{"id":40260,"date":"2025-03-03T05:28:19","date_gmt":"2025-03-03T10:28:19","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/?p=40260"},"modified":"2025-03-03T16:06:43","modified_gmt":"2025-03-03T21:06:43","slug":"expert-tips-webinar-questions","status":"publish","type":"post","link":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2025\/03\/03\/expert-tips-webinar-questions\/","title":{"rendered":"45 Patient Questions Answered by Dr. Doug Johnston!"},"content":{"rendered":"

Great news!<\/p>\n

During our recent webinar, \u201c6 Expert Tips for Heart Valve Patients\u201d<\/a>, I received 45 patient questions that we did not have time to answer during the live event.<\/p>\n

Imagine my surprise (and thankfulness) when\u00a0Dr. Doug Johnston<\/a>, Chief of Cardiac Surgery at Northwestern Medicine and a featured speaker of the webinar, typed up answers to each patient question and asked me to post them to help educate our patient community.<\/p>\n

 <\/p>\n

\"Dr.
\n 
\n <\/p>\n

<\/p>\n

Question #1: Bobby asks, \u201cI have had several TEEs, Echos and Cardiac MRIs over the last 22 months. They all vary from moderate to moderate-severe. Some recommend surgery while others say looks good see you in a year.<\/h2>\n

Mitral regurgitation can appear different in severity based on loading conditions, meaning how much fluid you have in your body at the time of the study.\u00a0 Sometimes it is best to get a stress echo to see how the valve is performing when you exercise. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question #2: Anonymous asks, \u201cIs it possible to develop complete heart block eight years after having Mitral Valve repair. I now have a pacemaker.\u201d<\/h2>\n

It is possible to develop late heart block, but often this occurs because the conduction system of the heart is changing over time, not due to the repair itself. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question #3: Shari asks, \u201cI am curious to know if doctors are recommending transcatheter valve replacement for patients under 60 years of age?<\/h2>\n

This is a great question.\u00a0 There is a lot of debate about the role of TAVR in younger patients.\u00a0 In general, whether TAVR or SAVR is a better option depends on what other medical problems the patient has, as well as the size and shape of the valve and condition of the other heart valves. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question #4: Anonymous asks, \u201cI have a trifecta valve which is deteriorating. Is TAVR an option to replace this valve?\u201d<\/h2>\n

TAVR can be an option in failing Trifecta valves.\u00a0 It will depend on the size of your aortic root, and the position of the coronary arteries, which can be determined on a TAVR CT scan. \u2013- Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question #5: Bobby asks, \u201cTwo surgeons were ready to do surgery based off of one Echo. Is that okay?\u201d<\/h2>\n

It sounds like you have gotten a number of different opinions.\u00a0 It is a good idea for your cardiologist and surgeon to review all the studies and get a consensus they can discuss with you. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question #6: Kim asks, \u201cWhat kind of symptoms happen if a mechanical aortic valve is failing?\u201d<\/h2>\n

Symptoms can include fatigue, shortness of breath, dizziness – all of the symptoms that can occur when a native valve is failing.\u00a0 An echocardiogram is the right first test to look at valve function. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question #7: Bobby asks, \u201cThe LA and LV some say severely dilated and other say normal size?\u201d<\/h2>\n

Your valve team should take a look at the actual dimensions of the LA.\u00a0 MRI and TEE tend to be the most accurate. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 8: Cynthia asks, \u201cCholesterol medicine if little blockage was present in heart arteries at time of SAVR (20%)?\u201d<\/h2>\n

Cholesterol medication may be indicated.\u00a0 This will also depend on what the blood tests for cholesterol show. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 9: Julie asks, \u201cI have diagnosed with Aortic stenosis, yet too early for surgery, how can I keep my valve healthy and open to avoid surgery?\u201d<\/h2>\n

The best thing to do is keep your whole heart healthy.\u00a0 Eat well, exercise, keep other cardiovascular risk factors in control.\u00a0 Valve disease tends to progress slowly, and there is not much a patient can do to change the course of aortic stenosis. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 10: Cynthia asks, \u201cCan a TAVR replace a 21mm SAVR bovine valve?\u201d<\/h2>\n

In some cases yes, although TAVR in a 21 mm valve may result in some residual stenosis. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 11: Susan asks, \u201cWhat is the success rate for a third redo for aortic valve replacement?\u201d<\/h2>\n

