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Fatigue After Mitral Valve Repair

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What Conditions Are Treated With Mitral Valve Repair

Mitral Valve Surgery – The Nebraska Medical Center

Mitral valve repair treats the following conditions:

  • Mitral valve regurgitation. This is commonly known as a leaky valve. Your valve flaps dont close all the way, leading to some blood leaking in the wrong direction. This is most often caused by mitral valve prolapse.
  • Mitral valve stenosis. This is a narrowing of your valve opening that prevents enough blood from flowing through.
  • Mitral valve prolapse. People with this condition have mitral valve flaps that are too floppy or stretchy. About 6 in 10 mitral valve surgeries are due to leaky valves that are caused by leaflet prolapse.

When Will I Feel More Energetic & Less Tired After Heart Surgery Asks Joan

By Adam Pick on August 22, 2012

I just received a very interesting from Joan about being tired after heart surgery.

In her email, Joan writes, I am now 7 weeks post-op and am tired all the time and have no energy. I remember so many folks telling me that after my surgery I would feel so much better and have all this amazing energy. Well, as of now I do not feel as energetic as I did before surgery by a long shot! I had no real symptoms prior to aortic valve replacement even though the valve was badly diseased. Now, everything is a major effort and I get out of breath with the slightest exertion. I have a feeling it may be caused by the metoprolol drug and I do have a call into my cardiologist to see if I can lower the dosage. I am eating a high protein diet and get lots of rest and a nap every afternoon. Do you know when I might be feeling more energetic?

I and many other patients in our community can relate to Joan. Although each patient heals at different rates, it seems like many of us are lethargic, fatigued and tired after heart surgery. Personally, I remember feeling exhausted for the first ten weeks after my valve replacement surgery. I remember saying to Robyn, my wife, Im soooooooo tired. When will I feel like my old self again?

In his response to Joan, Dr. Salenger noted the following:

I hope this Joan learn more about being tired after heart surgery. Thanks to Dr. Salenger for sharing his clinical expertise with our community.

Keep on tickin!

What Is The Mitral Valve And Where Is It Located

The mitral valve is located inside the heart between the left atrium and left ventricle of the heart. It consists of two flaps of tissue called leaflets. This valve allows blood to flow from the lungs to the left atrium and into the left ventricle.

Once blood reaches the left ventricle, the oxygenated blood is pumped to the aorta, which pumps blood throughout the body. When the heart squeezes, the two leaflets of the mitral valve snap shut and prevent any backflow of blood.

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Is Mitral Valve Repair A Major Surgery

Mitral valve repair constitutes a major procedure. It may be performed during an open-heart surgery, which involves definite risk with respect to incision size, anesthesia, and infection risks. In around 60-80% cases, the mitral valve repair can be done through a small skin incision on the right side of the chest. With the advancements in surgical care, the surgical robot further limits the incision size to 1 inch. Even in these cases, the ICU stay is mandated for the first 24 hours after the surgery, and because anesthesia risks are present, the repairs done via robotic or laparoscopic methods, which also fall under major surgery.

Reasons To Call Dr Adams Office:

Minimally Invasive Mitral Valve Surgery
  • If you experience drainage, redness or excessive pain at the sternal incision site.
  • If you have temperature greater than 101, or greater than 100 for over 24 hours.
  • If you experience weight gain or loss of 3-4 lbs in one day.
  • If swelling in hands or feet does not improve.
  • If you feel palpitations.
  • If you suddenly develop shortness of breath or fatigue with your daily activities.

We are aware that problems arise from time to time and that it is not always possible to contact your local doctor. Do not hesitate to call Dr. Adams office at 212-659-6820 and ask to speak to one of our Nurse Practitioners.

If your problem occurs at night or during the weekend and you feel that you can not wait until the morning, call Mount Sinai Hospital at 659-6800 and ask to speak with the Cardiothoracic Surgical Resident on call. If the problem is urgent come into to Emergency Room at Mount Sinai or the hospital nearest your home.

We will be seeing you frequently before your discharge and will try to make your transition from hospital to home as smooth as possible. Please ask any questions or relate any problems to any member of the Cardiothoracic Surgical Team. We will do our best to address your issues or concerns.

