Brief Answer:
I would explain as follows:

Detailed Answer:

Hello!

Welcome on HCM!

I understand your concern and would like to explain that when discussing about mitral valve surgery it is important to consider two main issues (which will determine to a major degree the most appropriate surgical strategy to follow):

1) the primary cause of mitral valve dysfunction.

Is it a consequence of an inflammatory/infectious disease such as rheumatic heart valve disease, endocarditis?

Or, it is caused by a systemic, degenerative disorder, such as any connective tissue disease leading to myxomatous degeneration of the valve and subsequently to mitral valve prolapse with severe mitral regurgitation.

Also, mitral valve calcification due to accelerated degenerative process with aging may be a cause of mitral valve disease (valve stenosis with/or regurgitation). This latter phenomenon is more likely in the presence of certain concomitant chronic disease (such as chronic renal disease, certain endocrine disorders, etc.).

In general, if the mitral valve is affected by rheumatic process; it become severely distorted (thickening and extreme calcification of valve leaflets with additional fusion of chordae tendineae and entire subvalvular apparatus) making valve repair and thus its preservation almost impossible.

Whether this kind of valve disorder may be repaired with valve preservation will depend on the degree of each valve components impairment. For serving this purpose, it is necessary to make a careful and precise cardiac ECHO evaluation.

If valve damage is severe enough to not permit repair, valve replacement remains the procedure to follow.

In your case a bioprosthesis would be more appropriate, as it would avoid anti-coagulation (with its potential complications) and also the risk of valve thrombosis.

If the valve is not severely affected, or if the cause of dysfunction is myxomatous disease (mitral valve prolapse), then repair would be more likely.

Nevertheless, I would like to let you know that, even when the valve could not be preserved, if surgery is performed by experienced hands and adequate long-term post-surgical care is maintained, there is no any substantial difference in prognosis and life expectancy for a patient of your age.

So, you shouldn't worry too much about!

Just relax, as your heart valve problems are easily managed nowadays.

2) the cardiac surgeon expertise.

When the surgical team possesses the adequate medical expertise on valve surgery (that is extended training and long daily practice with such patients treatment), then the likelihood of mitral valve repair is greater.

There are several cardiac surgical centers that may treat mitral valve disorders by applying mitral valve preservation with just repair procedures in up to 95 -97 % of patients.

That's why, it is important to have the opportunity of being treated by expertise hands.

Hope you will find this answer of some help.

In case you have any further uncertainties, or a recent echo report available, please let me know and upload the results for a second professional opinion.

Kind regards,

Dr. Iliri

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