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Mitral valve repair surgery
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Three weeks ago I had my mitral valve repaired and had a cryo-maze ablation. The surgery was minimally invasive and was done with the Davinci robot. It was still a horrible thing to go through. I was told by my surgeon I can begin lifting again and to keep my cardio workouts under 120 bpm. I started going to the gym this week, doing the elliptical for half an hour with very little resistance followed by hiding in the corner lifting the tiny pink weights. I was wondering if any ST'rs have had any similar cardiac surgery and how long it took to get back to training and racing. I will be on anti-coagulant therapy for 6 months. My cardiologist (who went out of his way to tell me he rides a Specialized) told me I can cycle but I am concerned about crashing and internal injury. I am a 46 year old male who up to this point has enjoyed near perfect health my entire life. At my pre-op cardiac cath the doc told me I have the coronary arteries of a baby. Thanks for reading.
Last edited by: chugger: Sep 28, 09 10:32
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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Cool - that Davinci Robot is pretty neat. Doesn't look like much, but ...

Local CT surgeon here (J. Michael Smith - also finished an IM) does lots of Davinci Robotic sx and did a friend valve/chord sx who is a good runner. He was back running pretty well at about 4 months post (age 49 when done I think).

Best of luck and speedy healing!

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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I'll tell you my experience...

In November, 2006, at the age of 46, while working out, I had chest pains that ended up with me getting an angioplasty on Thanksgiving day.

In 2007, I decided to start preparing for some triathlons in 2008 (I was an awful swimmer initially and improved to poor).

In early 2008, during a routine exam with my cardiologist, he noticed a new murmur. After some tests (echocardiogram, CT scan), I learned I had a dilatated ascending aorta that was causing my aortic valve to not seat properly and cause a moderate-severe regurgitation (insufficiency). I had surgery at the Mayo Clinic in Jacksonville to replace my ascending aorta and aortic valve on April 4, 2008. I was discharged on April 7. I was told to not work out at all for 2 weeks and to not swim or bike or run for 4 weeks.

I did my first triathlon on June, 2008, 12 weeks post-surgery. The swim was awful as my heart rate kept spiking and I had to float to keep it under control. The bike and run went okay. On April 5, 2009, 1 year and 1 day after my surgery, I did my first half Iron. I had a goal of breaking 6 hours, but I had shin splints for months before the half Iron that limited my run and although my swim is now poor, not awful, and bike was okay, I had severe cramps on the run and I went a little over 6 hours.

Although I take a calcium channel blocker that caps my heart rate, I get by. I am not fast but continue to improve. I am now preparing for 2 half Irons and IM Cozumel in 2010.

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"Well, I guess if a person never quit when the going got tough, they wouldn't have anything to regret for the rest of their life." Lance Armstrong to Peter LeFleur
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Re: Mitral valve repair surgery [3wayguy] [ In reply to ]
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Wow 3wayguy, very inspiring, there is light at the end of the tunnel. Do you have a natural or mechanical valve? Did you require anti-coagulant therapy?
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Re: Mitral valve repair surgery [rroof] [ In reply to ]
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In Reply To:
Cool - that Davinci Robot is pretty neat. Doesn't look like much, but ...

Local CT surgeon here (J. Michael Smith - also finished an IM) does lots of Davinci Robotic sx and did a friend valve/chord sx who is a good runner. He was back running pretty well at about 4 months post (age 49 when done I think).

Best of luck and speedy healing!

Thanks, yes that robot is pretty wild. I remember getting a quick look at it as I got onto the table. In my surgical report they use the terminology, "the patient was docked to the robot..." Pretty freaky.
Last edited by: chugger: Sep 28, 09 10:29
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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In Reply To:
Wow 3wayguy, very inspiring, there is light at the end of the tunnel. Do you have a natural or mechanical valve? Did you require anti-coagulant therapy?
Chugger, choosing the "right" type of valve, i.e., tissue or mechanical is a very personal and difficult decision based in large part on one's activity level and age. I went with a tissue valve (human cadaver) because I didn't want to be on coumadin for life, required with all mechanical valves, and at 49, I hope to get by with one more surgery in about 20 years. And there is a possibility of new technologies by then.

