I am 56 yr old female. I had a open mitral valvotomy done 20 years back. I have been on heart medication since with normal annual exams. My last exam reported MR. I have been asked to not exert, drink less than 1 litre of water a day with minimal salt and sugars besides medication, before a re-exam in 3 months. Is a surgery imminent? As I already had a valve repair, will it be replacement now? How successful is that and what are my chances of not needing surgery near term?
Last 2D Echo details
1. Mitral valve leaflet are thickened and mildly calcified with doming of AML and restricted movement of PML. Partial non-coaption of MV leaflets. Mean gradient across mitral valve 5mmHg
2. Moderately severe MR(eccentric jet directed medially) Moderate TR (PASP-37mmHg)
3. Mild thickening of aortic valve. No AS/AR. No PR
4. No LV regional wall motion abnormality. LVEF 60%
5. LA is dilated other cardiac chamber dimensions are normal
6. No intracardiac clot/pericardial effusion/vegetation
Other details
Aortic root diameter - 2.4cm
Aortic valve opening - 1.6m
Left Atrial dimension 4.1cm
Left Ventricle -
ED dim:4.6 cm, ES dim 2.5 cm: ED IVS thickness 0.9 cm:
ED PW thickness:0.9cm, ES IVS thicness:1.4cm, ES PW thickness: 1.4 cm
LV ejection fraction : 60
Mitral
E velocity - 153 cm/s , A vel - 125 cm/s, Max PG=9mm Hg, Mean PG=5mmHg
MR : moderately severe; stenosis : Nil
Aortic :
Max vel =131 cm/s, AR: Nil, No stenosis
Tricuspid
Max vel -45 cm/s : TR moderate, PASP=37 mm hg, No stenosis
Pulmonary
Max vel-80 m/sec, PR: nil, stenosis; Nil
Excepts from my earlier surgery note:
The mitral valve was severely stenosed with an orifice of about 7-8 mm in diameter. There was fibrous fusion of both the commissures and moderate involvement of the sub valvular apparatus. Post repair, mitral valve was tested by releasing the aortic cross clamp and tripping the aortic valve. The valve was found to be competent except for a trivial central leak.