Most of the time reoperative aortic valve replacement can be performed with similar risk to a first time operation. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 12: William asks, \u201cWhat is the current status of TAVR HALT treatment?\u201d<\/h2>\n

The mainstay of HALT treatment is blood thinners.\u00a0 If the HALT is caught early, the clot may dissolve and the valve return to normal function. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 13: Cynthia asks, \u201cIs a previous HIT II during SAVR a reason to have a future TAVR when needed?\u201d<\/h2>\n

Not necessarily.\u00a0 This would be a good discussion to have with your valve team.\u00a0 HIT is often temporary, and later procedures can often be performed safely with a single dose of heparin. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 14: Cathy asks, \u201cHow many cardioversions can a person have?\u201d<\/h2>\n

A person can have a lot of cardioversions, but at some point it makes sense to talk to your team about ablation procedures for the Afib, whether surgical or transcatheter. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 15: Chris asks, \u201cI\u2019m 66 a former runner (half marathons). I have congenital Bicuspid Aorta Valve. Diagnosed 6 years ago. I went in due to sudden onset of having it hard to breath during runs. went for a stress test echo and they found the issue. the breathing and chest pain seems to be getting more often with less stress. But my annual echo shows just moderate stenosis with slight worsening numbers every time and I keep hearing I\u2019ll need surgery in 3- 5 years. I\u2019m feeling I should maybe have the surgery next year\u2026 even though doctors have not suggest it. Thoughts?”<\/h2>\n

It would be important to look for other reasons for the shortness of breath.\u00a0 Usually moderate stenosis does not result in significant symptoms, but sometimes echo can underestimate the extent of disease.\u00a0 In some cases MRI can be useful to take another look at the valve. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 16: Richard asks, \u201cWhat is the best way to manage aftercare following surgery?\u201d<\/h2>\n

Early return to activity is important.\u00a0 Most patient can get back to aerobic activity very early after valve surgery, and can be at full activity in 6 weeks. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 17: Lew asks, \u201cI have been diagnosed with anemia and 8 months after my aortic valve replacement. Is it possible that my aortic valve is not sealed correctly?\u201d<\/h2>\n

In some cases a leak around the valve can lead to damage to red blood cells and hemolytic anemia.\u00a0 This can be hard to see on transthoracic echo (TTE).\u00a0 A TEE may be necessary to rule out a leak. There are also many potential causes of anemia not related to the valve. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 18: Judy asks, \u201cPlease comment on whether robotic mitral valve repair surgery is riskier because it takes longer and has increased risk of stroke. And how often does a mitral valve repair become a replacement?\u201d<\/h2>\n

Patient selection is very important for robotic surgery.\u00a0 We obtain a very detailed CT scan on all patients considered for any minimally invasive approach including robotics so that we minimize the risk of stroke.\u00a0 Robotic surgery should NOT be riskier than other approaches when patients are selected carefully.\u00a0 As with open surgery, repair is possible in greater than 95% of patients with degenerative mitral valve disease. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 19: Marc asks, \u201cBack in October I had “complex mitral valve repair, posterior MAC decalcification that was performed via sternotomy. What causes the calcification and how do I prevent it from returning?\u201d<\/h2>\n

We don’t have a good understanding of why mitral annular calcification occurs.\u00a0 The good news is it takes a long time to grow and is unlikely to grow back. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 20: Dave asks, \u201c2 weeks ago I had 3 valves repaired, mitral, tricuspid, aortic and the ascending aorta replaced.\u00a0 As an active 70 year old how long can I reasonably expect these repairs to hold up, given a good diet and staying active?\u201d<\/h2>\n

How long valve repairs last depends a lot on what is wrong with the valve in the first place.\u00a0 We expect a well done repair to last at least 10 years, in many cases more like 15-20.\u00a0 The same is true for tissue valve replacements. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 21: Allina asks, \u201cDo you expect that TEER will prove to increase life expectancy? Who decides the best regarding risks vs benefits cardiac surgeon\/ interventionist who is experienced in performing T TEER or HF cardiologist who knows the patient for a few months, if they disagree- one says safe, the other says very dangerous for 91 y.o? Thank you\u201d<\/h2>\n

The best way to look at risk and benefit of a procedure is to have a team of experts who understand the data, have a lot of experience with the procedure, and work TOGETHER to help you choose the right therapy.\u00a0 A patient should not be put in the position of deciding between conflicting opinions of two different doctors. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 22: Gutha asks, \u201cFor a calcified mitral valve, I have been advised to get it replaced. Am 72 and do not have any other co-morbidity. Please explain the differences between open heart Vs Robotic Vs Video assisted thoracotomy. What considerations should I factor in?\u201d<\/h2>\n

