Mitral valve repair prognosis?

My situation wasn't exactly like yours, but I can perhaps provide a little insight. Six years ago at age 60 I had OHS to replace my mitral valve. Unlike you, my situation was acute and surgery was a must, not an option. The surgery wasn't a walk in the park, but after a couple of rough weeks I started feeling much better, with each day literally being noticeably better than the one before. In retrospect, even if my situation wasn't an emergency I would have had it done. My bovine valve is still working great - I assume I'll need a replacement in a half dozen years or so.

The financial piece I cannot comment on. At the time I had regular insurance so it wasn't that expensive. One piece of advice I will offer is if you have it done, try to do it at a high volume, well regarded facility. I had mine done in Central Florida at a local hospital (no opportunity to shop around in my case), and while the valve is well seated and working properly, I have had some arrythmia issues since the procedure. Maybe it would be a side effect no matter where I had it done, but I have to wonder if I had been able to go up to Mayo Jacksonville for example if that would be the case. At any rate, I feel fortunate to have my new valve. Best of luck with your decision.

@jefftalley Many thanks. To clarify, my valve condition is now very severe, and time is of the essence, according to the structural cardiologist I saw. They are talkingbrepair instead if replace.

I cannot go to Mayo or similar, but the regional hospital has a very good reputation.

Most of the feedback I've got is that you feel like the surgery was a big mistake for the first three months, you get prescribed an ever-changing array of drugs that make you feel weird, then you need a pacemaker and get a-fib, then you get used to the "new normal" and trudge on.

It is nice to hear you actually felt better!

I am 78 and got a mitral valve repair at Cleveland Clinic at age 59. I had been “followed” by my cardiologist for 15 years, waiting watchfully during that time for a reduced ejection fraction, enlargement of the heart, and most importantly, how I felt. When I reported that I was getting fatigued and somewhat breathless with walking uphill, the date for surgery was set. Not getting the repair would have meant definite heart failure in my future. My regurgitation was classified as “moderate” at the time.
I had only a few inches of my sternum cut to provide access to the mitral valve. The recovery was quick. I was swinging a golf club within 6 weeks, little chip shots within 3 weeks. First days you will be quite sore but extra strength over the counter pain meds were adequate. Today, minimally invasive ( small incisions/ no sternum cut) is often possible. Everybody is at risk for AFib after this surgery. They will give you meds beforehand to avoid that reaction. I got one dose of Amiodorone and it did the trick. Even if your heart does react to the surgery with AFib, it is typically very short-lived.
My Blue Cross/Blue Shield insurance covered it. I live in PA with access to good hospitals but wanted the best available. Cleveland was # 1 in the world at the time. I called the 800 number for the hospital, was transferred through to cardiac surgery, asked if the Chief of Cardio thoracic surgery was available. ( Bruce Lytle at the time, since retired) Answer was yes. That hospital is a well- oiled machine. They are incredibly organized from start to finish. Yes, you will be a number- but in a good way. Plus, they somehow keep costs down, and serve as a model for other hospitals trying to do the same.
I would recommend calling the hospital ( go online and check Cleveland’s website related to heart surgery) and asking about costs when insurance doesn’t cover everything. Many hospitals have options and help for you in this regard.
I flew back to Philadelphia 5 days after the surgery, having followed a brochure you are given documenting everything that will happen during those 5 days, assuming everything goes as expected. That little addition was wonderful if you’re the type who wants to be informed, without surprises. Following surgery recovery, I did not transform into a decathlon level athlete but did feel far more energized and was glad to have it behind me. 18 years later, my mitral valve repair is still hanging in with only “trace” leakage.
Go for it! You’re too young and too needed to reject the help available to you at this amazing time of medical expertise.

Hello! My name is Tammy, and I am 59 years old. I had a Titanium Mitral Valve put in through open-heart surgery, about 9 years ago. It went well. It was hard on me, but well worth it. I fill so much better and have the strength to do what I need to do. Before I had it done, I couldn't walk that far and was so tired. My sister used to help me and thank God for her.

