Janet's Guestbook

Thank you so much, Delise, for reaching out to me. Mine started leaking, minimally, two days after surgery. An echo two months after surgery showed moderate regurgitation. I was so upset! Especially since the surgeon had told me after surgery that it was completely successful. My cardiologist, in consultation with the surgeon, put me on a beta blocker to slow down my heart and lower blood pressure in hopes that the heart will remodel and regurgitation will be less. I have an echo tomorrow and meet with the cardiologist next week. I'm hopeful, but very skeptical at this point. I just wish I had gotten a second opinion before surgery! You are right. There are great surgeons listed on this site. My first choice was the Cleveland Clinic, but I didn't want to travel if I could get the surgery done locally. Wish I had travelled. Will update this after I get an update from the cardiologist next week. I really dread going through heart surgery again. Once was more than enough! I'm so sorry that you had to go through that again. Please keep me posted on how you are doing after your latest surgery.

Hi, Janet, what is your BP,maybe this is cultprit? Is your BP high? Another reason is not good enough repair - did the surgeon put a new chords, or just made resection to tighten you valve? Which leaflet of the valve was affected - anterior or posterior, which segment of the leaflet?

Deena, I think they did try to explain why the leaflet became stenotic, but I honestly don't remember. I think something was said about the fact that the initial repair included putting a ring around the valve, and my tissue growing around it??? But, that may not be at all accurate. It was just the anterior leaflet that was affected.

My blood pressure is normal, but my heart rate went off the charts and is now controlled by beta blockers. The surgeon's report indicates that he replaced a ruptured chord and did something else with a chord. However, I don't know the specifics since he has chosen not to communicate with me on the surgery and its disappointing outcome.

Janet, I haven't been on this site for a while, but I am very sorry to hear that your surgeon is being unresponsive. Could your cardiologist give him a call to discuss? It won't hurt to ask. I know my surgeon and cardiologist communicated both before and after my surgery. Asking these two doctors to talk might provide you with the information you need. Best of luck to you!

The difficult lesson I learned is that the surgery can seem to eliminate regurgitation entirely. The initial TEE done before they completed the surgery showed no regurgitation. Two days later, an echo showed slight regurgitation. Eleven weeks later, an echo showed moderate regurgitation -- but, a much less forceful flow of blood backward into the left atrium. I wasn't prepared for those results. My left ventricle is smaller than it was before surgery and loose chordae (a new condition) are causing some regurgitation, although it's not as bad as it was before surgery. Now, I'm on a course of medical treatment to slow down the heart rate in the hopes that the heart will continue to remodel and the regurgitation will subside even more. I will have another echo in November, hoping that the results are better. I'm 12 weeks post-op and feeling stronger every week. That's the good news. Also the left ventricle's ejection fraction has returned to normal -- it wasn't where it needed to be at the one month post-op and there was speculation that drugs might be needed to correct that. Fortunately, it corrected itself! Which shows that the heart is a dynamic vessel. In my case, it certainly has done some shape shifting over the past twelve months. I wasn't aware that the initial good results could change after surgery. I just knew that Inova has a high success rate for mitral valve repair. The cautionary tale is that it may take a while for that success to fully, or partially, manifest itself. Good luck! I was overly optimistic about recovery. I was very fit and asymtomatic prior to surgery and thought I would be myself after 12 weeks. Cardiac rehab at the Fairfax Hospital has been highly beneficial and I've been able to shave lots of minutes off of the miles I'm hiking. At this point, restrictions have been lifted and I'm doing weight training and I'm back in the pool swimming laps. The nutritionist in rehab was a great resource. Inova is the hospital designated as a center of excellence for mitral valve in the DC area. I'm glad I had my surgery there. I guess my only advice is that you ask about possible outcomes so you are prepared for multiple scenarios!

Hi Janet - Thank you so much for this excellent explanation. You have made a great recovery and I really like your stepwise recovery. Great job! You mentioned the longer chord (chordae). Do you and Dr Sarin think this chordae issue could contribute to the moderate MR then, post surgery? How did you find the first two weeks - post recovery? I recall you mentioning needing help at first when I read back. I think I will need to line this up. Was INOVA impressive for the ICU and Step down care? Always happy to chat further - and I thank you sincerely for this. J A.

Dr. Sarin didn't respond to my messages asking why there was moderate regurgitation after he had declared the surgery results excellent. He speaks only with my cardiologist and dropped me like a hot potato once the echocardiogram showed significant problems. The cardiologist, after repeated questions from me, finally acknowledged that the loose chordae are causing the regurgitation now. I would not recommend Inova for heart surgery.