Ablation/mitral regurgitation/no obstruction?

[kthanki]

Finally, I had my echo done 6 weeks after my pacemaker implant. Pacemaker was implanted for 2nd deg. AV block-excersise & meal induced only.
Now the Dr. says my Mitral regurgitation is more than moderate. Left Atrium is slightly dilated measures about 41mm. My echo's have always said mild mitral regurgitation. I have no significant symptoms. Normal type of SOB when I do physical activity-thats about it.
The septal thickness is the same 2.2cm, there is no obstruction. No gradient. I did see during the echo that mitral valve was touching the septum.
My question is has anybody had septal ablation done for mitral regurgitation ?
Without having obstruction, can septal reduction help mitral leak?

Thoughts ????

[Sarah]

Re: Ablation/mitral regurgitation/no obstruction?

Ketan,

Septal ablations, by definition, are to reduce obstruction. If there is no obstruction, there is nothing to ablate. If your regurgitation is due to a leaky valve, then the only solution is a new valve --if you really need one. If you aren't miserable, it is unlikely that you really need anything done about it. Regurg is pretty common with HCM.

S

[kthanki]

Re: Ablation/mitral regurgitation/no obstruction?

Thanks Sarah..
I understand regurg is pretty common with HCM... but my concern is can it eventually lead to CHF?

Is there a way/test to figure out the reason for leaky valve without surgery? As I mentioned, I did see the valve touching the septum. Can that phenomena impact the regurg. process?

[Lisa Salberg]

Re: Ablation/mitral regurgitation/no obstruction?

You are dealing with seperate issues. Have you seen an HCM specialist yet?
Lisa

[Sarah]

Re: Ablation/mitral regurgitation/no obstruction?

Dear Ketan,

CHF is caused more by a stretched out heart than by regurgitation. As long as you are in sinus rhythm, it isn't a big concern.

I missed the part where you said you saw the valve touching the septum. This begs the question --how are you not obstructed when the definition of obstruction is that the mitral valve is unable to open and close free b/c it is obstructed by the septal wall? Either it just looked like it was touching or you are obstructed. I can only ask --are you seeing a specialist and if not, why not? Lisa can help you find one if you haven't talked to her yet.

Curiouser and curiouser...

S

[kthanki]

Re: Ablation/mitral regurgitation/no obstruction?

No, I haven't seen a HCM specialist yet. Closest center to Vegas is Mayo.
My cardiologist is dictating a letter today for me to go to Mayo in Roc.,MN.
I am planning a visit in first/second week of July if I can get an appt. I will have clearer picture then.
I just wanted to see if anybody had experience with, more than moderate mitral regurg with no obstruction. Also, isn't a dilate left atrium sign of stretching of the heart,(at least one chamber). I have read that increase in size of the left atrium is a sign of MR that needs to be addressed. This was leading me towards CHF line of thinking.

Also to clarify Sarah, i saw the mitral leaflet touching the septum when it was completely open during echo. Although, according to the echo tech. it wasn't touching. The echo is such a low resolution image. That technology definitely needs advancement..
It seems like a lot is left to opinion of the viewer. The measurements done also seem very approximate.
Thanks guys

[Sarah]

Re: Ablation/mitral regurgitation/no obstruction?

K

I'm very glad you are going to Mayo --they are great!

Dilated atrium is stretching, but as big of a concern as ventricular dilation. My brother and I both have large atriums from afib, but no CHF.

I'm sure others will chime in with their experiences soon.

take care,

S

[Lisa Salberg]

Re: Ablation/mitral regurgitation/no obstruction?

Most people with HCM have a dilated left atrium. I think it is really time for that trip to Mayo. Something is a bit odd here and needs to be evaluated by someone who sees HCM on a reg. basis.
Be well,
Lisa

[kthanki]

Re: Ablation/mitral regurgitation/no obstruction?

Spoke to Susane at Mayo and got the appointment for 2nd week of July.
The doc working with me will be Dr. Steve Omnen( I don't know the spelling).
People a Mayo seem very nice, at least over the phone compared to the Vegas experience. An actual nurse came over the phone before making an appointment and explained all that is involved in process.
They mentioned something about O2 stress echo. I presume it measures oxygen efficiency of the heart during stress?? is that correct..

Lisa Thanks for the Mayo contact info..
K

[Lisa Salberg]

Re: Ablation/mitral regurgitation/no obstruction?

You are very welcome. Dr. Omen is a speaker at this years HCMA meeting - that should tell you how much we think of him!

Your in great hands!
Lisa