not go into a surgery thinking it is likely to be repaired.

Best wishes,

 

[McCln]

My aortic valve was first repaired, then, 28 years later, replaced. That was my luck. But when they had done the repair, I was told that eventually the aortic valve would have to be replaced. I was born with a congential heart defect, heart murmur. So, the replacement was known for many years. When it was removed, it was in very bad shape. So I felt lucky with the surgeon I had. I still send him a Christmas card every year. So, education is the key. There are so many repair techniques out there. Good luck on your valve.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve

 

[Karlynn]

I was told that they would try to do a repair, but wouldn't know until they got in if they would be able to do so. My valve was really damaged and it was replaced.

If I were you, I'd get a surgeon that does a lot of repairs and then ask for his stats on how long his repairs last. You certainly wouldn't want a surgeon who would do a repair when a replacement is the better choice.

As you can see, this is something you need to take an active role in and do your homework.

 

[Sherry]

I had one of the finest cardiac surgeons in Indianapolis try to repair mine seven years ago. He spent hours snipping and sewing, but in the end, it was still leaking. He cut all of his fine work out and put in the St. Jude's. My RN sister-in-law sat in on the procedure and said he gave it a Herculean effort for five+ hours, but it just was too damaged to work properly. It's really an unknown until they get in there and start working.

 

[Harpoon]

If they CAN repair it, they WILL repair it.


That was the plan my surgeon had going in, the artificial valve was a back-up.


When he got in there, the first thing that was noticed was that one of the tricuspid valve leaflets was GONE.

Can't fix what's no longer there....


I think it's wrong to say surgeons go mechanical for the money. There's no real guarantee that, A) your valve will fail within your lifetime and, B) if it fails, your surgeon will still be working, C) you'll go back to that same surgeon....



My first open heart surgery was 30 years ago. I had transposition of the great vessels and my heart was rebuild by a phenominal surgeon who really was THE best surgeon in the world at that time for treating pediatric heart defects such as mine.

Now, he's a lawyer in another state on the other side of the country from here. He would never have been available to "refix" my heart.


If you seriously think heart surgeons like the ones we deal with are looking to make temporary repairs so they can make more money off of their patients just like a bad mechanic might do with a car, then you really need to address some trust issues with your physicians...


Just saying is all. =)

 

[Tom F.]

Repair of the aortic valve is a developing area of surgery. They cannot generally repair a biscupid aortic valve, although Dr David in Canada has been doing some repairs. Generally, if the issue is an aneurysm of the aorta, and if the valve itself is normal and generally undamaged by the aneurysm then they can repair the aortic valve.

 

[epstns]

Oopsy,
You haven't said what problem exists with your valve, or which valve is involved. As others have mentioned, mitral valve repairs are much more commonly attempted than aortic repairs. Also, leaking valves (insufficiency or regurgitation of valve) are more commonly repairable than stenotic (calcified) valves.

Why not tell us a bit more about your situation -- we may be able to be a bit more specific in advice. Also, don't forget that you can discuss it with your surgeon prior to finalizing choice or surgeons, etc.

Either way, good luck, and come on visiting often.

 

[oopsyadaisy]

I dont know

I dont know

I dont know much of anything at this point. Living in canada seems to be a current negative. All I know is that I am trying to get the second echo sent to the cardiologist so We definately know what is going on. The heart specialist just told me that a valve blew. The cardiologist said to me its like a parachute and one of the chords snapped. But he said not to worry becasuse we dont know anything defiante yet. Well go one step at a time. Im not happy about that because If its broken i want it fixed now. Delay can make it so they cannot repair it. Its an eh situation.

 

[Mary]

Maybe this is what he means

Maybe this is what he means

The heart specialist just told me that a valve blew. The cardiologist said to me its like a parachute and one of the chords snapped.

When I first read this post to my husband, he suggested that the cardiologist is referring to the chordae tendineae. They sometimes use the analogy to a parachute.
Mary

 

[tobagotwo]

I went to a marysville site and actually watched a video of this guy get a mininmal invasive surgery done on his valve and they repa ired it not replaced it. They said that over 80 per cent of valves CAN be repaired. Why doctors are so quick to stick in all these other valves is most likely because you will be back and you need to come back so they will get paid. If I lived in the states I would have gone to marysville just so I could get mine dealt with.

