- The operation requires special expertise.
- In a small percentage of patients, replacement of the pulmonary valve may be required later.
Heart Disease Treatment
1 AnswerDisadvantages of the Ross Procedure include:
The Ross Procedure is particularly appropriate for children and young adults with diseased aortic valves. The pulmonary valve is a good match in size to the aortic valve, it has the potential to grow as the child grows (which artificial valves cannot do), and it is well suited to the high pressures in the aorta. The procedure is also a good option for women who wish to become pregnant and for active patients who do not wish to take anticoagulants.
1 AnswerThe most common valve operation is aortic valve replacement for aortic stenosis. The aortic valve resides deep within the heart and regulates the blood supply to all of the major vessels of the body. In aortic stenosis, the aortic valve tightens or narrows, preventing blood from easily flowing through. Aortic stenosis may manifest itself along with other heart problems such as coronary artery blockages or other valvular disease.
Aortic insufficiency may also require aortic valve replacement. With aortic insufficiency, the aortic valve no longer adequately retains blood, allowing leakage through the valve back into the heart. Aortic insufficiency can lead to heart failure.
Surgical options for either aortic stenosis or insufficiency include the implantation of a mechanical valve, a tissue valve, or your own valve (the Ross procedure). The type of valve used typically depends on the severity of symptoms and other individual health concerns, such as age and the use of blood thinners. The procedure may require a sternotomy (opening of the chest bone) or, in select cases, may be performed through a minimally invasive approach, using a series of small incisions.
1 AnswerWhen choosing a cardiac rehabilitation facility, first, check to see that the program is certified by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). There are about 2,600 cardiac rehab centers nationwide, and about 1,400 have been certified by the AACVPR. The following list of questions can help you decide on a facility:
- Does the staff include trained cardiac nurses, exercise specialists, dietitians, and mental health specialists?
- Is there a doctor on the premises?
- Is the staff ratio at least one to four patients?
- Is the staff certified in basic and advanced life support skills?
- Does the program offer workshops and counseling?
- Are assessments and treatment plans individualized?
- Will someone on staff file your insurance claim?
- Will the staff stay in regular contact with your cardiologist?
- Is there a post-rehab program available that would allow you to continue to exercise at the facility for a fee?
- a variety of exercise equipment such as treadmills, elliptical trainers, stationary bikes, and step machines
- equipment that's modified for elderly or disabled patients
- free weights, wall pulleys, and rowing machines
3 AnswersMichael Roizen, MD, Internal Medicine, answeredIf you go into cardiac rehab immediately after a heart attack, you'll slash your risk of a repeat heart attack in half. Go into intensive cardiac rehab and your heart attack risk falls by 90%. Bottom line: Everyone, no matter what their heart-health issue, lives a longer, healthier, and more productive life.
2 AnswersWith the help of medications, most people with coronary artery disease can live normal lives with few limitations. However, some people benefit from revascularization procedures, which restore blood flow to areas of the heart muscle that have been affected by the blocked artery. The two main procedures are angioplasty and coronary artery bypass surgery.
2 AnswersA number of combination medications are available to treat coronary artery disease. Most aim to control high blood pressure by combining a diuretic with a beta blocker, calcium-channel blocker, angiotensin converting enzyme (ACE) inhibitor, angiotensin-receptor blockers (ARB), or a different type of diuretic.
Is a combination drug right for you? It depends on your situation. Many people take more than one drug to control blood pressure or cholesterol, for instance. If you find you routinely miss doses or get confused about which medications you have taken, it may make sense to take a combination pill.
Cost is another consideration, especially if you have to make a copayment each time you purchase a medication. Using a combination drug means you would make one copayment instead of two. But if you pay for your medication yourself, or if your health plan charges a higher copayment for brand-name drugs than for generics (as is often the case), a combination could prove more expensive, as some combination drugs include one or more brand-name drugs for which less expensive generic versions are available. Indeed, combination drugs represent a growth industry for drug makers: they can help a company extend high-profit sales of a drug whose patent is about to expire.
Another drawback to combination medications is that it is hard to adjust the dose, and changing dosage is a fact of life for people using cardiovascular drugs. Doctors often start patients on low doses of particular medications and then increase specific ones as needed to control one or more factors such as blood pressure, cholesterol, or blood sugar. But in a combination drug, the doses are paired: you can't increase one medication without increasing the other.
So what do you do? Combination drugs probably aren't a good idea if you are just starting drug therapy for a condition, or if your doctor needs to change the dose often. On the other hand, if you have been taking two well-established medications at stable doses for some time, a combination that delivers both of them at the right doses is worth looking into, especially if it contains generic versions of the drugs.
1 AnswerIf you are having only a small or trivial amount of leakage of your mitral valve, the chance you will ever need surgery is vanishingly small. In fact, even normal mitral valves leak a little bit, and today's echocardiography equipment is so sensitive that it can detect this small amount of back flow. Mitral valve surgery is necessary only when the leakage (called mitral regurgitation) is substantial. This puts a burden on the heart because it has to "re-pump" the blood that spurts backward into the left atrium with each beat instead of flowing out into the aorta and on to the body. The strain of doing this extra work causes the heart to enlarge over time, which isn't good for the heart or health. It's best to repair or replace the mitral valve before the heart gets too big.
If the regurgitation is significant, most doctors recommend periodic echocardiograms to keep an eye on the leakage and the size of the heart. Surgery isn't recommended unless the left ventricle shows signs of dysfunction or the heart enlarges beyond a certain threshold. The onset of shortness of breath or unusual fatigue are also signs that the mitral valve should be repaired or replaced.
1 AnswerSecondsCount.org answered
If you are taking medication for heart disease or to protect a stent from forming a blood clot, you should not assume that if you do not feel better the medication isn’t working. Some important medications are not going to change the way you feel, but they will affect your chances of having a heart attack or stroke.
Never stop taking a medication without first speaking with the prescribing physician, as doing so can put your health at serious risk. Speak with your physician about any concerns you have about medications you are taking.
1 AnswerSecondsCount.org answered
If you are experiencing side effects from a heart medication, trust your intuition: if a side effect seems serious, get help right away.
However, do not stop taking a medication without consulting your doctor. Doing so may present other dangers to your health. For example, many side effects are better than a cardiovascular event such as a heart attack.
It is important to make your doctor aware of any side effects you are experiencing. If you are experiencing a non-emergency symptom and want to try to identify if it is caused by the medication, the medication information pamphlet and prescription bottle labels are good places to start. They will list common side effects, including ones that may be cause for immediate concern.