Valve Replacement Surgery: Do I Need it? Next Article
Surgery is often promoted as the best option for valvular heart disease. Whether it is right for you largely depends on which type of valve malfunction you have. I often see patients with mitral regurgitation for whom another doctor has recommended surgery.
When the mitral valve leaks, the left atrium of the heart becomes stretched. This can certainly create problems, but it is less critical to overall cardiac function than the effects of aortic regurgitation or leak from the aortic valve. Therefore, I tend to be very conservative when it comes to mitral valve surgery unless quality of life is compromised.
For example, I do not believe surgery is best for someone age 80 or older, who has tolerated a leaky valve for many years. For those folks, and others with the condition, I usually recommend they monitor their symptoms carefully and see their cardiologist if symptoms intensify. You should have annual echocardiograms to monitor the status of your leaky valve.
Metabolic Cardiology has enormously improved patients with heart failure or dilated cardiomyopathy as a result of regurgitation or leaky heart valve.
Metabolic Cardiology involves increasing the energy reserves of the heart, and increasing ATP that the heart needs to function.
These targeted nutritional’s include Q10, magnesium, carnitine and D-ribose pqq, daily to support heart health.
It is a different, and more troubling situation for aortic valve.
When this becomes leaking, especially if the heart has started to become enlarged as a result, the condition must be followed closely. This condition called aortic regurgitation, if severe, is an indication for surgery. The heart pumps blood out of the left ventricle into the aortic valve, where it moves into the aorta and to the rest of the body.
Because a leaky valve cannot shut tight, some of the blood will slosh back into the left ventricle. The left ventricle then has to work harder to completely expel the fluid, and it eventually becomes swollen. Once the heart wall stretches and thins, it will not return to normal size. Sometimes medications have shown improvement, but long-term follow up is needed. The timing of aortic valve replacement is somewhat a dilemma.
I choose to be aggressive. I prefer aortic replacement sooner rather than later when less damage to the heart has been done.
There are new, minimally invasive, transcatheter approaches in replacement of the valves. They appear to be effective with decreased mortality and morbidity, especially in the elderly and nonsurgical candidates.