I agree with Steve that they wouldn't do a replacement for the money. Even if one would assume they'd do something for the money, there's really no money there for them to get more of. There is some steady money in INR testing, but that would not go to the surgeon, but rather to a lab, a PCP, or a regular cardiologists' group, to which they're not normally associated. Plus, a failed repair is also a rebooked surgery, so there is still the opportunity to see the patient again. So, there's no percentage in it for them.

Besides, good surgeons don't need repeat business as far as I can see; their dance cards seem to always be full without it.

I'm certainly not a cardiologist or a surgeon, but from what I've seen on these pages, 80% sounds like an aggressive statement, unless it was applied toward a very specific part of the mitral community. This appears particularly so when there are so many different types of mitral injury.

When it can happen, repair is surely the best course. However, as with all of the other remedies we discuss on these forums, bear in mind that even this doesn't always work as the surgeon wishes. Even when the outcome looks good at close-up time, the proof awaits in recovery. Pick a surgeon you trust in a facility that is well set up for this type of surgery. That's about the best you can do for the most part.

Best wishes,

 

[Nancy]

oopsyadaisy-

As many have mentioned, and so have I, there are no guarantees with any of this.

We have to keep in mind that this is not like getting a carpenter to fix something, or a plumber to put in a new part. Those things can be measured and they are not living tissues which are in constant movement. Living tissues can have all sorts of things happen. Fitting a new part into living tissue, or even repairing and altering the tissue can have unexpected results in some cases.

I agree with tobagotwo, every surgeon we have ever come into contact with has been extremely busy from the very early morning until, in some cases, late into the evening. Most have back to back surgeries scheduled all day long. They really don't have to "manufacture" business.

 

[Marge]

<< 80% sounds like an aggressive statement, unless it was applied toward a very specific part of the mitral community.>>

I think 80% refers SPECIFICALLY to mitral valves.

The University of Maryland does a lot of valve repair. Their site has this to say:

<<The key innovation in the treatment of mitral valve disease came in the early 1980?s when world-renowned French cardiac surgeon Alain Carpentier introduced techniques of fixing a diseased mitral valve rather than replacing it. "His original paper was called the 'French Correction,'" says Dr. Gammie. "His techniques have slowly been adopted. Now, we always prefer to fix rather than replace the valve because the repair is durable and rarely requires a repeat operation." Currently, only 40% of mitral valve surgery patients nationwide have the repair. At the University of Maryland Heart Center, the repair versus replacement rate is 85%. "We can never fix 100% of the valves," says Dr. Gammie. "Some are beyond fixing. ... It is important that the patient have mitral valve surgery at a center which is dedicated to that specialty."

There is more info about valve repair at
http://www.umm.edu/heart/valve_repair.html

 

[doberman]

great docs in Canada

great docs in Canada

This is not really a negative, I live in Toronto and my first cardiologist gave me advice i was not comfortable with so I found another, find the cardiologists in your area that specialize in you area and see them. There are many fine doctors in Canada. As my surgeon wrote in an interview, if he had wanted to make money he would have gone into business, he is a very dedicated surgeon. Find a doctor that you will trust your life with and you will feel much better.

 

[weekycat]

Yes, that would be the mitral valve

Yes, that would be the mitral valve

When I first read this post to my husband, he suggested that the cardiologist is referring to the chordae tendineae. They sometimes use the analogy to a parachute.
Mary

As Mary's husband mentioned, your cardiologist was most likely referring to the chordae tendinae of the mitral valve. Two of mine had "snapped" and fortunately, my surgeon was able to repair it. The surgery did take a little over 6 hours though, so it wasn't an easy repair. If it was not possible, the plan was to go with a mechanical. I'm very glad he was able to repair it, and I'm sure your surgeon will do what needs to be done.

 

[catwoman]

My case was like Sherry's: My surgeon did repair the chordae tendinae, but the TEE showed the valve was still very bad. So, he did a replacement. I had expected a repair would not work, so I was not surprised and was satisfied with the outcome.