Which surgical approaches are safe for mitral replacement depend a lot on how much calcium is present and where it is.\u00a0 It is sometimes difficult to deal with severe invasive calcification through a small incision.\u00a0 It is important to talk to your surgeon about exactly how the calcium will be dealt with, for example will it be removed so the largest possible valve can be implanted? \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 23: Anonymous asks, \u201cI am getting mitral valve repair next month. I have been debating if it is better to get robotic or traditional sternotomy. I am being offered robotic. Is the repair just as good with robotic? I hear you are on the heart lung machine longer with robotic ? Is that a big concern. I am 48yo. I also hear if things go south with robotic surgery and they have to open you up it can cause a lot of complications.\u201d<\/h2>\n

A robotic approach can be an excellent option provided the patient has good anatomy for a robotic repair, there are no other heart which might complicate the approach, and the surgical team is very experienced with robotic repair.\u00a0 Time on the heart lung machine tends to be slightly longer, but not much compared with sternotomy.\u00a0 It’s important to know the results of the team you are working with, and how they think about robotic vs sternotomy or other minimally invasive approaches. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 24: Cathy asks, \u201cWill an enlarged left atrium cause future problems?\u201d<\/h2>\n

An enlarged left atrium can lead to a higher risk of atrial fibrillation, but what is more important is what caused the enlargement. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 25: Richard asks, \u201cDoing my heart valve surgery, I was told I had a minor stroke. Is it common to have a minor stroke during this surgery?\u201d<\/h2>\n

Fortunately, strokes are not common with valve surgery, but they do occur in a small number of patients.\u00a0 About half of strokes occur during surgery and half in the few days afterwards. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 26: Daneen asks, \u201cI just had surgical aortic valve and aorta resection in August of 2024 and just found out my mitral valve regurgitation just worsened to moderate regurgitation.\u00a0 Can I wait until I have to get a reoperation for my aortic porcine valve to then also get a mitral valve replacement\/repair?\u201d<\/h2>\n

In some cases the changes in heart shape and function after aortic valve surgery can affect the mitral valve, but fortunately moderate mitral regurgitation is not usually something that needs intervention.\u00a0 Your team should be following you with regular echocardiograms. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 27: David asks, \u201cIf you had an AV bioprosthetic valve, and you need a redo at some point in the future and are healthy enough for open heart, is open heart valve replacement give you a better result than transcatheter AV replacement?<\/h2>\n

There are currently several studies underway to look at outcomes for redo surgery after aortic valve replacement vs valve in valve.\u00a0 There is some evidence that redo surgery may be more durable, but this depends a lot on what valve is in place, the size of the valve, and other factors related to the patient. Stay tuned as I expect we will learn a lot more in the coming year. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 28: Sravanthy asks, \u201cWhen patients as young as 16 yrs old get Ross procedure done where the prosthetic pulmonary valve can last for just 10 to 12 yrs.. can get it replaced through trans catheter procedure for only thrice\u2026\u00a0 What options are left for such patients later?\u201d<\/h2>\n

A pulmonary homograft can be replaced with surgery if there are no transcatheter options. This is generally a low risk operation. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 29: David asks, \u201cAre there any lifestyle, diet, supplements that can make your heart valve last longer or is bioprosthetic valve lifespan a mystery from one patient to the next.\u00a0 I know younger patients bio valves don’t last as long due to immune response? Does someone who likes to exercise wear it out faster?\u201d<\/h2>\n

Fortunately exercise does not wear out valves faster.\u00a0 The only thing to avoid is taking very high doses of calcium.\u00a0 Otherwise bioprosthetic valve durability is very much independent of lifestyle.\u00a0 While it is true that valves don’t last as long in younger patients, they can still last for more than a decade even in patients under 50. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 30: Joni asks, \u201cI got discharged from a congenital heart Dacron graft with untreated pneumonia for 10 months (even with 5 follow-up visits with the cardiologists and chest x-rays all stating such). My aortic valve went bad causing the need for a replacement. My new cardiovascular surgeon told me “I died on the table” and replaced my mitral valve with too small of a cow valve as that was all they had in stock. Did the untreated pneumonia cause the valves to go bad?\u201d<\/h2>\n

