43 Patient Questions Answered by Dr. Kevin Hodges!
Written By: Adam Pick, Patient Advocate, Author & Website Founder
Medical Expert: Kevin Hodges, MD, Cardiac Surgeon, Northwestern Medicine
Published: April 17, 2024
Fantastic!
During our recent patient webinar, “5 Warning Signs You May Need Heart Valve Surgery”, I received 43 questions that we did not have time to answer during the live event. Imagine my surprise when Dr. Kevin Hodges, a leading minimally-invasive heart surgeon at Northwestern Medicine and the featured speaker of the webinar, typed up answers to each patient question and asked me to post them here to help educate our patient community.
Question #1: Deborah asks, “Had an aortic bivalve replaced in 2017. Now another valve is beginning to regurgitate…moderately… Is this unusual, when I haven’t had any issues with other valves before, or does this happen?
Every patient, heart, and valve is a little bit different. We do see that over time patients may develop new or worsening regurgitation in a different valve. For instance, a patient with a previous aortic valve operation may subsequently develop mitral valve regurgitation, which is not necessarily unusual. We would recommend monitoring the other valve with regular echocardiograms and looking out for signs and symptoms of heart failure or decreased heart function. If the regurgitation becomes severe, it is possible you may need a second procedure. — Dr. Kevin Hodges
Question #2: Chris asks, “If one has both persistent A-Fib AND moderate Aortic Valve Stenosis, which should get fixed first? Secondly, what is the key determining condition for TAVR procedure?”
For patients with atrial fibrillation and significant valvular heart disease, we often address both simultaneously during a concomitant procedure. For instance, a patient could have an aortic valve replacement and a maze procedure with left atrial appendage ligation in the same setting. In your case, the approach would be partly determined by the severity of the aortic valve stenosis (is it barely moderate or nearly severe) and the symptom burden of your atrial fibrillation. There are multiple treatment options for both problems, which need to be individualized for a particular patient. Patient selection for TAVR is based on a number of factors, including the type of aortic valve disease, anatomy of the valve, and patient risk factors and comorbidities. One condition that favors surgical aortic valve replacement is atrial fibrillation, because that can be addressed with a concomitant maze procedure at the time of aortic valve replacement. — Dr. Kevin Hodges
Question #3: Robyn asks, “Can you fix Afib at the same time as the valve if you are doing an open heart surgery?”
Yes. For patients with atrial fibrillation who need heart valve surgery, we perform a concomitant procedure called a maze procedure. This is a type of ablation procedure with an 80-90% chance of eliminating atrial fibrillation. We also close of the left atrial appendage with a clip, which reduces the chance of stroke. — Dr. Kevin Hodges
Question #4: Nader asks, “I’ve been in persistent AFIB for almost 2 years and been on Calcium blocker and 81 mg aspirin. I’m a 53 year old male and no high blood pressure or diabetes just a little high LDL. I recently found out my MVR became severe. I am the sole bread winner for my family and cannot afford 3 plus months recovery time. What qualifies me for minimally invasive repair with robotics?”
There are a number of factors that determine whether a patient is a good candidate for a robotic operation. These are based in part on results of an echocardiogram, CT scan, and coronary angiography. For patients with significant atrial fibrillation, sometimes a traditional operation is best, because it gives us the best chance of completely eliminating the atrial fibrillation and managing the left atrial appendage, which has a significant effect on long-term outcomes and even life expectancy. However, we always weigh multiple factors when planning an operation. It is also worth noting that the recovery time following a traditional operation for a healthy 53 year old is likely to be much shorter than 3 months and probably closer to 6-8 weeks. — Dr. Kevin Hodges
Question #5: Georgia asks, “What age is considered “TOO YOUNG” for TAVR as initial treatment of calcified AVR?”
There is no hard cut-off for TAVR vs surgical AVR (SAVR) in terms of age. We weigh multiple factors, including age, risk factors for surgery, comorbidities, and valve anatomy (e.g. tricuspid vs bicuspid). This field is also evolving rapidly as we gain more experience with TAVR and as new technology becomes available. In general, I think most would agree that younger patients (especially younger than 60) are still best treated with surgical aortic valve replacement as long as they are low risk for surgery. The good news is most younger patients can be treated with a minimally invasive approach. In many cases, this can be a right anterior mini thoracotomy that does not require dividing the sternum. — Dr. Kevin Hodges
Question #6: Dixie asks, “Should I only consider a doctor or hospital that will do the Sentinel procedure for the TAVR? My mother had a stroke and had AFib.”
