Special Video: The Final “Ask Me Anything” from the Mitral Conclave
By Adam Pick on June 30, 2015
Great news! Our ‘Ask Me Anything’ video series from the Mitral Conclave Conference has been an educational hit!
In this… The final video, we wanted to do something special. We didn’t just answer one question. Nope! We wanted to jam-pack this educational video with some of the most important and the most commonly asked questions you submitted about mitral valve surgery. So, in the video below, you will find six questions answered!
Many thanks to Drs. Adams, Anyanwu, Boateng, El-Eshmawi and Swain for taking the time to answer your questions in this final Ask Me Anything from the Mitral Conclave!!!
To watch our other AMA videos:
- Ask Me Anything #3 – How bad does my murmur have to be before it’s fixed?
- Ask Me Anything #2 – Is the MitraClip a standard procedure?
- Ask Me Anything #1 – Are palpitations a sign of mitral valve disease?
Keep on tickin!
P.S. For the hearing impaired members of our community, I have provide a written transcript of this video below:
Question #1: What is your advice for a patient diagnosed with mitral valve regurgitation?
Dr. David Adams: If you’ve been told that you have mitral valve regurgitation, you should go see a Cardiologist. The Cardiologist will do a physical exam, and based on that physical exam and your history, he can then decide whether you need an echocardiogram. A transthoracic ECO is not invasive; it’s a 15 or 20-minute study and it gives us a baseline to understand not only your mitral valve function but also your ventricular function. How strong your pump is squeezing. If there’s any concern at all, an echocardiogram is a very easy way to understand better whether it’s something that’s going need to be focused on in the future.
Question #2: Why is a mitral valve repair better than replacement?
Dr. Ahmed El-Eshmawi: Across the boards now, it is well known that a repaired valve is a procedure with less risk during surgery than a valve prosthesis. Survival after mitral repair, there is no doubt it’s better than mitral valve replacement. The reason for that, you keep the natural tissue, you keep the blood supply, resistance to infection is better. You have less chances of having endocarditis on a repaired valve. Putting in a prosthesis is a risk. If you have a metal valve, you’re going to be at risk of thrombosis, risk of strokes. Still we believe in the biological repair as a biological solution for the mitral valve disease.
Question #3: Is there anything a patient can do to enhance the durability of a mitral valve repair?
Dr. Percy Boateng: Well there’s not much a patient can do to enhance the durability of a for mitral valve repair. The first key thing to having to do a mitral valve repair is having to further repair an initial operation. You cannot break the mitral valve until it’s fixed. You should not have to think very much about it after it’s repaired. You should have a normal life, not worry about any other factors. You should be able to just live your life without thinking of your valve.
Question #4: How does the heart bypass machine affect the brain during and after mitral valve surgery?
Dr. Anelechi Anyanwu: During routine mitral valve surgery, the bypass machine has a negligible effect on the brain. The vast majority of patients will go through surgery with no noticeable effect whatsoever on the brain. There are, however, a very small minority of patients, usually below 2%, that can suffer a significant clinically relevant brain injury, for example, having a stroke after heart surgery, which thankfully, is quite rare. If it occurs, in most patients it is treatable and most patients will get reasonable recovery.
Question #5: Why is it so difficult for patients to get accurate information about things like quality and mortality rates at hospitals?
Dr. Julie Swain: If you’re looking at cardiac surgery, quality is difficult to define by everyone. We have the best measures and data of any specialty in medicine, but it doesn’t capture everything. The difficulty is finding data that you can trust that really reflects what the whole program does. There’s a correlation – it’s not perfect – between volume and outcomes. I would be looking at a high volume center, but that’s not good enough to do a lot; you have to know that you do them well. You would like to know the patient mortality or death rates with the procedures associated and other major complications, like stroke. Again, hospitals don’t operate, surgeons do, so you not only want a hospital that is good at this but you want surgeons that are individually good at it.
Question #6: I was told need mitral valve surgery. What should be my next step?
Dr. David Adams: I think patients that are told they need mitral valve surgery should get themselves educated, particularly if it’s elective. Get a couple of opinions. Make sure that you’re going to keep your valve; it’s a living part of your body. There’s no artificial device we can put inside the heart that can beat your own living tissue. I think it’s so important to get opinions and be really confident in your team before you undergo a procedure like that.