Wow I am very sorry to hear about your experience.\u00a0 That sounds like a complicated situation.\u00a0 It is possible for bacteria from pneumonia to get into the bloodstream and cause an infection of the valves.\u00a0 That is something that usually can be determined at the time of surgery, or by looking at the pathology report to see if the valves were infected. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 31: Bernadine asks, \u201cGood evening!\u00a0 I had my aorta valve replaced in Jan. 2024 with a Bovine valve-how will I know if the valve start failing?\u201d<\/h2>\n

Congratulations on your new valve.\u00a0 The good news is that these valves typically last a very long time.\u00a0 Your team will likely schedule you for a yearly echocardiogram, which will show when the valve starts to narrow or leak.\u00a0 Hopefully it will be many years in the future. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 32: Sher asks, \u201cCan robotics (minimally invasive) now be used for Aortic aneurysm grafts and valve repair?\u201d<\/h2>\n

Minimally invasive approaches are possible for many patients needing aortic valve and ascending aortic aneurysm repair.\u00a0 While robotic approaches are very useful for mitral valve operations, and are slowly gaining traction for the aortic valve, minimally invasive aneurysm repairs are usually performed through a small incision in the upper part of the sternum without using the robot. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 33: Grace asks, \u201cWhat can I do to prevent calcification of a new replacement valve?\u00a0 Do I need to avoid phosphorus or foods?\u201d<\/h2>\n

Other than avoiding very high doses of calcium supplements, there is nothing you need to avoid in terms of lifestyle or foods. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 34: Anonymous asks, \u201cAt my first annual post TAVR procedure I asked my cardio if I needed to have a Echo and he said no my heart will let me know when one is needed. Should I change doctors?\u201d<\/h2>\n

At Northwestern we believe every patient with a replacement valve, TAVR or otherwise, should have an annual echocardiogram to evaluate the valve function, especially since valves usually start to show signs of failure by echo long before patients get symptoms. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 35: Alan asks, \u201cI had a TAVR recently for bicuspid aortic valve and after the surgery had several episodes of V-tach including an episode that my implanted defibrillator shocked me.\u00a0 I was told that the new valve needs to epithelialize.\u00a0 Have you heard of this and how long does it take to recover.\u201d<\/h2>\n

Ventricular tachycardia is an uncommon rhythm after valve surgery.\u00a0 While newly implanted valves do develop an ingrowth of tissue including endothelial cells, I’m not sure how that will impact the risk of recurrent V-Tach.\u00a0 That sounds like a good question for an electrophysiologist. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 36: Susan asks, \u201cI understand the trifecta valve was recalled. I\u2019ve had mine for 10 years and still ok.\u00a0 Is there any risk to still have this in me.\u201d<\/h2>\n

Though the Trifecta valve is no longer being sold, many Trifecta valves have very good durability.\u00a0 The most important thing is to monitor the pressure gradients through the valve, and any evidence of leakage, with regular echocardiograms.\u00a0 As long as it is functioning well it should be no riskier to you than any other valve. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 37: Matthew asks, \u201cHi Doctors, I am 53 I’ve been diagnosed with bicuspid valve.\u00a0 Is there anything that can be done – other than surgery – to help the valve or to otherwise put off the surgery, e.g., pharmaceutical, diet, exercise, aspirin, etc…\u00a0 Or is this just waiting until I become symptomatic.\u201d<\/h2>\n

The good and bad news, depending on how you look at it, is there is nothing we know of that will alter the course of the valve if it is becoming narrow or leaky.\u00a0 That said you should not wait until you develop symptoms!\u00a0 Healthy patients often develop symptoms very late.\u00a0 Be sure you and your team are following the valve with regular echocardiograms. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 38: Robert asks, \u201cI had my aortic valve replaced with a bovine valve in November 2024 along with repairs to both mitral and tricuspid.\u00a0 Things were great until mid January and they now suspect paravalvular leak of my replacement valve.\u00a0 My hematologist now has diagnosed me with hemolysis and hemolytic anemia from blood loss and he suspects this is a result of the open heart surgery.\u00a0 What are possible options to repair the leaking replacement valve?\u201d<\/h2>\n

