Re: OT: Mitral Regurgitation, durability of repair

dave a wrote:
Mark & Steven Bornfeld wrote:
Yes, I do trust youze guys enough to discuss this with you--I think there's probably more medical smarts here than on sci.med (where this is also posted). Those who ever look in on sci.med may know that with a very few exceptions, this is in the "damning with faint praise" category. In any case...


My brother underwent a mitral valve repair about 6 weeks ago. His postop course was complicated by bleeding requiring transfusion and a return trip to the OR on a fruitless search for bleeders. Otherwise his postop healing has been satisfactory. He still suffers from dysgeusia which does not seem to be resolving as yet.
In my brother's ill-advised quest to drive himself crazy by searching for depressing clinical studies on the web, he's found this:

http://circ.ahajournals.org/cgi/content/abstract/107/12/1609

Now, admitting that this is not a new review, and that results may be markedly different depending upon how the statistics are parsed, does this say anything about the advisability of surgerizing totally compensated mitral regurgitation?
I'd love to know what you think before I go for my first echo in 25 years in a couple of weeks.


TIA,
Steve




Well, I have no medical expertise whatsoever, but, the article you linked to seems to say that if it's not broken, don't fix it.

- dave a

P.S. Hope your brother has a complete recovery.


Thanks. And (fulfilling my prediction) my post generated a reply sooner than it did to sci.med.

With regard to the review article, I was a bit wary from the first when surgery was recommended to my brother. What we didn't know is how long the mitral regurgitation had existed, and whether and how fast it was progressing. This is the stick they hit you with--if you wait for cardiac decompensation, the results won't be so great.
It's also possible that even if there is relapse of the regurgitation that the possible sequellae (most importantly cardiomyopathy and progression to heart failure) may have been delayed by the years during which there was no regurgitation. So I'm not saying that the surgery is not warranted. But obviously given the serious nature of the surgery, it's not unreasonable to expect a more durable result.

Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
.

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