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Conventional Mitral Valve Repair And Replacement

Sixteen studies included patient populations who had undergone conventional MVr and MVR. The majority confirmed significant HRQOL improvements following surgery. The largest study by Hansen et al. assessed the safety and efficacy of MVr in 663 patients classified by aetiology . HRQOL improved in all aetiologies post-surgery, with patients with degenerative MR showing better physical scores than an age- and gender-matched population. Patients with idiopathic cardiomyopathy had the worst HRQOL at follow-up. This study also found worse postoperative HRQOL in female patients, even though the male population had more co-morbidities. Van Leeuwen et al. also found that HRQOL was good and comparable to a Dutch population post-MVr in those with asymptomatic severe MR . The physical domains and composite PCSs were even better than those of the general population. These studies support the call for early intervention in asymptomatic patients with severe degenerative MR .

Study Objectives Designs And Population

The 43 studies included comprised a total of 6865 participants . Twenty-one studies were prospective cohorts six were retrospective cohorts three were randomized controlled trials three were non-randomized controlled trials three were cross-sectional studies three were retrospective cross-sectional studies two were postapproval studies one was a prospective casecontrol study and one was a prospective longitudinal study . All studies included patients who underwent intervention from 1976 to the present. Twenty-six studies originated from Europe, 13 from the USA, 4 from Canada and 1 from Australia. Thirteen were multicentre studies.

For ease of reading and improved clarity of results, the studies were categorized into three groups .

Studies including conventional MV interventions

Twenty-three studies reported outcomes from conventional MVr or MVR . .

Twelve of the studies reported isolated HRQOL in MVr or MVR patients treated via a median sternotomy . Generally, patients were found to have improved HRQOL postoperatively, with scores comparable to or exceeding those of normal populations. Interventions appeared to have a greater impact on physical component scores than on mental component scores .

Studies including MitraClip implantation

Sixteen studies reported on MitraClip implantation . All of them showed significant HRQOL improvements postimplantation. Only three studies compared MitraClip with conventional surgery and found similar HRQOL at follow-up.

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Mitral Valve Repair Gives Stover Man Energy To Tackle New Projects

Right next to Kerry Frys home in Stover, Missouri, is a small building with a sign above the door that says, Papas Workshop. It is Frys happy place. Its where he goes to tinker with his immaculately maintained Harley-Davidson motorcycle and build wooden toys and furniture for his grandkids.

But in 2021, the Harley started to gather dust and the woodworking tools didnt get much work. Fry, who was 74 at the time, needed breaks to catch his breath while he and his wife, Sharon, took their evening walks. Eventually, even the short jaunt between his home and workshop was exhausting.

I would just walk a few feet and get really winded, Fry said.

He had suffered a heart attack 25 years earlier, and it damaged the muscle that supported his mitral valve, which separates the left chambers of the heart. The leaflets of the mitral valve didnt close properly to form a tight seal, so blood leaked from his left ventricle back to his left atrium with each heartbeat. The condition called mitral valve regurgitation prevented Frys heart from effectively pumping blood to the rest of his body, which caused him to tire easily.

Mitral valve regurgitation is predominantly seen in middle-aged and older individuals,” said Chirag Bavishi, MD, an interventional cardiologist at MU Health Care. Severe mitral regurgitation can be quite devastating. In addition to frequent symptoms and hospitalizations, it eventually leads to permanent damage to the heart muscle and heart failure.

How Is Mitral Valve Repair Surgery Performed

Transcatheter Mitral Valve Repair: Mitraclip

While you are under anesthesia, your surgeon will make a small skin incision on your chest, opening the middle of your chest at the breastbone to access your heart. Depending on the severity and type of mitral valve disease, surgery may include removing excess tissue from the valve and reconnecting or separating the leaflets of the mitral valve, says Gammie.

Your surgeon may tighten the valve by performing the following techniques:

  • Annuloplasty: During an annuloplasty, the ring around the mitral valve, called the annulus, is tightened or reinforced to reshape the valve so it can function properly.
  • Mitral Valve Clip: A small metal device called a mitral valve clip can be inserted through a catheter from an artery, leg or the groin to the heart. Your surgeon can use the clip to reshape the mitral valve. This type of procedure is considered minimally invasive, and may be used for patients who are at a high risk of complications from open heart surgery.

