Smoking causes Heart disease and increases your chance of heart failure vastly. If your heart is already in bad shape which it is if you need a mitral valve replacement which is on the left side of the heart. Then I would say that you are only damaging the heart even more if it is in bad shape as is.
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Aortic Valve Replacement is a major surgery, and therefore comes with many health risks. Heart surgery can, and does, save many lives, but it is also a very serious operation where many things could go wrong.
Risks associated with aortic valve replacement include embolism, bleeding, and operative valvular endocarditis. Hemolysis is associated with certain types of mechanical valves, but is not a contraindication for implantation.
A pet would need a PET/CT scan for the same reason a person would which would be looking for potential health risks. It is often used in Veterinary Medicine to diagnose severe health problems seen in animals.
pressure may cause it to bulge like a balloon directly above or below the blockage, causing a weakening of the vessel wall. The aorta may eventually rupture, causing massive bleeding and death
Structural failure.