urgent advice please

[carroll998]

my cardiologist peers are unsure wether to seal a medium size hole i have had from birth, it did no effect me till i was 54, my right side of my heart is dilated, i have had afib only twice in a year, my blood is mixing, but only abit, the reason they are hesitating is because i have only had afib twice, and i only have a small leak, but i want to have it sealed, i dont want to be on beta blockers and warfarin for the rest of my life, i will know what the have decided in 2 weeks, but i could tell my the doctors face it is doughtful if they will do it, what can i do to change their minds, my heart is already enlarged and i would have thought that not to seal the hole could lead to futher damage. thank you

[carroll998]

thank you so much for your reply, the closures of asd are not done using open heart surgery, they insert a tube with a piece of whatever on the end on it through the thigh and upto the heart and cover it, my cardiologist who i spoke to said when he had a meeting about me with his superior and the person who carries out the procedure, that they were unsure whether to carryout the procedure because the ra filling defect which is the good blood mixing with the bad blood was only a small amount, my arguement is if the procedure is alot more easier now why not do it, my heart is enlarged so why risk, because of the hole of it getting it any bigger which could eventually lead to heart failure, the sealing of the hole would stop this and also the attrial fibrillation, tiredness and short of breath on exertion, he said at the moment he his fighting for me to have it done, but i could tell from what he said he has got a fight on his hands with his peers. why should i be on beta blockers and warfarin if i dont have to be. once again thank you so much for your reply, regards carroll

[BLM_56]

Carroll,
I would think that it is basically a matter of risk vs benefit.  I am not sure why the MDs are divided over the surgery but you need to find out.  ASAP!  Tell the MD you are a big girl and MAKE him/her tell you.  Make him/her explain the reasons/arguments for and against the surgery.  Remember he/she is only the hired consultant.  Your health is your responsibility (if you decide wrongly and opt for an operation YOU could DIE where the worst the MD faces is a measly malpractice suit) and the decision is ultimately yours to make.  As the "pro choice" crowd keeps reminding us, it is "your body, your choice".  

There are very good websites operated by various groups like the American Heart Association - www.americanheart.org - where you can get good information about the risks associated with such a procedure.  For a nominal fee you can get that question answered on the MD side of this site.

If I am not mistaken, repairing a defect in the septum is a procedure that can only be done open heart.  Talk to someone you know who has had any kind of open heart surgery done.  Get them to "reminisce" about the lovely time following the surgery.  Anything done open heart is risky.  The external heart-lung machine is not particularly good for your blood.  Having one's breast bone broke and split open is not terribly good for you.  

If the right side of your heart is enlarged there might be increased risks associated with cutting on the hypertrophied tissue.  We are neither of us spring chickens (I'm 57) and as you well know we do not bounce back from injury as quickly as we did when we were 20.

Oh, and having to be on coumadin for the rest of your life isn't so bad.  Me, I use it as an excuse not to eat broccoli, brussels sprouts and other foods I do not like and which are high in vitamin K.

Keep us posted,
Bionic Bill  
Cyborg At Large