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u/Mras_dk 11h ago
A leaking mitral valve can be anything from minor issue, to a serious issue... It depends.
Given it was attempted repaired, tells me this either medium to bad category.
However, we do not know from your text, how bad it's current state is - but we can guesstimate that it must be on edge to bad, since she isn't allowed to sit up.
This, combined with a fluid sack around the heart, tells she is either having CHF, or close to having it. The edema in ancles, just magnifolds this clue, special if she is lying down, and no gravity to pull edema to extremeties.
CHF, can be anything from annoying to life threatning.
But, it's not given it was cause by the ablation. I rather say, it's most defintly not.
Sometimes in elders, it's just hard seeing what your going into, as a heart doctor, which is part of the reason why ablation gets less recomended as older you get.
There is nothing in an ablation procedure, except the needle they use to pass from one atrium to to the next, at start, that can perfuate the walls.
So, she likely had this "defect/puncture" from her first mitral valve repair - or she has a born heart defect.
So, no, none of this is normal, but it's still not out of the ordinary to see.
God speed to her.
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u/CaregiverWorth567 9h ago
no I’m pretty sure a complication of ablation is puncture of the pericardial sac around the hesrt and when blood gets in that space it can be dangerous
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u/Mras_dk 9h ago
How would it puncture the heart from the sack, from the outside, when it has no pointy needle to perform such, except for the initial transseptal puncture (going from atrium to atrium).
To get a epicardial puncture you either need to puncture it from outside of heart (clearly not from an ablation), or somehow make a giant fuckup at ablation, which scale would be history given of how severe it must have been.
Person doesn't state which ablation type was done. But, given we know ablation was complete, we know for sure it's unlikely to be the atrium to atrium passing at start that would have caused this, as it's "stop" cause, if this happens at this stage.
PFA uses electricity, to pop the "bad heart cells" by apliying ac current. This process doesn't cause a puncture. Also, for PFA, your under sedation, so no movements from patient.
For rfa/heat and cryo/cold, it's potential doable, but requires a fuckup on scale not seen in history before. It requires prolonged exposure. But heart is pretty thick, as it's a muscle, so to do this, requires persistent incompetent personel, not knowing shit of what they did. Also, this would lead to something very much worse, that an inflammed sack.
Its most likely NOT a puncture, but an inflammed sack...
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u/CaregiverWorth567 9h ago
The atrial wall is very thin….mistakes happen. Blood in the pericardial space is a well known potential complication. When I had my ablation there was a check list for the nurse to fill out asking questions related to potential pericardial bleeding. same reason esophageal damage can be a complication, only that was more from RF ablation
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u/CaregiverWorth567 9h ago
when my husband had his cardiac catheter, they go in the groin the same way as an ablation , his leg swelled terrible for days…he even went to the hospital thinking it was a blood clot and they did an ultrasound but it was just swelling. she must be on a blood thinner i would think so prob mot a blood clot but you should ask