The Sentinel device is a type of filter that is designed to prevent debris from the aortic valve from causing a stroke during a TAVR procedure. A large study of this device did not show a statistically significant reduction in stroke in patients who had this device in place during a TAVR procedure (https://www.nejm.org/doi/full/10.1056/NEJMoa2204961). However, there are many who believe strongly in the value of the Sentinel device and who use it routinely. From the above study, it also seems that there were few risks associated with use of the Sentinel device. Based on the available data, I don’t think it would be fair to say you should only consider a center that uses Sentinel, but I would encourage you to discuss this issue with your providers when deciding where to have your procedure. — Dr. Kevin Hodges
Question #7: Pat asks, “Does exercise help or hinder valve regurgitation?”
I am not aware of any data to suggest that exercise (or diet for that matter) affects the rate of progression of valvular heart disease, but a healthy lifestyle can certainly help with the recovery from any potential valve surgery or procedure. However, in patients with severe valve disease, strenuous exercise can sometimes be dangerous, and I would recommend talking to your doctor about your exercise plans. — Dr. Kevin Hodges
Question #8: Bill asks, “My situation looks like the left pic but they say I have severe leaky mitral valve. I don’t have any symptoms except sometimes I feel a little tired periodically during the day and so when do I need to do the surgery?”
Timing of surgery in your situation has to do primarily with (1) how likely we are to get a good, durable repair and (2) how risky it would be to perform surgery based on your comorbidities. For healthy patients with a high likelihood of a durable repair, we offer early surgery because this is associated with the best long-term outcomes. In patients with multiple other medical problems or a valve that may not be repairable, we recommend waiting until you develop symptoms or signs of worsening left ventricular function. — Dr. Kevin Hodges
Question #9: Peter asks, “Is a prolapsed mitral valve actually heart “disease” or is it really more of a mechanical malfunction?”
Often when people say “heart disease” in the media we think of coronary artery disease but this term applies to a broad range of conditions. Mitral valve prolapse is more on the spectrum of congenital or genetic heart disease that leads to a mechanical malfunction of the valve over time. — Dr. Kevin Hodges
Question #10: Anonymous Attendee asks, “I have severe tricuspid regurgitation Previously I had mitral valve repair (14 years ago). Now with congestive heart failure my dr has said he will not ever have me under open heart surgery and thinks that a tricuspid clip is likely not to help me with my particular situation. I don’t understand this- might you be able to speculate why a clip would not benefit me?”
Some patients have progression of tricuspid regurgitation after a mitral valve repair procedure. In most cases, these patients had mild to moderate tricuspid regurgitation at the time of their first operation. Reoperation for severe tricuspid regurgitation is associated with increased surgical risk (at least 5-10% operative mortality), especially if patients have developed liver or kidney failure from their leaky tricuspid valve. However, high risk surgery may be appropriate for certain patients and there are a number of investigational transcatheter repair or replacement options that could be considered. I recommend getting a second opinion (this is never wrong) from a center that participates in trials of transcather tricuspid replacement to ensure that you have exhausted all of your options. — Dr. Kevin Hodges
Question #11: Michael asks, “My diagnosis is severe aortic stenosis. I have been doing a ton of research on newest studies for reversal and decalcification. Can you share your thoughts on this?”
So far, there is no convincing data for a way to reverse aortic stenosis or decalcify an aortic valve. At this time, patients with severe aortic stenosis should be thinking about a valve replacement procedure, either surgically or with a TAVR procedure. The specifics of timing and choice of procedure are based on the severity of the aortic valve stenosis and patient comorbidities, including age and other medical problems. — Dr. Kevin Hodges
Question #12: Anonymous Attendee asks, “I developed HFrEF after robotic mitral valve surgery with 37% EF. One year later and after using the 4 pillars of medications it is now 56%. Is this common?”
It is not uncommon for a patient’s ejection fraction to decrease after mitral valve repair. This is because ejection fraction, which is a two-dimensional estimate of left ventricular function, can be overestimated in the setting of severe mitral regurgitation. After surgery, when the mitral regurgitation has been eliminated, the ejection fraction is often initially lower. In many cases the heart will remodel over time and the ejection fraction will return to normal or near-normal over the course of several months. — Dr. Kevin Hodges
Question #13: Michael asks, “Where can I get a second opinion?”