I take Plavix but not coumadin.

You might want to take a look at http://www.cardiacathletes.org forum. There are a number of triathletes there, all of whom have had some cardiac work.

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"Well, I guess if a person never quit when the going got tough, they wouldn't have anything to regret for the rest of their life." Lance Armstrong to Peter LeFleur
Last edited by: 3wayguy: Sep 26, 09 18:57
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Re: Mitral valve repair surgery [3wayguy] [ In reply to ]
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In Reply To:
In Reply To:
Wow 3wayguy, very inspiring, there is light at the end of the tunnel. Do you have a natural or mechanical valve? Did you require anti-coagulant therapy?
Chugger, choosing the "right" type of valve, i.e., tissue or mechanical is a very personal and difficult decision based in large part on one's activity level and age. I went with a tissue valve (human cadaver) because I didn't want to be on coumadin for life, required with all mechanical valves, and at 49, I hope to get by with one more surgery in about 20 years. And there is a possibility of new technologies by then.

I take Plavix but not coumadin.

You might want to take a look at http://www.cardiacathletes.org forum. There are a number of triathletes there, all of whom have had some cardiac work.
I'd been lurking on that forum and joined a week ago, haven't yet received my confirmation email and still can't post.
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Re: Mitral valve repair surgery [3wayguy] [ In reply to ]
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thanks for the link! I have looked around out there but there is very little information for athletes with this condition to help them decide how to approach endurance sports.
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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I had open heart surgery 6/07 to replace my aortic valve(I was born with a bi-cuspid aortic valve). I went with a mechanical valve and am on coumadin for life. I also have a mitral valve prolapse,but didn't need it repaired at time of surgery. I had completed 6 IM and dozens of other triathlons, marathons,road races prior. After surgery it was a matter of two steps forward and one back as I tried to recover and rehabilitate. Seven months after surgery I completed the Miami Marathon. The following year I completed IM Wisconsin and then ran the Twin Cities Marathon 4 weeks latter(qualifying for Boston).

If you want PM me and I can help expedite your admission onto the Cardiac Athlete website forum.

All the best!
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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Underdog is a good guy and one heckuva of an athlete, cardiac or not. We met at a triathlon this summer and he smoked me (and won't let me forget it). Another member is the reigning world champion road biker of Bahamas, also with aortic valve surgery.

I will pm the cardiac athletes forum guru and ask them to expedite your membership.

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"Well, I guess if a person never quit when the going got tough, they wouldn't have anything to regret for the rest of their life." Lance Armstrong to Peter LeFleur
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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If your concern is primarily about riding with coumadin, go for it.
I ride without concern. I haven't crashed on the road, but I race Xterra and MTB and have had some spectacular crashes this year including a very rough one this Saturday. With your INR in the appropriate therapeutic zone you aren't at as great a risk as you would think.
The only difference I would expect is that you should obtain and wear a medic-alert bracelet, and if you have a crash and can tell that you took a hard blow to the chest/abdominal region or the head, go straight in to the ER rather than shaking it off as normal.
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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I was just diagnosed with a heart murmur. i was then sent to a cardiologist and I have a stress test done (perfect), then an echo-cardiogram where I was diagnosed with Mitral Valve Prolapse with regurgitation. I told him I was athletic and he just said, "well this is something we want to monitor", so he said i'll see you again in 2 years time??

Now i'm reading that people have surgery for this thing? At what point do you have surgery to repair your mitral valve??? The Dr. never mentioned to me about having any surgery should I be concerned?
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Re: Mitral valve repair surgery [Shelleytri's] [ In reply to ]
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don't fret too much. It's the moderate regurg and any enlarging of the LV or surrounding vessels that they monitor. My doc tells me: "you may never need surgery or you may ultimately need surgery because of an acute symptom(s) or you may need to decide on surgery while having no symptoms but an enlarging LV..... we don't know what the future holds exactly, we make decisions one year at a time. But ultimately, it's prob better to arrive on the operating table, if it happens, fit and healthy". I get monitored yearly and do long course tri. Talk to your cardiologist about it. I'm not advocating shopping around until you find an answer you like, but if your doc isnt' comfortable with athletic endeavors with your condition, seek out a doc that has some experience. Their goal is to keep you alive and some docs are more conservative than others while trying to achieve that goal.
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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I had my mitral valve repaired with an anulus ring in 2005 along with an aortic root graft (both my mitral and aortic valves were saved - no blood thinners). To make a long story as short as possible, I was training again in just a few months and had 90% of my functional threshold power back on the bike in less than a year. (Although it took a catheter ablation procedure 8 months post op to correct frequent arrhythmias.) I still struggle with sporatic atrial tachycardia though but not enough to keep me from training hard. My competitive days are over though - I just don't want to take the risk involved in pushing myself to competitive exercise intensities.