@wcuro Thanks. My Medicare plan does not allow me to go top-notch facility, but the regional hospital is very good.

I never discussed sob, dizziness, or my other symptoms with my cardiologist because if you're a woman, they wave off anything they can't see, hear, or otherwise measure as menopause or stress. Plus, I tend to push through things because in America we like winners not whiners.

The TEE and ECG that revealed that the regurg was severe and a drop in ejection fraction from 60 to 50 were what motivated my cardio to decide I needed to be seen by structural cardio and surgeon.

Too needed? Too young? I loved my job teaching college lit and writing x 30 years. But a rare chronic blood cancer and caring for my mom before she died wore me out at 63. I hate retirement.

I have weakened immunity from daily oral chemo, so the volunteering I'd hoped to do is very limited. I read books, knit, try to be patient with my husband's failing cognitive function, and miss our son who moved to the West Coast this year. I have a few close friends and the cats to keep me going.

But I am in no way mentally ready for the kind of surgery I'm facing or the rehab I'm going to have to do to get myself back in shape to keep going.

Hoping my PC, whom I see next week has some ideas.

Thanks for listening.

I am at the point in my life where I am grateful for my stoicism, an orientation to life that I built as a young officer candidate in the Canadian Army several decades back. It was a grind...no other way to describe it...designed to make you quit or to realize you didn't really need to...only wanted to. That's the difference. You can do anything you set your mind to. It only requires the minimum motivation that the task needs for you to overcome your reticence and your fears. Or laziness....which I have in abundance.

I enjoy routine and comfort (I know, I know...who doesn't). So, when things are obviously beginning to slide, I sit up and deal with it. Right now. I have learned long since that letting things slide means a lot more work, expense, and inconvenience later when the need is much more acute. With heart problems, you want them done right away....the right way. Whatever it takes, git 'er done. And endure, and grit yer teeth, and ensure you do your part, which is going to be made very clear to you in pre and post-op instructions. This means pain, suffering, maybe some second-guessing. But, eventually you smell the ocean, eventually the sun begins to peek out from a break in the greyness, and you'll sense that you're on your way back to normalcy, to that routine and comfort you long for. It may never be quite the same (after all, you HAVE aged another four-six months), and other stuff happens over time that cannot wait. But you can put this misery behind you and look forward to years of happy and productive life.

Qui non proficit deficit. 'Who does not advance falls behind.'

Question for anyone: How strenuous is the rehab? I understand from my mother's refusal to do any rehab after AVR, that this is vital to best possible outcomes. I am concerned that, as a chronic cancer patient this will be difficult, especially since I will need to drive 60 miles round trip to the rehab facility.

Thanks.

Cariac rehab is designed for the individual. Where I am the nurses do a base line, a "walk for 6 minutes test", check blood pressure, hand strength (and a couple other things I don't remember) to see your physical condition, then design your individual rehab program around that. In my program, we had a small group of people, all recovering from different procedure and all with varying levels of condition, and everyone was doing things within their limits.

I would highly recommend taking part in a rehab program.
All the best!

My niece is scheduled for open heart surgery to repair her mitral valve on the 27 of this month. She had the clip put on in December but said she never felt a 100% but she did well till now and had an a fib attack and went to ER then to her doctors and they said clip not holding and open heart is best way to repair this. She is 74 and still works as a realtor. She does enjoy her job not in hurry to retire and she has had this most of her life but was manageable until now. Doc said 2 weeks at home then rehab and they think all looks good. I Pray you will decide what is best for you also. Sorry about the insurance as I know how that figures into the decision. Prayers for you.

@tammyc123 Hi, I had a titanium mitral valve through open heart surgery 6 weeks ago. I have chronic A fib my whole life, unfortunately it's still with me. I have recovered well. The only problem is since my op I have had terrible pains left side of my head and behind my eye. It is awful. They seem to be reducing about 3 times a week at the moment. Apparently these headaches are a result of being on the heart lung machine. Has anyone else experienced this type of headache and also how long did they last after your op.