Video Q&A about Valvular Heart Disease

Tue, Aug 20, 2019
2:30pm to 3:00pm CT

Description

Dr. Peter Pollak, cardiologist, and Dr. Abdallah El Sabbagh, cardiologist, answer questions about valvular heart disease.

Location

Online

At what point should mild tricuspid regurgitation require treatment?

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What is aortic valve diameter requiring replacement in asypmtomatic patient?

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Are there differences in prognosis or treatment for valve issues caused by congenital defects versus acquired heart disease?

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Is it common for a congenital aortic valve tear to require a valve replacement?

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Two part question. Is it possible for the heart to regain normal function (in terms of exercise tolerance) after multiple valve (mitral & aortic) replacements? Why or why not? What about atrial size and remodeling — does that improve as well? I have a history of rheumatic heart disease and my valves were replaced 3 years ago. I am in my 60s and very active but my fitness level has stayed the same.

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I have aortic insufficiency, along with diastolic dysfunction but I have a normal ejection fraction. Does the normal EF make me not a candidate for valve replacement?

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Hey Connect members! We're going to go live at 2:15 CT instead of 2:30, due to the physicians' schedules. If you miss the first part, worry not! It will be archived here for later viewing. FYI @kanaazpereira.

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@audreylaine

Hey Connect members! We're going to go live at 2:15 CT instead of 2:30, due to the physicians' schedules. If you miss the first part, worry not! It will be archived here for later viewing. FYI @kanaazpereira.

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2.15 ET?

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In reply to @sayaboleh "2.15 ET?" + (show)
@sayaboleh

Oops! CT

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Hello @aclanton @m3shl1992 @swsider @cline07,

I’d like to welcome you to Mayo Clinic Connect and let you know that the video has been recorded, and will be archived on this page for future viewing.

I also thought you may also be interested in joining and meeting other members who are talking about heart conditions, including valve disease, rhythm disorders. You can share your story (if you wish), ask questions, get support, and connect with many others like you.

For instance…

@aclanton, you might find this conversation about tricuspid valve regurgitation helpful:
– 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/

@m3shl1992, I found an informative Connect discussion and journal article related to your question:
– Aortic Stenosis & Valve Replacement https://connect.mayoclinic.org/discussion/aortic-valve-calcification/
– Management of Asymptomatic Aortic Stenosis – Evolving Concepts in Timing of Valve Replacement http://imaging.onlinejacc.org/content/early/2019/06/07/j.jcmg.2019.01.036

@swsider, you might be interested in viewing this video Q&A where Mayo Clinic experts talk about congenital heart disorders:
https://connect.mayoclinic.org/webinar/webinar-topic-challenges-in-adult-congenital-heart-disease-what-the-patient-needs/
– Congenital Heart Disease Requires Lifelong Care https://connect.mayoclinic.org/page/congenital-heart-disease/newsfeed-post/infographic-congenital-heart-disease-requires-lifelong-care/

@cline07, an aortic dissection, (or aortic tear) occurs in a weakened area of the aortic wall or when a tear develops in the inner layer of the wall of the aorta. In this discussion, https://connect.mayoclinic.org/discussion/aortic-aneurysms-introduce-yourself-meet-others/ you will meet many members talking about aortic dissection.

I hope this helps, and I truly look forward to getting to know you all.

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@aclanton

At what point should mild tricuspid regurgitation require treatment?

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From Dr. El Sabbagh: Mild tricuspid valve regurgitation is not uncommon. It does not require treatment. It requires follow-up with a yearly physical examination and an echocardiogram every 3 years if you have other cardiovascular comorbidities or 5 years if you do not have any cardiovascular comorbidities.

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@m3shl1992

What is aortic valve diameter requiring replacement in asypmtomatic patient?

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From Dr. El Sabbagh: We use diameter measurements in managing aortic dilatation. We do not use diameter measurements of the aortic valve itself. Remember the aortic valve is connected to the aorta and if you were told that there is a diameter cut off, then this is probably alluding to what I mentioned, which is the aortic dilatation. It depends on many factors including the underlying cause of your aortic dilatation, such as bicuspid aortic valve or a connective tissue disease, as well as family history. If your aortic diameter is more than 3.5-4 cm, then you should follow-up with your cardiologist for investigating the cause and device thing a follow-up plan to monitor closely the rate of aortic dilatation.

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@swsider

Are there differences in prognosis or treatment for valve issues caused by congenital defects versus acquired heart disease?

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From Dr. El Sabbagh: Yes. There are differences in prognosis or treatment of congenital versus acquired valvular heart disease. It depends on the type of congenital heart disease and acquired heart disease. Often, valvular heart disease from congenital heart disease is associated with other congenital defects that would be managed differently than acquired valvular heart disease.

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@cline07

Is it common for a congenital aortic valve tear to require a valve replacement?

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From Dr. El Sabbagh: I am unsure of what congenital aortic valve tear is. If you mean aortic dissection which is a tear in the wall of the aorta, then it depends on the location of the tear. If the tear is in the ascending aorta, then it would need to be replaced. If it is in the descending aorta, some of those can be treated medically. Aortic valve replacement might be needed if the aortic valve is affected.

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@sayaboleh

Two part question. Is it possible for the heart to regain normal function (in terms of exercise tolerance) after multiple valve (mitral & aortic) replacements? Why or why not? What about atrial size and remodeling — does that improve as well? I have a history of rheumatic heart disease and my valves were replaced 3 years ago. I am in my 60s and very active but my fitness level has stayed the same.

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From Dr. El Sabbagh: Great question. The ability to regain exercise tolerance after valve surgery depends on multiple factors, including whether not you have other comorbidities, your baseline level of fitness and functionality before surgery, the extent of damage to the heart from chronic valvular heart disease, medications as well as surgical outcomes. We encourage you to stay active as you are. If you feel that you are not reaching an adequate level of activity and fitness, please consult with your cardiologist to look for the possible causes and who can help you improve your functional capacity.

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