DEAR DR. DONOHUE: I am a 97-year-old man. My aortic valve has been closing for many years. Now it has become serious. I have congestive heart failure. I turned down an operation to put in a new valve because of my age. Would you tell me something about a procedure I saw on TV where they put in a valve without the usual operation?  0151 L.B.

ANSWER: The aortic valve is positioned between the left ventricle — the main pumping chamber — and the aorta — the main body artery. It closes after the heart pumps out blood to prevent the blood from flowing back into the heart. Aortic stenosis is the name of your condition. It means the valve has narrowed so greatly that it’s hard for the heart to pump blood out. Your heart failure, breathlessness on minimal exertion, indicates that a critical point has been reached. Chest pain and fainting spells are two other signals for urgent action.

The usual operation for replacement of the aortic valve involves splitting the breastbone (sternum) and maintaining circulation throughout the operation by using a pump as an artificial heart.

The new procedure you saw is called transcatheter aortic valve implantation (TAVI). A catheter — a thin, pliable tube — is directed into the heart through a surface blood vessel. When the catheter reaches the valve location, a balloon, carried by the catheter, is inflated. The inflation of the balloon pushes the valve into place, and the new valve is then secured to replace the old one. No chest incision is made. It’s magic. It’s treatment reserved for those who are unable to withstand the physical demands of invasive surgery. The procedure has a good outcome for most. It can, however, lead to strokes in a very few.

This surgery isn’t done throughout North America. However, you live in a place not far from medical schools and hospitals that most likely are staffed with doctors who are trained in this technique. Your family doctor or heart doctor can help you make arrangements with one of these institutions if that’s what you want.

The booklet on heart valve problems discusses the more common valve problems. Readers can obtain a copy by writing: Dr. Donohue — No. 105, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Vitamin C helps stop bruising. Did you forget that Capt. James Cook had his crew eat citrus fruit to stop scurvy? This treatment worked well for his crew. — C.W.

ANSWER: Scurvy took an unbelievable toll on the health and lives of 18th-century sailors. Capt. James Cook made changes in the diet of his crew and included citrus fruit with the sailors’ meals. Not only did the citrus fruit cure those who were stricken with scurvy, but it also prevented other sailors from coming down with it. Scurvy features bleeding and bruising, and is due to a lack of vitamin C. Lack of vitamin C weakens the walls of blood vessels. Citrus fruits are a good source of the vitamin. The actual vitamin wasn’t discovered until the 20th century. Scurvy has become a rarity. Unfortunately, neither citrus fruit nor vitamin C prevents bruising and bleeding from other causes.

DEAR DR. DONOHUE: I sent you a letter saying my red blood cell count was low, at 10.7. I realize you can’t answer every letter, but I thought my letter was a little more important than the one from a man who stood on his head to cure a headache. — J.H.

ANSWER: That 10.7 must be grams of hemoglobin, a huge protein inside every red blood cell. It’s a magnet for oxygen, picking it up when the blood flows through the lungs and depositing it in organs and tissues in need of more oxygen. Hemoglobin serves as an indication of the number of red blood cells. A low hemoglobin indicates a deficiency of red blood cells. That’s an anemia.

Hemoglobin doesn’t, however, disclose the cause of anemia. Other tests have to be done. One common cause is silent (painless) bleeding in the digestive tract. The primary cure for it is stopping such bleeding and giving iron for the iron that’s lost from the blood. I need some more details from you.

I’ll stand on my head to get them.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.