Valve repair

Posted by ventura @ventura, Oct 18, 2017

1 1/2 years ago I experienced shortness of breath upon exercise. This was accompanied by painful joint swelling. Cardiologist administered echocardiogram stress test (only lasted a couple of minutes through test) and this showed my heart ejection fraction at 30%. Cardiologist suspected defective valve or artery blockage. With vegan low fat diet for one year, I experienced less frequent shortness of breath and was able to pass simulated stress test for 12 minutes on tread machine. Lately, I again am experiencing some shortness of breath upon exercise. I am very active in swimming, walking, yoga, etc. 1 1/2 years ago acupuncturist detected heart murmur in left side of heart and this is also detected today. This would seem to be a heart valve issue (I have had tests for rheumatoid arthritis and lyme disease and have tested negative on both). What percentage of heart valve surgery can be done via catherization vs open heart surgery? What are prognosis for catherization and open heart for valve repair/replace? Positive results? Fatalities? I am male, 72 years old. Heavy smoker from age 18 through 35. Male family history of heart issues.

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Hello @ventura,

Welcome to Connect. Heart valve surgery via catherization is an evolving procedure, with newer technology and a specialist would be best able to answer your questions. Mayo Clinic cardiac surgeons work together as a multidisciplinary team with cardiologists and other health care professionals to provide coordinated, comprehensive care for people with all types of heart valve disease. Here is more information from Mayo Clinic: https://www.mayoclinic.org/tests-procedures/heart-valve-surgery/details/mayo-clinic-approach/orc-20306326

I would also encourage you to view this information about Mayo Clinic's Heart Failure Clinic: http://www.mayoclinic.org/departments-centers/cardiovascular-medicine/overview/specialty-groups/heart-failure-clinic/overview
As a Mayo Clinic patient, you will be able to consult with doctors on the latest advances relevant to your condition, the heart failure specialists will determine which part of your heart is responsible for the shortness of breath, and will refer you to the appropriate sub-specialist or be treated in the catheterization lab soon after. http://mayocl.in/2xOC7QI

We have several great discussions about heart valve conditions and repair, taking place on Connect:
– mitral/tricuspid valves https://connect.mayoclinic.org/discussion/mitraltricuspid-valves/
– Aortic Stenosis & Valve Replacement https://connect.mayoclinic.org/discussion/aortic-valve-calcification/
– Mitral Valve & Tricuspid valve regurgitation: when to see a cardiologist? https://connect.mayoclinic.org/discussion/i-was-just-diagnosised-with-mitral-valve-and-tricuspid-insufficiency-i-have/
– I was diagnosed with Mitral Valve Regurgitation and Pulmonary Arterial Hypertension https://connect.mayoclinic.org/discussion/i-was-diagnosed-with-mitral-valve-regurgitation-and-pulmonary-arterial-hypertension-2/

Finally, I'd like to introduce you to a few members who might provide more insight from their heart experiences. Please meet @bjanderson @tomonthebeach @carnes @lyndylou @frande @dave2455 @shakuni11 @ch246cf10 @lizm53 @tavrm and Mentors @hopeful33250 and @predictable.

@ventura, I understand you must be worried about your symptoms; have you been prescribed any medications to manage your symptoms? Have you undergone any tests to determine which of the four valves may be affected? We look forward to getting to know you.

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I hope you are doing well, it sounds like you are tolerating a low ejection fraction pretty well, if you are only having SOB with exertion. Do you have problems while laying down flat, without head raised for more than a few minutes? Do you have any pains, or ever come close to passing out, or have visual disturbances?
Approx 1/100 people are born with a bicuspid (instead of tricuspid) aortic valve and it can start affecting a patient at any age, but usually starts causing symptoms at around your age. There is nothing to be done except valve repair/replacement, if it is this.
I would highly recommend being seen at the Mayo Clinic, or a heart valve specialist group which is also very experienced, if you have the option to do either.
Good luck, and keep taking care of yourself as well as you do, but I would take it easy on any possibly vigorous cardio workouts until you know what's going on exactly.

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@srounkle

I hope you are doing well, it sounds like you are tolerating a low ejection fraction pretty well, if you are only having SOB with exertion. Do you have problems while laying down flat, without head raised for more than a few minutes? Do you have any pains, or ever come close to passing out, or have visual disturbances?
Approx 1/100 people are born with a bicuspid (instead of tricuspid) aortic valve and it can start affecting a patient at any age, but usually starts causing symptoms at around your age. There is nothing to be done except valve repair/replacement, if it is this.
I would highly recommend being seen at the Mayo Clinic, or a heart valve specialist group which is also very experienced, if you have the option to do either.
Good luck, and keep taking care of yourself as well as you do, but I would take it easy on any possibly vigorous cardio workouts until you know what's going on exactly.

Jump to this post

Thanks for the responses! These are greatly appreciated.
When my heart was checked with a stethoscope on 19/18/2017, the murmur was heard in the lower left quadrant. So I assume this would be the aortic valve. As indicated in the posting by @srounkle this could very well be the issue. I also have read that this condition is most prominently found in men. I still do not rule out the fact that my joint swellings began at the same time as the shortness of breath. Maybe I contracted some kind of bacteria which caused the valve to malfunction? If that is the case, I am hoping that maybe if that bacteria has stopped then the valve could heal. Also, over the past year my shortness of breath was getting less and less and then over the past couple of months, my condition deteriorated somewhat. Something which happened about two months ago was a very painful toothache and the dentist said the tooth was draining. I have now had that teeth pulled. In addition, I had a return of a painful joint in my thigh.

Overall this currently does not cause major changes to my lifestyle (other than I am unable to jog 6 miles like I did in the past). However, day to day activities are mostly normal. I normally only have symptoms when exercising and not when laying down; no passing out; no visual disturbances. I am currently on no pharmaceutical drugs

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@ventura

I am glad to hear that you are managing so well without any medications. You mentioned SOB and the stress test. I was wondering if you have ever had CardioPulmonary Exercise test? It's like a stress test (done on a treadmill while you are hooked up to an EKG monitor) however the major difference is that you have a gizmo in your mouth that measures your breathing/oxygen use. It is a bit more sophisticated in terms of the information your doctor receives about your heart functioning.

I am 69 years of age, with a history of heart valve problems that go back to age 11. In the past 4 years, I've had 2 CardioPulmonary Exercise tests. They have provided excellent information.

Here is a rather technical article from Mayo Clinic regarding this test, http://www.mayoclinicproceedings.org/article/S0025-6196(11)60946-4/pdf. If you would like a more sophisticated look at what is going on regarding oxygen as well as heart functioning, you might seek out a cardiologist who can administer this test. Most major health centers will do the CardioPulmonary Exercise test, however, it probably won't be available in a regular or general cardiologist office.

Have you considered a 2nd opinion from a major medical center?

Teresa

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