Non-invasive mitral valve repair vs. open heart procedure

I am a 58 year old male who has always enjoyed good health. I have had
a leaky mitral valve for about 4 years. I noticed severe shortness of
breath on March 14, 2005. On April 1 my primary care physician
diagnosed an irregular heart beat. He referred me to a cardiologist
who performed a catheterization on May 11. The cardiologist saw a
minor artery 80% blocked at the point close to where it is
perpendicular to a major one, the left coronary artery I believe,
although I am not sure. Being so close to a major artery, my
cardiologist did not want to risk cleaning the blockage and putting in
a stent. He said that while blockage could cause a heart attack; it is
not life threatening.


I had a cardioversion on June 4. When I went to my cardiologist on
July 14, I had an irregular beat again. Also, my left ventricle had
increased in size by "about 10%." My cardiologist said, "If I
went by the book, I would recommend open heart surgery" to repair the
valve and a bypass to get around the blockage. He also recommended a
maze procedure to prevent the arrhythmia from recurring. He said my
heart had not increased in size so much that the process was
irreversible; but it would unless I acted soon to correct both the
leaky valve and arrhythmia. He said I was a candidate for the
non-invasive procedure and referred me to a cardiac surgeon.


The cardiac surgeon recommended the open heart procedure. He said I
was a low risk candidate. "You are half-way between catching this
early and getting to it late," he observed. He said he was "90%
sure" he could repair the valve instead of having to replace it. I
asked him if I was a candidate for the non-invasive procedure. He said
yes, adding that he could do one-half of the maze non-invasively
compared to the entire maze under the open heart method. He said the
maze procedure for his patients, when he did all of it, has been 100%
effective. He could not perform the bypass.


My cardiologist again said that I was a candidate for the non-invasive
technique. He said that it is possible to clean the blocked artery via
catheterization, adding that the partial maze would be 70% effective in
preventing a recurrence of the arrhythmia.

All along my cardiologist has said the leaky valve is causing the
irregular heart beat.

I am trying to think through the pros and cons of doing the
non-invasive procedure. I see them as follows. I do not get a bypass;
but the blockage can be cleared via an angioplasty, albeit one that
carries more risk due to the blockage location. I get less than a 100%
maze; one that has a 70% chance of preventing arrhythmia recurrence.
Since the cause of the arrhythmia, the leaky valve, will be repaired
under both procedures, I ask myself do I need the maze, other than
getting "insurance" against something else causing the irregular
heart beat. I wonder if something else has developed other then the
leaky valve that would cause the arrhythmia, for example, the heart
enlarging. The mortality rate for the non-invasive method is less than
open heart.


I am willing to live with the blockage. If indeed the leaky valve is
causing the arrhythmia, then the odds of the partial maze under the
non-invasive procedure are a risk worth taking. Under both scenarios I
have to improve my diet. As for exercising, I have always done it. I
will continue, but now of course at a lesser pace.

I would be grateful for any comments, reference to other websites or
any advice.

Thank you in advance.

Tucker

.

Relevant Pages