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Recovering From Mitral Valve Replacement Surgery

You will spend five to seven nights in the hospital following your surgery. After discharge, you will need to rest and recover for three to four weeks at home. Your doctor will talk to you about how to slowly increase your activity for a safe and successful recovery. You will need someone to drive you home from the hospital.

You will be on a blood thinner medication for at least several months following your surgery. Some patients will need to take a blood thinner for the rest of their life.

Learn More About Mitral Valve Regurgitation

  • Types: Primary , secondary .
  • Common causes: Age-related degeneration, prior heart attack, heart failure or infection.
  • Symptoms: Shortness of breath, lightheadedness, fatigue, decrease in exercise tolerance, palpitations and swelling of the legs.
  • Treatments: Medication , percutaneous intervention or open-heart surgery .

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What Are The Risk Factors

Common risk factors for leaky valves are older age, family history, history of heart infections, high cholesterol, high blood pressure, obesity, diabetes, smoking, and lack of physical exercise. Some medications can also put you at risk of developing a leaky valve. While genetic or age-related risk factors cant be changed, managing or reducing the controllable risk factors as much as possible can help reduce your overall risk for leaky valves. Not smoking, maintaining a healthy weight, and daily exercise like walking are important steps to reduce overall risk. As always, check with a doctor before beginning a new exercise program if you have any existing health conditions.

Can Mitral Valve Regurgitation Cause Fatigue And Shortness Of Breath

Minimally Invasive Mitral Valve Surgery

ANSWER

Mitral valve regurgitation might cause fatigue and shortness of breath. The blood coming through the left side of your heart fuels your body, bringing oxygen from your lungs to your cells. If some of that blood is flowing back into the heart instead, you might end up feeling tired or lightheaded, particularly if youve been active. In severe cases, you can find yourself feeling tired or short of breath even when youre at rest.

American Heart Association. Problem: Mitral Valve Regurgitation, What Is Echocardiography?

Johns Hopkins Medicine. Heart Valve Diseases.

Columbia University Medical Center: Mitral regurgitation.

Mayo Clinic. Mitral Valve Regurgitation , .

Harvard Health Publications: Skipping a beat — the surprise of heart palpitations.

MyHeart.Net: Mitral Regurgitation.

NIH. National Heart, Lung, and Blood Institute. How Is Mitral Valve Prolapse Diagnosed?

American Heart Association. Problem: Mitral Valve Regurgitation, What Is Echocardiography?

Johns Hopkins Medicine. Heart Valve Diseases.

Columbia University Medical Center: Mitral regurgitation.

Mayo Clinic. Mitral Valve Regurgitation , .

Harvard Health Publications: Skipping a beat — the surprise of heart palpitations.

MyHeart.Net: Mitral Regurgitation.

NIH. National Heart, Lung, and Blood Institute. How Is Mitral Valve Prolapse Diagnosed?

Other Answers On:

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How Do I Get Ready For An Open Mitral Valve Replacement

As you plan for the surgery, you and your doctor will decide what kind of valve will work best for you. Your surgeon will replace your valve with a biological valve or a mechanical valve.

  • Biological valves are made mainly from pig, cow, or human heart tissue. Biological valves dont last as long as mechanical valves
  • Mechanical valves are man-made. If you receive a mechanical valve, you will need to take blood-thinning medicine for the rest of your life. Mechanical valves also have an increased risk of infection.

Talk with your doctor about how to prepare for your upcoming surgery. Remember the following:

  • Avoid eating or drinking anything after midnight before your surgery.
  • Try to stop smoking before your operation. Ask your doctor for ways to help.
  • You may need to stop taking certain medicines before your surgery. Follow your doctors instructions if you usually take blood-thinning medicines like warfarin or aspirin.

You may need to arrive at the hospital the afternoon before your operation. This is a good time to ask any questions you have about the procedure. You may need some routine tests before the procedure to assess your health before surgery. These may include:

  • Chest X-ray
  • Echocardiogram
  • Coronary angiogram

About an hour before the operation, someone will give you medicines to help you relax. In most cases your surgery will proceed as planned, but sometimes another emergency might delay your operation.

Why Its Better To Have Your Mitral Valve Repaired Than Replaced

Having your mitral valve repaired before symptoms become severe can increase your longevity. Heres one patients story.