You are always more than welcome to get a second opinion from Northwestern Medicine from anywhere in the world via telehealth (or in person, if you prefer). Otherwise, the Society of Thoracic Surgeons (STS) provides a star ranking system for programs based on certain common cardiac surgery procedures, which can give you some guidance on the quality of programs in your region. There are national rankings, like US News & World Report, which can be useful but should be taken with a grain of salt. One great resource is Adam Pick and his excellent patient advocacy site, heart-valve-surgery.com. — Dr. Kevin Hodges
Question #14: Trish asks, “What is the age for TAVR? My doctor said I’m too young at 59. They are wanting me to have the older way with cutting my chest plate open.”
There is no hard cut-off for TAVR vs surgical AVR (SAVR) in terms of age. We weigh multiple factors, including age, risk factors for surgery, comorbidities, and valve anatomy (e.g. tricuspid vs bicuspid). This field is also evolving rapidly as we gain more experience with TAVR and as new technology becomes available. In general, I think most would agree that younger patients (especially younger than 60) are still best treated with surgical aortic valve replacement as long as they are low risk for surgery. The good news is most younger patients can be treated with a minimally invasive approach. In many cases, this can be a right anterior mini thoracotomy that does not require dividing the sternum. — Dr. Kevin Hodges
Question #15: Robyn asks, “If you have been an athlete most of your life, doesn’t that also assist as your heart muscle is strong?”
There is no doubt that patients who have been very active are better able to tolerate a heart valve problem as their heart typically has more “reserve”. Healthy, active patients also typically have an easier and faster recovery when they do need an operation. — Dr. Kevin Hodges
Question #16: Trish asks, “My echo says do it now, the angiogram and TEE say I can wait.”
Timing of heart valve surgery can be a complex decision and often requires balancing data from multiple tests. When there is competing (or even conflicting) data, that is a great time to get a second opinion to ensure that you are making the right decision. — Dr. Kevin Hodges
Question #17: Madlyn asks, “I have a mitral valve repair with a ring around the valve. I am also in Afib. Is the ring around the valve failing?”
The development of atrial fibrillation after a mitral valve repair is somewhat common. Having atrial fibrillation does not necessarily mean there is a problem with the repair, but if this is a new finding, it may be a good idea to see your cardiologist for an echocardiogram to make sure your valve is functioning appropriately. There are also a number of treatment options for atrial fibrillation, including medications and catheter ablations that do not require another open heart operation. — Dr. Kevin Hodges
Question #18: Georgia asks, “Do Surgical review boards have the final say if SAVR or TAVR can occur?”
The decision between SAVR and TAVR is made by a team of cardiologists and heart surgeons at an individual medical center, and most importantly through a discussion with the patient. Your doctors will weigh a number of factors including valve anatomy, risk factors, and age and give you a recommendation for which procedure they think is best for you. However, it is ultimately a joint decision based on your preferences that determines how to proceed. — Dr. Kevin Hodges
Question #19: Robyn asks, “I felt like I was 30 years older at age 58, as my valve was failing. I just thought it was part of my disease and being tired and not feeling great was the “new normal”. Then, I was told it was time for open heart surgery to replace the aortic valve and my aneurysm.”
Your experience is very common. If you have not yet had your operation, then know that a working valve can help you feel the way you should for your age. If you have already had surgery then I hope that you are doing very well and back to feeling yourself. — Dr. Kevin Hodges
Question #20: Anonymous Attendee asks, “If the left ventricle grows from 6 to 6.4 in six months… When should the valve be replaced in your opinion?”
Timing of valve surgery based on left ventricular size depends on the valve in question and whether the bad valve is causing the ventricle to stretch or vice versa. For instance, a patient with severe mitral valve regurgitation from mitral valve prolapse and a previously healthy ventricle probably should have their valve fixed if the end diastolic diameter (the larger of two common measurement) is above 6cm. However, in some cases the primary problem is actually the ventricle itself, which we refer to as cardiomyopathy. These situations are more complicated and require a dedicated team to decide the right course of action. — Dr. Kevin Hodges
Question #21: Mike asks, “Is there any connection between bundle branch block and aortic valve stenosis?”
