Comments on: Register Now For Dr. Gillinov’s Interactive Chat On Wednesday, February 3!

By: brian Sorenson

brian Sorenson — Wed, 03 Feb 2010 19:01:38 +0000

Hi Dr. Gillinov. I am a 50 yr old male who had his aortic valve replaced with a cow valve on May 13, 2008. Up until then I ran 7 min. miles, 4 miles per day and was fit. For two weeks after surgery I was off of pain pills and walking three miles per day. Then at around two weeks I started getting chest pain in the night so bad I went to the hospital. They found a small effusion on the pericardital sack. I was given some pills to take for a week. For months after that every couple weeks I would get severe chest pain that would knock me to my knees. It would last five minutes or so. I have gradually gone down hill to the point that if I am active the chest pain starts to build (like someone is standing on my chest). If I sit down when I first feel it it will gradually go away but if I continue being active the pain goes to a eight on the scale and lasts for hours. I take about three to four Lorcets a day for the pain. The cardiologist have done many tests and only can find a hardened off area on the sack in which they don’t think will cause this kind of pain. They took me off my aspirin and within two weeks I had two TIA’s. The Neurologist thinks that if the heart sack is anything like the sack around the brain, it is full of nerves and this would be causing me the pain. He wants me to try Lyrica to deaden the nerves. My quality of life is really bad and at my wits end. The cardiologist thinks its a 50/50 chance its the sack. Please help. Thanks

By: Dana Robertson

Dana Robertson — Wed, 03 Feb 2010 18:51:56 +0000

Can you speak briefly about appropriate valve surgery for patients with HCM. I read and hear discussions about using rings for repair, but I understand that is NOT the way to go for HCM patients as that may cause the condition to worsen.
thanks

By: Gregg Pearlstone

Gregg Pearlstone — Wed, 03 Feb 2010 17:51:35 +0000

I am a 48 year old male with BAV. I have no real issues with stenosis to date. I do have an issue with an enlarged aorta. The enlargement is at the root (4.4 cm). I would like to know your thoughts on aerobic excercise for someone in my condition. I currently run about 20 miles per week. I have shifted to running inside on a treadmill and occassionally use of a eliptical trainer. I guess I did this for peace of mind in case something happens I would have people around to call for help. Should I be monitoring my blood pressure while excercising? I don\’t have any blood pressure issues at this time. Typically averaging, at rest somewhere around 125/85. I am also scheduled my 6 month Eco follow up the first of March. Thanks.

By: John Adourian

John Adourian — Wed, 03 Feb 2010 17:45:56 +0000

questions for Dr. Gillinov:
!. Do you have any dietary recommendations to slow the progression of stenosis for folks who have high HDL and low LDL/triglycerides ie Vitiman D?

2. Do you see advances coming in the near term for removing calcium from the flaps arthroscopically with long term success?

By: Sam Swerdlow

Sam Swerdlow — Wed, 03 Feb 2010 17:09:22 +0000

Dr. Gillinov,
Are you performiing aortic valve replacements in the minimally invasive procedure carried out through the third intercostal space (in-between two ribs) and therefore eliminating any bone cutting? If so, who may be a candidate for this procedure and why?
Thank You,
Sam

By: Michel

Michel — Wed, 03 Feb 2010 14:27:37 +0000

Hello Dr. Gillinov
I am 44 years old (male) french living in France.
I have an aortic stenosis and need an AVR in the next few month (mean gradient 45 mm Hg, Peak velocity across aortic valve is 4.3 m/s, aortic valve area index is .5cm2/m2). I am full asymptomatic.
I do not smoke , no alcohol and do sports (running, soccer without problem), well active. I travel a lot for my job. My cardiologist wants absolutely a mechanical valve, because he’s scared for the 2nd surgery. I would prefer a valve repair or a tissue valve to conserve all my activities. What do you think about that. Am I right to impose a biological valve ? Is it convenient to undergo a surgery while asymptomatic.

Thank you very much

By: Mark

Mark — Tue, 02 Feb 2010 22:38:47 +0000

Dear Dr. Gillinov:
I am a 76 yr. old who for about 20 yrs. was diagnosed with MVP and mild to moderate MVR but whose regurgitation was found severe first time in May 2008. I also underwent in Nov. 2009 an unsuccessful attempt to implant a mitraclip (e-Valve) transcatheter device at fhe end of which the device was withdrawn without problems as not being able to adequately reduce the regurgitation level. I have also scoliosis, but besides my MV problem and a moderately enlarged left atrium nothing else was found wrong with my heart and coronary arteries (clear of plaques).
Based on these facts;
1.Could the failed implant of the mitraclip affect in any way the nature of the contemplated MV surgery (repair)?
2.How does the presence of scoliosis impact on the nature of surgery?
a. does it entails a (much) higher surgery risk and if so, how much higher?
b. could it preclude the repair of MV thus requiring a replacement?
c. could it affect the options of using minimally invasive or robotic procedures?
Many thanks, Mark

By: Kathy

Kathy — Tue, 02 Feb 2010 19:52:32 +0000

had minimally invasive arotic valve replacement at cleveland clinic dec. 09. how long could i be on metoprolol? i normally do not have a blood pressure problem?

By: Dorothy Delman

Dorothy Delman — Tue, 02 Feb 2010 19:33:16 +0000

Dear Dr. Gillinov:

On what basis is a determination made to use a bovine vs. a porcine valve?

Thank you!
Dorothy

By: Micki

Micki — Tue, 02 Feb 2010 14:54:31 +0000

My surgery was 8 months ago. My sternum has not healed properly. I can still feel it move. My surgeon can feel it as well and CT scans have proven that. I am scheduled for surgery later this month. I have been informed that there are a few options but they won’t know for sure what the procedure will be until they open me up and see what is there. Is this normal? And should I be concerned? I orginially had a bicuspid aortic valve replaced with a bovine valve and had a 5.5cm aneurysm in the ascending aorta. The aorta was very thin and needed to be grafted. 16 hours after my surgery I did code twice and a week later had a defibrillaor inserted. I feel great but I am concerned I am 63 yrs old and in excellent health. All of this came as a surprise to me when I made a visit to an emergency room just because I felt odd. I am so glad I made that visit.