Can Surgery Improve Mild Mitral and Tricuspid Valve Insufficiency?

Can surgery improve tricuspid regurgitation?

Is it possible to improve mitral and tricuspid valve insufficiency through surgery? I was diagnosed with mild mitral and tricuspid valve regurgitation at Taipei Medical University Hospital, and the echocardiogram showed it is within acceptable limits.
However, I may have mild thalassemia, and I can only stay awake for five hours before needing to rest.
This has been going on for several years.
Sometimes I don't feel tired at all, but my heart feels increasingly tight and requires rest.
I wake up with a heavy head, and my sleep schedule is often disrupted; if I sleep too much during the day, I can't sleep at night.
When five hours are up, it's almost dawn, and waking up feels very stressful, with a heavy head and constant dizziness.
I also experience chest tightness, as if a heavy stone is pressing on my chest, and my digestion is often poor.
I cannot engage in vigorous exercise, and my upper body feels particularly weak.
Even shoveling dirt for less than a minute causes my chest and head to tighten to the point where I can't move.
The doctor who examined me only advised me to take heart rhythm medication to keep my heart rate below 80 beats per minute and to rest when needed.
However, I feel like I am incapacitated and unable to work; my physical condition makes it difficult to move, and it's very painful.
I truly don't know what to do if my condition worsens in the future...
I don't feel like a person anymore! Would surgery to repair the valves be better? Is heart transplantation a possibility?

Xiao Gao, 40~49 year old female. Ask Date: 2021/09/01

Dr. Wu Xueming reply Cardiology

Mild mitral and tricuspid valve prolapse do not affect cardiac function and do not require surgical repair.

Reply Date: 2021/09/01

More Info

Mitral and tricuspid valve insufficiency, even when classified as mild, can significantly impact a patient's quality of life, especially when accompanied by other health issues such as anemia or chronic fatigue. In your case, the symptoms you describe—persistent fatigue, chest tightness, and difficulty with physical exertion—suggest that your heart is struggling to meet the demands placed upon it, even if the valve insufficiency is currently mild.

Surgical intervention for valve insufficiency is typically considered when the condition is moderate to severe and is causing significant symptoms or complications. In cases of mild insufficiency, the approach is often more conservative, focusing on medical management and regular monitoring. However, if symptoms worsen or if there is evidence of heart function deterioration, surgical options may be revisited.

1. Surgical Options: For mitral valve insufficiency, surgical repair is often preferred over replacement, as it tends to have better outcomes and preserves the patient's own valve structure. Tricuspid valve surgery can also be performed, but it is less common unless there are significant symptoms or associated conditions like right heart failure. The decision to proceed with surgery would depend on a comprehensive evaluation by a cardiologist and possibly a cardiac surgeon, who would consider factors such as the severity of the valve insufficiency, the presence of symptoms, and the overall function of the heart.

2. Risks and Benefits: Surgery carries inherent risks, including infection, bleeding, and complications related to anesthesia. However, the potential benefits—improved symptoms, enhanced quality of life, and prevention of further heart damage—must be weighed against these risks. If your symptoms are significantly impacting your daily life, discussing surgical options with your healthcare team may be warranted.

3. Heart Transplant: Heart transplantation is typically reserved for patients with end-stage heart disease who have not responded to other treatments. Given that your valve insufficiency is currently mild, it is unlikely that you would be a candidate for a heart transplant at this stage. However, if your condition were to progress significantly, this option could be considered in the future.

4. Management of Symptoms: In the meantime, managing your symptoms is crucial. This may include medications to help control heart rate and blood pressure, as well as lifestyle modifications such as dietary changes, regular but moderate exercise, and stress management techniques. It is also essential to maintain regular follow-ups with your healthcare provider to monitor your condition and adjust treatment as necessary.

5. Quality of Life Considerations: Your description of feeling like a "废人" (a burden) due to your symptoms is concerning. It is important to address not only the physical aspects of your health but also the emotional and psychological impacts. Seeking support from mental health professionals, support groups, or counseling can be beneficial in coping with chronic health issues.

In conclusion, while surgery can improve valve insufficiency, the decision to proceed with surgical intervention should be based on a thorough evaluation of your specific situation. Regular monitoring and medical management are essential, and if your symptoms worsen, a discussion about surgical options may be appropriate. Always consult with your healthcare team for personalized advice and treatment plans tailored to your needs.

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