I will admit that I do not know whether there is a causative relationship between aortic stenosis and a bundle branch block, but this is certainly plausible. However, the existence of a bundle branch block does have implications for aortic valve replacement (TAVR or SAVR). One of the risks of either of these procedure is the need for a pacemaker, and patients with a bundle branch block are at higher risk for requiring a pacemaker after their procedure. — Dr. Kevin Hodges
Question #22: Patty asks, “I have severe/moderate aortic stenosis and was recently diagnosed with HFpEF with normal BNP. I am in a wait and see status working on heart conditioning, daily walking etc. I have increased symptoms, exercise intolerance, shortness of breath, chest tightness with exercise, lightheadness no syncope. Are these symptoms a result of the HFpEF or am I close to valve replacement?”
Generally speaking, patients with significant aortic stenosis and symptoms of shortness of breath, chest pain, or syncope should have an aortic valve replacement. If there is uncertainty about whether these symptoms are related to the aortic valve, then a stress echocardiogram can be useful. — Dr. Kevin Hodges
Question #23: Joni asks, “What else could cause the stroke? I had a major one with delayed treatment of TPA, causing my left side to be weak and I keep falling.”
There are a number of potential causes of a stroke. In cases where the cause is uncertain, a team of cardiologists and neurologists may use a combination of the features of the stroke and a patient’s risk factors to determine the most likely cause. If a preventable cause is identified, they will recommend treatment to limit the risk of another stroke. — Dr. Kevin Hodges
Question #24: Andrew asks, “How common is Afib after valve surgery? What is the difference between afib and atrial tachycardia?”
Atrial fibrillation and a related arrhythmia called atrial flutter are very common after valve surgery. For mitral valve repair, for instance, the rate is more than 30% during the first 30 days after surgery. This risk is slightly lower with a robotic operation. Generally, post-operative atrial fibrillation can be managed very effectively with medications and the risk decreases back to baseline after a few months. Atrial tachycardia is a different type of atrial arrhythmia that is not as closely related to heart valve surgery. — Dr. Kevin Hodges
Question #25: Anonymous Attendee asks, “What percentage is considered high surgical risk? Thank you for this excellent presentation.”
High risk means something different for every patient and includes factors like chance of mortality, major complications (e.g. stroke, needing dialysis or a tracheostomy, and potential quality of life). For a reference, the first trial of TAVR vs surgical aortic valve replacement used a cutoff of 10% predicated risk of mortality to define “high risk”. For any patient who is considering a high risk operation, the most important thing is to have a detailed discussion about risks and benefits with your surgical team before settling on a plan. — Dr. Kevin Hodges
Question #26: Robyn asks, “Is there a chart that identifies the risk levels for surgical options?”
The Society of Thoracic Surgeons (STS) has an online tool that predicts the risk of mortality or major complications with certain common cardiac operations. These are based on national data and may vary significantly between centers based on volume and expertise. Generally speaking, high volume centers have risk profiles that are more favorable than the national average. Some of this variability is captured in the STS star ranking system for cardiac surgery programs. — Dr. Kevin Hodges
Question #27: Tina asks, “Many thanks to Dr. Hodges for sharing his expertise! Will please comment on how “surgical risk” is defined? Thanks!”
Surgical risk means the likelihood of an adverse outcome, including death, stroke, dialysis, tracheostomy, wound infection, or a pacemaker. What is considered acceptable risk is different for every patient and every operation. Most operations have a modest risk of serious complications, but understanding the risk of surgery requires an in depth conversation with your surgical team. — Dr. Kevin Hodges
Question #28: Joni asks, “What is the alternative test to the stress echo? I recall having one decades ago.”
There are a number of tests that help us determine the severity of a heart valve problem. These include a stress echocardiogram, cardiac MRI, cardiac catheterization (right or left heart catheterization), or even more specialized tests in unique circumstances. — Dr. Kevin Hodges
Question #29: Deb asks, “If you’ve already had mitral valve surgery (valve repair) for severe regurgitation and the surgery reduces the regurgitation to mild but then (around 7 yrs later) the regurg progresses to moderate worse again…. What are the complications or risks of having surgery again to reduce the regurg again? And also what is the probability of that surgery resolving the issue completely and not having to go thru another surgery again?”
Generally speaking, redo surgery is reserved for patients who progress all the way back to severe mitral valve regurgitation. In that situation a re-repair or a replacement is indicated to address the leaky valve. The risks of redo mitral valve surgery are specific to individual cases but are generally slightly higher than the risk of a first-time operation. However, in most cases the risk is still low and surgery can be performed safely and with excellent outcomes. In certain cases, when a re-repair can be performed with a high likelihood of a durable result, then this is an excellent option. In other cases it may be best to replace the valve. Redo mitral valve surgery should be performed at a high volume center with a team that has expertise in assessing the appropriateness of re-repair and the likelihood of success. — Dr. Kevin Hodges
Question #30: Anonymous Attendee asks, “Had aortic valve replacement almost 16 years ago & I’m in my late 70’s. Other than that I’ve felt tiredness for a couple of years, should I be concerned?”