When Thomas Kimble discovered he would need to have his mitral valve repaired, he was happy to get a recommendation from his Florida cardiologist for a surgeon highly skilled in minimally invasive procedures.

This eased the decision for the Florida resident to move forward, even though, like many individuals, he wasnt experiencing symptoms of his mitral valve regurgitation, which may include fatigue, shortness of breath, chest pain and an irregular heartbeat.

In fact, just prior to his November 2020 surgery with Michigan Medicine Frankel Cardiovascular Center surgeon Gorav Ailawadi, M.D., the 68-year-old was hiking at 11,000 feet in Breckinridge, Colorado. I may have felt a little fatigued, but I attributed it to my age, he says.

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When Should I Call

  • If you experience drainage, redness or excessive pain at the sternal incision site.
  • If you have temperature greater than 101, or greater than 100 for over 24 hours.
  • If you experience weight gain or loss of 3-4 lbs in one day.
  • If swelling in hands or feet does not improve.
  • If you feel palpitations and suddenly develop shortness of breath or fatigue with your daily activities.
  • Do not hesitate to Cardiovascular Surgery at 212-659-6800 and ask to speak to one of our Nurse Practitioners.

    If your problem occurs at night or during the weekend and you feel that you cannot wait until the morning, call Mount Sinai Hospital at 659-6800 and ask to speak with the Cardiothoracic Surgical Nurse Practitioner or Physician Assistant or Resident on call.

    Page Created: December 19, 2017

    Edwards Sapien 3 And Edwards Sapien 3 Ultra Transcatheter Heart Valve System

    After Mitral Valve Repair, Brian Walsh Keeps On Running!

    Indications:

    The Edwards SAPIEN 3 and SAPIEN 3 Ultra Transcatheter Heart Valve system is indicated for relief of aortic stenosis in patients with symptomatic heart disease due to severe native calcific aortic stenosis who are judged by a Heart Team, including a cardiac surgeon, to be appropriate for the transcatheter heart valve replacement therapy.

    The Edwards SAPIEN 3 and SAPIEN 3 Ultra Transcatheter Heart Valve system is indicated for patients with symptomatic heart disease due to failing of a surgical or transcatheter bioprosthetic aortic valve, a surgical bioprosthetic mitral valve, or a native mitral valve with an annuloplasty ring who are judged by a heart team, including a cardiac surgeon, to be at high or greater risk for open surgical therapy risk score and other clinical co-morbidities unmeasured by the STS risk calculator).

    Contraindications :

    The Edwards SAPIEN 3 and Edwards SAPIEN 3 Ultra Transcatheter Heart Valve System should not be used in patients who:

    • Cannot tolerate medications that thin the blood or prevent blood clots from forming.
    • Have an active infection in the heart or elsewhere.
    • Have a mitral ring that is damaged and can no longer support the valve.

    Warnings:

    Precautions:

    The safety and effectiveness of the transcatheter heart valves are also not known for patients who have:

    Potential risks associated with the procedure include:

    Additional potential risks specifically associated with the use of the heart valves include:

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    Suggestions For Further Research

    Although HRQOL is not new , it is surprising that not many studies have included this parameter. Given the greater importance of HRQOL than clinical variables to patients, it should become an essential tool to evaluate patient-centred benefits. Furthermore, though most studies included used the SF-36, there has been no consensus as to which instrument is best to determine HRQOL improvements in MV surgery and in fact whether a separate one is needed altogether.

    Most of the studies support the fact that MV surgery appears to have a more significant impact on physical rather than mental functioning. With the improvement of technology, the inclusion of activity monitors, such as wrist-worn accelerometers or even smartphone applications that exploit built-in accelerometers, might be useful in monitoring physical activity before and after intervention, providing another corollary to reinforce HRQOL conclusions.

    As established by certain studies, clinical and demographic parameters may be used to predict post-surgical HRQOL improvements . However, these studies have been unable to quantify the effect each had on HRQOL impairment. Further research that establishes quantifiable predictors of a change in HRQOL, for example physiological biomarkers , may allow more innovative analysis, correlating magnitude of improvement to changes in these markers. Radiological measures were not analysed in any of the studies and should be used as future markers of functional outcome.

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