Should My Mom Undergo Surgery for Mitral Valve Regurgitation?

Sudden shortness of breath. The doctor diagnosed it as mitral valve insufficiency. Should surgery be considered for treatment?

My mother is 50 years old.
One day, she suddenly had difficulty breathing and her head and hands turned dark.
She was taken to the emergency room, where she was diagnosed with acute pulmonary edema.
Fortunately, she responded well to the medication; otherwise, she would have needed intubation.
She is currently in the intensive care unit.
On the third day, she underwent a cardiac catheterization, which diagnosed her with mitral valve insufficiency.
The doctor recommended surgery.
My uncle suggested waiting and observing first, as some hospitals tend to recommend surgery for profit, even when patients might recover on their own.
However, the decision is in my hands.
I am currently very hesitant about whether to proceed with the surgery.
After all, she is my beloved mother, and I want to make the best choice.
I would like to ask if this condition can heal on its own without surgery? Should we go ahead with the surgery or not? If we do proceed with surgery, what are the potential complications?

Xiao Yu, 20~29 year old female. Ask Date: 2006/03/30

Dr. He Dongjin reply Cardiology

Dear Xiao Yu,
Based on your description, your mother's condition appears to be severe mitral valve regurgitation, which is causing pulmonary edema that will not resolve on its own.
The need for surgery should be determined based on the clinical symptoms of the patient, and it seems that surgery may be necessary.
If her response to medication is good, it may be advisable to wait until her symptoms are more stable before proceeding with surgery.
Your mother is still young, and her prognosis after surgery should be quite favorable.
It is also important to monitor her fluid intake and manage her weight appropriately.
Thank you for your letter.
Changhua Hospital cares about you.

Reply Date: 2006/03/30

More Info

When considering whether your mother should undergo surgery for mitral valve regurgitation, it's essential to weigh the risks and benefits carefully. Mitral valve regurgitation occurs when the heart's mitral valve does not close tightly, allowing blood to flow backward into the heart. This condition can lead to various complications, including heart failure, arrhythmias, and pulmonary hypertension, especially if it is severe.

Given your mother's recent acute pulmonary edema, which is a serious condition often caused by heart failure, it indicates that her heart is struggling to pump effectively. The fact that she responded well to medication is a positive sign, but it does not eliminate the underlying issue of the mitral valve regurgitation.
Surgical intervention is often recommended for significant mitral valve regurgitation, particularly when symptoms are present or if there is evidence of heart dysfunction. The surgery can involve repairing the existing valve or replacing it, depending on the severity of the regurgitation and the condition of the valve itself.
Your uncle's suggestion to wait and see is not uncommon, especially in cases where the regurgitation is mild and the patient is asymptomatic. However, in your mother's case, given the acute episode and the diagnosis of severe regurgitation, delaying surgery could lead to worsening heart function and more severe complications down the line.

It's also important to consider the potential risks associated with surgery. Like any surgical procedure, mitral valve surgery carries risks, including infection, bleeding, and complications related to anesthesia. However, the benefits of correcting the valve dysfunction often outweigh these risks, especially in symptomatic patients. Many patients experience significant improvement in their quality of life and a reduction in symptoms after surgery.

In terms of whether mitral valve regurgitation can resolve on its own, it is unlikely that significant regurgitation will improve without surgical intervention. While some mild cases may stabilize or improve, severe regurgitation typically requires surgical correction to prevent further complications.

Ultimately, the decision should be made in consultation with your mother's cardiologist and possibly a cardiac surgeon. They can provide a thorough evaluation of her specific case, including the severity of the regurgitation, her overall heart function, and any other underlying health issues. They can also discuss the potential outcomes of surgery versus conservative management.

In summary, while the decision to proceed with surgery is significant and understandably causes hesitation, the presence of acute symptoms and the diagnosis of severe mitral valve regurgitation suggest that surgery may be the best option for your mother's health and quality of life. Engaging in an open dialogue with her healthcare team will help you make an informed decision that aligns with her best interests.

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