Tiredness is sometimes a difficult symptom to pin down. To know whether this is related to your prosthetic aortic valve, the first thing to do would be to see you cardiologist and check an echocardiogram. If the valve is working well on echocardiogram, it is not likely to be the problem. — Dr. Kevin Hodges
Question #31: Salvatore asks, “5 years ago, I had mitral valve repair. Last review shows mild regurgitation & LAFB. Should I avoid exercise for concern that doing so could make my conditions worse?”
I would consult with your cardiologist before starting an exercise program, but mild mitral regurgitation (this sound like a good repair) and left anterior fascicular block, by themselves, should not limit your exercise. — Dr. Kevin Hodges
Question #32: Maryanne asks, “My cardiologist does the echocardiogram for the past 5 years and he said in the last two years my mild to moderate regurg. changed to mild. How could this be possible?”
There are a number of factors that determine the severity of valve regurgitation and it is not uncommon for severity to fluctuate somewhat over time. The good news is that neither mild or mild-moderate regurgitation needs an intervention, so you can continue to follow this with periodic echocardiograms. — Dr. Kevin Hodges
Question #33: Bill asks, “I want revised my question. I have AFib and recently I was diagnosed I have severe mitral valve regurgitation. I don’t have any symptoms. What procedure and when should I have it done?”
The decision to proceed with an operation is based on the severity of mitral regurgitation (yours is severe), likelihood of a durable result based on review of your echocardiogram, and your individual risk of undergoing cardiac surgery, based on your overall health. The presence of atrial fibrillation favors earlier surgery, even in the absence of symptoms, because it indicates significant mitral regurgitation, is associated with poor outcomes if left untreated, and can be treated with a concomitant maze procedure with left atrial appendage ligation at the time of surgery. For an otherwise healthy patient with this combination of problems (and assuming that your valve is repairable), I would recommend that you proceed with a mitral valve repair and a maze procedure with left atrial appendage ligation. This does not sound like an urgent situation, but one that you should think of addressing during the next few months. — Dr. Kevin Hodges
Question #34: Anonymous Attendee asks, “I was diagnosed in 2013 with mitral valve regurgitation which was mild at the time, it has progressed to moderate. Why do patients have to wait until it becomes severe which at that point may make for a harder recovery? Why do you have to nearly die to get repair and at what stage would you suggest a repair?”
The grading system of valvular heart disease is based in part on the likelihood of the valve disease leading to symptoms or heart failure. Generally speaking, less than severe mitral regurgitation is not sufficient to cause significant problems, and many patients with mild or moderate regurgitation will never progress to severe. The other thing to consider is that any operation carries some risk of serious complications and even death, even if that risk is very low. We don’t want to offer an operation that could lead to serious complication if we are not sure that the mitral regurgitation will eventually become an important problem. — Dr. Kevin Hodges
Question #35: Jennifer asks, “Is there a relationship between MR, Hypertension, A-fib and Hypertrophic Cardiomyopathy?”
Absolutely. Patients with hypertrophic cardiomyopathy (HOCM) are prone to developing mitral valve regurgitation due to a phenomenon call systolic anterior motion (SAM) of the mitral valve. Patients with HOCM may also develop mitral valve regurgitation for other more typical reasons (i.e. mitral valve prolapse). HOCM is also associated with higher rates of atrial fibrillation. In patients with this combination of problems, who require surgery, we can typically address all three at the same time with a septal myectomy, possibly a mitral valve repair if myectomy alone is insufficient, and a maze procedure with left atrial appendage ligation.
Question #36: Anonymous Attendee asks, “How prevalent is Thoracic ascending aortic aneurysm surgery using robotics/minimally invasive?”
I am not personally aware of any robotic ascending aneurysm surgery. There are surgeons who have described repairing an ascending aneurysm through a right anterior mini thoracotomy. In my practice, I offer patients with isolated ascending aortic aneurysms the option of an upper hemisternotomy, which I feel offers the best combination of exposure, safety, and limited invasiveness. — Dr. Kevin Hodges
Question #37: Daneen asks, “Is getting a second opinion getting an opinion from your cardiologist and a surgeon?”