Hang in there. It will get better.
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Re: Mitral valve repair surgery [Shelleytri's] [ In reply to ]
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In Reply To:
I was just diagnosed with a heart murmur. i was then sent to a cardiologist and I have a stress test done (perfect), then an echo-cardiogram where I was diagnosed with Mitral Valve Prolapse with regurgitation. I told him I was athletic and he just said, "well this is something we want to monitor", so he said i'll see you again in 2 years time??

Now i'm reading that people have surgery for this thing? At what point do you have surgery to repair your mitral valve??? The Dr. never mentioned to me about having any surgery should I be concerned?

You need to get checked every 6 months, not every 2 years. My valve progressed like this: 2003, diagnosed with mitral valve prolapse, 2008, moderate mitral valve regurgitation. August 24th, 2009, I was in mile 4 of an easy bike ride when I started to feel something wrong. My heart was pounding out of my chest. Went to the ER, was told I was in atrial fibrillation and my resting HR was 140 bpm. I was told it was time to repair my valve, as the regurg had progressed to severe.

Don't lift heavy weights and don't push yourself to "win." Listen to your body while training and don't be afraid to back off. Go to the Dr or ER immediately if something doesn't feel right.

I wouldn't be too concerned right now if your regurg is trace or min. Get a stress echocardiogram. It's a combination stress test and echocardiogram. Of course your stress test was perfect, mine too, we're athletes. I was also told my coronary arteries were completely clear, and I'm 46 years old. I learned though, that these valve abnormalities have nothing to do with that. PM me if have any specific questions.
Last edited by: chugger: Sep 28, 09 13:59
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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When is it advisable to have Mitral Valve prolapse surgery? My wife has it, and gets Pains without her meds. She wants to do an Iron Aquabike next year. She just swam
at Redman for a team in 1:12:00. Why would one have the surgery if it is controlled with meds? Is it a dangerous condition left alone? I think the guy in Chicago died of it
in the marathon. My wife is 45 and cant run anymore(knees).

"Im not young enough to know everything."
Oscar Wilde
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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I think every 6 months would be a little to much if the Mitral valve prolapse is only showing signs of trace or minimal regurgitation. I have a yearly MRI and stress echo. If something progresses then you be asked to come back every 6 months. I was diagnosed in 2004 with my bicuspid Aortic valve and Mitral Valve prolapse. Given the all clear to continue doing Ironman by 3 different cardiologists. I only had a minimal amount of regurgitation of the Aortic valve and trace with the mitral. Told they might progress the point of needing surgery in 5,10,20 years or never.I had annual exams until just the year before the year of the surgery when I was bumped up to every 6 months. I completed 2 more IM before Aortic valve progressed to the point of needing surgery(When it reached severe regurgitation and began experiencing shortness of breath).

But don't listen to any of this without consulting with your doctors and get second opinions as needed.
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Re: Mitral valve repair surgery [pertinax4] [ In reply to ]
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In Reply To:
When is it advisable to have Mitral Valve prolapse surgery? My wife has it, and gets Pains without her meds. She wants to do an Iron Aquabike next year. She just swam
at Redman for a team in 1:12:00. Why would one have the surgery if it is controlled with meds? Is it a dangerous condition left alone? I think the guy in Chicago died of it
in the marathon. My wife is 45 and cant run anymore(knees).

