Walters surgery serious, but outcomes good

PHILADELPHIA - May 10, 2010

However, if there is heart disease... Or just age can start to wear the valves out... And then they need to be replaced.

Cardiologist Dr. Sara Sirna of the Temple Heart Center says 80-year-old Barbara Walters most likely has stenosis, or narrowing & stiffening, of the aortic valve. She says 60 to 70% of older patients face that problem, with a much lower segment experiencing a leaky valve, known as mitral valve regurgitation.

Signs of that include chest pain, light-headedness, dizziness, and shortness of breath.

Those symptoms often come on slowly, and can be missed, or attributed to "simply getting older." Walters says she didn't feel bad right now, but didn't make any other comment on her symptoms, or on how the problem was detected.

Dr. Sirna says doctors don't generally operate unless a patient has significant symptoms, because of the risks from surgery.

Dr. Sirna says new valves are human or animal tissue, or mechanical. Mechanical valves have a higher risk of blood clots. Dr. Sirna says most older patients get pig or cadaver valves, so that they don't have to worry about taking blood-thinners to prevent clots for the rest of their lives.

She says the tissue valve last about 15 years.

Replacing the valve almost always means open-heart surgery.

Dr. Sirna says, "It's a major operation. It involves general anesthesia. It involves opening the chest wall, so that means going through bone, muscle tissue. it also involves putting the patient on a bypass pump to halt the heart."

Despite the extent of the surgery, Dr. Sirna says older patients who are fit like Walters do very well with the operation. They will usually have a week in the hospital, with a total recovery time of about 3 months.

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