I just received a unique question from Dave about situs inversus and heart valve replacement.

Dave writes, “Hi Adam, I was recently diagnosed with severe aortic regurgitation and a dilated aorta. It’s now time for a valve replacement. I was born with situs inversus with dextrocardia – a rare condition in which my abdominal organs are reversed so my heart is located in the right side of my chest. I’m wondering if any of your readers have situs inversus? I would like to hear their experiences with valve replacement surgery. Thanks for your book! Dave”

This is the first time I heard about situs inversus with dextrocardia. That said, I really wanted to help Dave and learn more about this condition. I wasted no time in contacting two, surgical experts for their opinions.

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I just received an interesting question from Jenny about the size of a mechanical heart valve replacement.

Jenny writes to me, “Adam – Like many patients on your blog, I’m preparing for aortic valve replacement. I’m young, 29, with a bicuspid aortic valve that has severe stenosis. I’m thinking a mechanical valve is the best option for me. However, I can’t stop thinking about the little device clicking away in my heart. Quick question… Do you know the size of a mechanical heart valve? Thanks, Jenny”

There are a few ways to answer Jenny’s question. On one hand, I could assemble a table which contains the different sizes of mechanical valves — by diameter and by surface area. However, I often think the cliche, “A picture is worth a thousand words”, is more appropriate. That said, a mechanical valve is about this big…

Pretty neat picture, right?

However, I thought Jenny might want to learn the actual dimensions of a mechanical valve replacement.

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I just received a very unique question from Barb about carcinoid tumor injections and bovine heart valve replacements. Barb writes to me:

Bovine Aortic Valve Replacement

Hi Adam,

First, I’d like to express my appreciation to you for your very informative book and emails.  I am a 54-year-old woman who was aware of aortic valve stenosis since the age of 16, and finally had an aortic bovine valve replacement in January 2009.  I also had an aortic root aneurysm repair.  I’ve done very well in my recovery, and found your book extremely helpful.

I was diagnosed with carcinoid cancer in 2001.  Surgery was all that was required at that time.  I know that carcinoid cancer and valve problems often go hand-in-hand, although I’ve been told by my doctor that it’s not usually the aortic valve that is involved.  In November 2009, my carcinoid cancer returned.

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Here’s an interesting question from Julie about heart valve stenosis and enlarged hearts.

Julie writes to me, “Adam – Like you, I was diagnosed with heart valve stenosis and an enlarged heart. I’m just curious. How big can a dilated heart get before failure? 20% bigger? 50% bigger? Any thoughts? Thanks, Julie”

I wanted an expert opinion for Julie’s question, so I contacted Dr. Kevin Accola, M.D., one of the leading heart valve surgeons from Florida Hospital Cardiovascular Institute. (As you might recall, Dr. Accola has operated on several patients, like Scott Nieman, that regularly visit this blog.)

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I just received a great question from Diane about heart valve replacements.

Diane writes, “Adam – Yesterday, I was diagnosed with severe mitral regurgitation. My cardiologist said I should start planning on having my heart valve replaced soon. I’m confused by all of this. One thing I can’t figure out is where will the new valve goes? Do you have any pictures that could help me visualize this? Diane”

To see how a heart valve replacement device is positioned in the mitral location, please review the picture above. As you can see, a mitral valve replacement – which is typically a tissue valve or a mechanical valve – is inserted where the defective valve previously resided in the heart.

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