A: It is always a good idea to get another opinion, especially when 
it comes to surgery. After all, it is 
your body, and you want to be sure the decisions made are the absolute best for you. Ask your doctor for another recommended cardiologist 
or visit the American College of Cardiology Web site (acc.org) to find someone near you. 

Blood Pressure Boosters

Get Second Opinion About Surgery The Saturday Evening Post

I am glad you like my column, and that you plan to subscribe to the Post to read it. Thank you. Porcine heart valves (made from pig hearts) have been used to replace narrowed and/or leaking human aortic and mitral valves since about 1965. Tissue valves eliminate the need for anticoagulation with warfarin that is required for mechanical prostheses. On the downside, they are not as durable as mechanical valves and therefore do not last as long. In several studies, by 15 years the porcine valve has failed in 30 percent to 60 percent of patients. Elevated cholesterol seems to contribute to valve degeneration. Valve failure is more frequent in the mitral than aortic position. Also, the rate of valve failure is significantly less in patients older than 65, with more than 90 percent of the valves functioning well at 10 years. Degeneration is rare in patients past 70 years old. Your choice of valve was excellent because your age and the fact that the valve is in the aortic position make it very likely the valve will last as long as you do!

Artificial Heart Valves The Saturday Evening Post

Mechanical heart valves usually last the life of the patient, while tissue valves last an average of five to fifteen years, with the shorter span occurring in younger patients. You don’t say which kind you have, but regardless, at your age and barring complications, you should not need a valve replacement. The pain in your legs may be caused by peripheral vascular disease, a process of plaque buildup that also may have occurred in your coronary arteries, and which is now obstructing blood flow to the muscles in your legs. A treadmill stress test is used to uncover blockages in arteries supplying the heart with blood. Walking up an incline can stress the muscles in the legs. The exercising muscles need more blood, and if there are obstructions preventing this increase, they become ischemic (starved of blood) and cause pain. This problem should be evaluated by your doctor.

It is difficult for me to prescribe how much exercise to do without knowing more about your condition. Generally I tell my patients to “listen to your body.” When your body “talks to you” in the form of pain, abnormal shortness of breath, or other symptoms, stop or slow down what you are doing. Exercise within those limits is usually okay.

Heart Valves, Leg Pain, and Exercise The Saturday Evening Post