I’m sorry to hear about your paravalvular leak.\u00a0 There are basically two options to deal with this if your team has decided the leak is too severe, or is causing too much hemolysis, to manage medically.\u00a0 In some cases a plug can be placed in the leak using a catheter going from the groin.\u00a0 This is not possible in all cases due to the size and location of the leak.\u00a0 If a pluch is not possible then redo surgery may be necessary. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 39: Anne asks, \u201cI am 53 and have an Edward\u2019s Resila biological tissue valve, replaced 3 years ago. What factors contribute to the tissue valve deterioration that would lead to either a TAVR need or a second SAVR to replace it.\u00a0 Bench tests suggested the valve would last 10-15 years. My intervention cardiologist suggests maybe even 20. \u00a0If a TAVR was suggested for me at about age 65, what would the likely durability be? Would I potentially need another SAVR?\u201d<\/h2>\n

Most tissue valves fail very slowly because of deposition of calcium on the leaflets causing narrowing.\u00a0 You are right that there is a good chance for the valve to last 15 years based on studies of older tissue valves.\u00a0 We don’t know as much about how long a valve in valve TAVR will last, but there is some data to suggest these won’t last as long as a SAVR.\u00a0 It’s possible that you might need another SAVR, but we will know a lot more about the durability of these valves in the coming years. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 40: Cathy asks, \u201cMy husband has had 2 mitral valve surgeries, the first was 23 years ago and he had a tissue valve put in.\u00a0 This valve lasted about 17 years and he has since received an On-x mechanical valve.\u00a0 He has an enlarged left atrium which we think happened in between valves.\u00a0 He has had a little trouble with afib but had an ablation which seems to have worked.\u00a0 He has only had one afib episode since October.\u00a0 What do you think the future is for this mechanical valve?\u201d<\/h2>\n

The On-X valve is a very well proven mechanical valve and should have very long durability assuming the Warfarin is well managed. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 41: Kathryn asks, \u201cI had prolapsed mitral valve repaired with Cosgrove Annuloplasty Band and Atricure Atriclip. Chest was closed with SS rings. The Surgeon said that I should never have an MRI, but both companies state that their product does not preclude an MRI. Are the SS rings an issue or should I be eligible for an MRI (knee, hip etc)?\u201d<\/h2>\n

If what you are referring to are stainless steel wires, then MRI should be possible. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 42: Jim asks, \u201cI have been on amiodarone, 100 mg, for the past two years. What are the risks factors for the medication? This medication is for control of Arrythmia. I am also taking Eliquis.\u201d<\/h2>\n

Risks for long term amiodarone in general have to do with lung function.\u00a0 Your doctor may want to talk to you about risks of lung disease and possibly obtain lung function tests. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 43: Alina asks, \u201cTricuspid severe regurgitation, anteroposterior annulus 4.2 cm, 91 y o, annulus dilatation, a candidate anatomically. Vina contracta 0.55 cm. Do risks overweight benefits?\u201d<\/h2>\n

This sounds like a great question for a second opinion consultation.\u00a0 We would need to know more about you and your valve to answer the question. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 44: Mark asks, \u201cDoctors, i am 70\u00a0 and had open heart surgery to repair my mitral regurgitation by installing a ring at the vale. I now have developed aorta regurgitation and the efficiency has gone from 65% efficiency to 55% in the last year. 3 months ago\u00a0 I collapsed from VT and had to be shocked, leading to a defibrillator implant. At what point would you recommend take action? My aorta is a little odd shaped causing the leakage, but the leaflets are calcium fee. Thank You.\u201d<\/h2>\n

Sorry to hear about your collapse.\u00a0 It would be important to know some more about how bad the leak is and how big your heart is to understand if the aortic valve needs to be replaced. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

 <\/p>\n

 <\/p>\n

Question 45: Kellee asks, \u201cWhat do you think of surgeon curing an enlarged heart to make I smaller before trying to fix continuous afib?\u201d<\/h2>\n

Would need to know more about what chambers are enlarged to help with this question. \u2013 Dr. Doug Johnston<\/p><\/blockquote>\n

<\/h2>\n

 <\/p>\n

Many Thanks Dr. Doug Johnston!!!<\/h2>\n

I have to extend a mighty \u201cTHANK YOU\u201d to\u00a0Dr. Doug Johnston<\/a> for taking the time to answer the patient questions submitted during our special webinar.<\/p>\n

Keep on tickin!
\nAdam<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":25672,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[63],"tags":[],"class_list":["post-40260","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-adams-updates"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts\/40260","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/comments?post=40260"}],"version-history":[{"count":2,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts\/40260\/revisions"}],"predecessor-version":[{"id":40273,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts\/40260\/revisions\/40273"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/media\/25672"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/media?parent=40260"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/categories?post=40260"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/tags?post=40260"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}