Getting a second opinion generally means getting another opinion from a cardiologist and/or surgeon at another center, which may have different practice patterns or resources. Cardiologists and surgeons that work together on a regular basis tend to share the same opinions about which are the best treatment strategies. Sometimes we are all guilty of presenting our opinions as the only option and it can be very helpful to hear another perspective. Many centers, like Northwestern Medicine, offer a virtual second opinion option and will review your records and meet with you virtually. Getting a second opinion does not need to mean completely establishing care with a new set of doctors. — Dr. Kevin Hodges
Question #38: Mike asks, “Where can patients find the standards like Dr. Hodges showed for recommendations for having surgery?”
The most recent American society guidelines for valvular heart disease (2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines) can be found at: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000923. — Dr. Kevin Hodges
Question #39: Anonymous Attendee asks, “What can be done to minimize stroke during aortic valve replacement?”
The risk of stroke is related to a number of factors, including valve anatomy, degree of calcification, and other patient-specific risk factors (i.e. carotid artery stenosis, extensive calcification of the aorta, history of previous stroke). The best way to minimize risk is thorough pre-operative work-up and meticulous attention to detail during the operation. — Dr. Kevin Hodges
Question #40: Karen asks, “What about early surgery for tricuspid valve? Is that recommended for a leaky tricuspid valve?”
Timing of surgery for tricuspid valve surgery is a little bit more complicated than aortic or mitral valve surgery. Historically, patients have been referred for tricuspid surgery only when the develop symptoms of heart failure because of the belief that (1) patients remain asymptomatic with severe tricuspid regurgitation for a long time and (2) tricuspid valve surgery is high risk. The problem is that by the time patients develop symptoms from their tricuspid valve disease they often have significant right ventricular dysfunction and damage to their liver and kidneys, which probably explains why tricuspid valve surgery has a higher mortality rate (5-10%). Recently their has been a push for more proactive surgery, especially in otherwise healthy patients with preserved right ventricular function. We evaluate these patients on a case by case basis, but often offer early surgery when patients are good candidates for early repair. — Dr. Kevin Hodges
Question #41: Stefani asks, “What can an EKGs show for vlave disease? It appears most doctors only really look at or care about that a normal sinus rhythm is occurring and don’t really use the ECG/EKG to help tell the story.”
EKGs can tell us whether patients are in a normal sinus rhythm or if they have certain abnormal heart rhythms (i.e. atrial fibrillation, PVCs). EKGs can also suggest whether certain heart chambers (i.e. the left atrium or left ventricle) are enlarged, but these things are better seen with other imaging modalities like echocardiogram, CT scan, or cardiac MRI. — Dr. Kevin Hodges
Question #42: Jims asks, “Is there any research on the causation of calcification on the mitral valve?”
Certain causes of mitral valve calcification, like rheumatic heart disease, are fairly well understood. Others, particularly mitral annular calcification, are more of a mystery. We know that mitral annular calcification is more common in older patients, women, patients with chronic kidney disease, and in certain subsets of patients with mitral valve prolapse. However, we do not fully understand the mechanism for the calcification process. — Dr. Kevin Hodges
Question #43: Chad asks, “I found a very interesting study I thought you might find interesting. It’s from 2019, and shows that continuously taking beta blockers helps prevent structural valve deterioration, vs not taking them, for those with bioproshethic mitral valves. Curious if any of your experts have seen any similar studies for bioprosthetic aortic valve replacements, TAVRs, etc?”
Thank you for sharing. This is a small, single center, retrospective analysis so I would caution against taking it as very strong evidence, but it is certainly thought provoking. There have been a number of studies looking at factors that affect prosthetic valve degeneration (and native valve calcification, for that matter) but the process remains incompletely understood. This is a big issue for valve manufacturers who put a great deal of effort into anti-calcification technologies for bioprosthetic valves. As we get more experience with each new generation of bioprosthetic valve, we will get a sense of how effective these processes are. — Dr. Kevin Hodges
Many Thanks Dr. Kevin Hodges!
I have to extend a mighty “THANK YOU” to Dr. Kevin Hodges for taking the time to answer the patient questions submitted during our special webinar, “5 Warning Signs You May Need Heart Valve Surgery”.
Keep on tickin!
Adam
Written by Adam Pick
- Patient & Website Founder
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