From what I just learned, you don't have surgery for the prolapse, only if it progresses to severe regurgitation or if you progress to other associated problems like atrial fibrillation, enlarged left ventricle, CHF, SOB with minimal exertion, etc. The docs told me I'd never have a heart attack, but if I pushed myself too hard I could have too much backflow of blood in my heart and I could pass out. I never thought I'd go into atrial fib and require the surgery so young though. It was a big monkey on my back that always loomed in the front of my mind and is now over and done with, and for that I'm glad. The surgery was tough to go through, physically painful and very emotional.

I had chest pains pre surgery for a few years. Docs told me it wasn't angina, as my coronaries were clear. They said it could be the chords that open and close the valve being stretched, it could be psychological because now I know I have a heart condition, and I am a neurotic/worrier type guy, and I have a stressful job (police officer), or my chest pains could be a combination of both. I was never given a definitive answer for my chest pains.
Last edited by: chugger: Sep 28, 09 14:43
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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bump
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Re: Mitral valve repair surgery [3wayguy] [ In reply to ]
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Underdog is a good guy and one heckuva of an athlete, cardiac or not. We met at a triathlon this summer and he smoked me (and won't let me forget it). Another member is the reigning world champion road biker of Bahamas, also with aortic valve surgery.

I will pm the cardiac athletes forum guru and ask them to expedite your membership.
Thanks, I just checked cardiac athletes and my account hasn't been activated yet, it's been over a week since I signed up. I used the same handle, chugger. I PM'd underdog. Any help you guys could give would be most appreciated. Thanks a lot.
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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I pmed the moderator of cardiacathletes.org earlier today. You definitely shouldn't have to wait a week!

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"Well, I guess if a person never quit when the going got tough, they wouldn't have anything to regret for the rest of their life." Lance Armstrong to Peter LeFleur
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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I also just notified the administrator. Can't wait for you to join!
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Re: Mitral valve repair surgery [underdog] [ In reply to ]
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To Underdog and 3wayguy:

Thank you very much. It pays to know people in high places.

Dear Chugger,

We have now activated your account at the Cardiac Athlete Forums.


Last edited by: chugger: Sep 29, 09 14:17
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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I was recently was initially diagnosed with Hypertropic Cardiomyopathy and Mitral Value Regurgitation. This diagnosis and the symptoms came out of no where as I always been very healthy and athletic.
All this begin on June 12, 2010 while competing in the Boise 70.3 when I began to feel short breathe and dizzy while running, although it was determined that I was severely dehydrated and passing kidney stone during the run. This was confirmed the morning after the race when I passed the stone. That was the worst pain I've ever experienced. I took a week off after Boise from running and once I resumed short runs I was experiencing the same symptoms as above. I experience no problems swimming and biking although my HR was much lower.
I then attempted to do a practice triathlon on 6/23 only to begin feeling short of breathe, dizzy and coughing up blood while running which lead me to going to the ER. I had to hospitialized with fluid on my lungs for 3 days where they ran almost every test imaginable to determine what is worng with me. They determined that my Mitral Valve isn't closing properly when my HR is above 150.
I had a heart cath today to rule blockage of the arteries, however I now have TEE scheduled for Thursday 7/8.
My situation is very unqiue in that when my heart is at rest I have no mitral valve regurgitation, however when my heart rate is elavated my mitral valve is wide opened. My cardiologist is consulting with his partners to determine the next steps as to why this is happening.
After all the training and racing I've done my entire I really trying to wrap my head around it all. Why would this happen now? How could I feel in the best shape of my life and then 4 weeks later feel like my life was not in my control.
I swim in college and I've raced over 100 triathlons including Xterra World Championship, IM CDA 04 & 05 and IM Canada 08. I've run 15 marathons including Boston in 07 and an Ultra Marathon in 2010.
I'm just trying to sort all this out as I take one day at a time. Any feedback would be appreciated.

Thanks,
Scott

Enjoy the journey!
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Re: Mitral valve repair surgery [chugger] [ In reply to ]
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I hope to God you got a Cardiac MRI before you went for the surgery. My cardiologist told me I needed surgery to repair my Mitral valve because of the regurgitation and when I got the Cardiac MRI guess what....mild regurgitation! Echos are not the final word for MV....not by a long shot!
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