Mitral and tricuspid valves replacement surgery

[Tam]

My mother is 64 years old with a long history of heart problems. She had rheumatic fever as a child.  Rheumatic heart disease was diagnosed in 1963 during childbirth.  Surgery to remove scarring of the mitral valve was performed in 1970.  She has not felt well all these years but is not a complainer, so nothing more has been done up until now.  She had a catheterization done about 18 months ago and discovered that the tricuspid valve is now involved.  Her heart is quite enlarged.  She eats a healthy diet and is quite thin, even losing about 7 pounds this year without trying.  The local cardiologists and surgeons do not suggest surgery.  They believe her chances of surviving are rather small.  She is in constant pain and almost constant depression.  She doesn't sleep much and has a lot of diarrhea.
I hate to see her suffer.  Do you think I should urge her to go to a larger heart center for a second opinion?  Would she be a candidate for a heart transplant?
Thanks for your time.

[CCF-M.D.-CRC]

Dear Tam,

It's hard to say without knowing what all the data are.  However, if she wants to do everything possible and is willing to take the risks of surgery then this may be the best course of action.  I would recommend that she get a second opinion at a heart center.  She is probably not a transplant candidate due to her age but may still be a good surgical candidate.  If she wants to be seen at the Cleveland Clinic I would recommend Dr. Richard Grimm or Dr. William Stewart.

[Tam]

To add to my question.......
My mother is on medication for heart failure:coumadin, two diuretics, and an ace inhibitor.