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Does a dilated left ventricle shrink back to normal?

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  • Does a dilated left ventricle shrink back to normal?

    I had congestive heart failure caused by aortic valve regurgitation. X-rays showed that my heart was enlarged. On March 4, 2010, surgery replaced my aortic valve with a bovine one. Since then I have exercised according to prescription and in May 2012, my cardiologist told me not to worry about my heart rate and exercise as hard as I feel comfortable. I have been swimming and have managed to go 2.5 km in one go.

    However, I am still retaining water even though I have changed my diet have not lost any weight.

    Am I stuck with the dilated left ventricle or will my heart muscles return to my normal size?
    Perimount Pericardial Bioprosthesis Aortic (Bovine)
    29 mm valve replacement. Dr. Roderick MacArthur
    Mazankowski Center, University of Alberta Hospital

  • #2
    In the same boat.

    J, I empathize with you as this has been my problem, too. I've had the same cardiologist since I was first diagnosed ten years ago and I've come to trust him for both his competence and being honest with me. He says that this is such an individual problem that no one can know how far the heart will go in returning to normal which, as I know, isn't all that reassuring. He told me the significant issue is that as the heart compensates for the damaged valve the walls of the left ventricle become more stiff as they thicken. The stiffness prevents the ventricle from fully relaxing during the diastolic beat when the chamber fills so less blood is pumped out on the systolic beat leading to some degree of insufficiency. The main symptom of "diastolic dysfunction" seems to be fluid retention.

    My cardio thinks that a combination of exercise and drug therapy following the valve replacement are likely to improve the condition over time. In a week, I will reach the second anniversary of my valve replacement. I can tell you that the fluid retention has been reduced which seems to indicate improving heart function. It used to be believed that the benefit from an AVR would be seen in the first few months after surgery. My doctor says there is now good evidence that the heart often continues improving for years afterwards. So the answer I have is not all that satisfying but it does offer hope. What has your cardio told you. Perhaps there will be others reading your post who can share more helpful information.

    AVR 22 SEP 09
    Carpentier-Edwards Bovine Pericardial "Magna" with Sternal Talons
    Oklahoma Heart Institute, Tulsa, OK


    • #3
      Originally posted by Mentu View Post
      It used to be believed that the benefit from an AVR would be seen in the first few months after surgery. My doctor says there is now good evidence that the heart often continues improving for years afterwards. So the answer I have is not all that satisfying but it does offer hope.

      Obviously I'm no doctor but after studying the heart for a few years on my own and working in the medical field for 6 years I've noticed something about medicine and science that people tend to forget. ITS ALL OBSERVATION. Things we are taught as law in medicine change every 10 years and change in the universities.

      In short I think its absurd to think that after only 3 months after valve replacement that the heart has seen all the improvement its going to get. GIVE IT TEN YEARS AND THEN WE'LL TALK sounds more reasonable than 3 months.

      I know some of us don't have 10 more years and some things for whatever reason don't change after a point but coming back to reality; recovery after any heart issue takes several years not several months. DOESN'T HURT TO PRAY AND BELIEVE IN MIRACLES contrary to popular belief. :thumbup:
      Renaissance began on July 27th 2011 @ Hoag Dr. Aidan Raney On-X 23mm Valve with Valsava Graft
      Medtronic ADDR01 Pacemaker for heart block on August 3rd 2011 @ Hoag Dr. Michael Panutich
      Coaguchek Home Testing Since 2012


      • #4
        I had my AVR in January with a left ventricle size of 65mm after my 6 month echocardiograph the ventricle size has now reduced to 58mm, my surgeon expects the ventricle size to return to 45mm (normal size is 35mm). I had no heart failure, maintain a healthy weight and exercise daily with fast walking 4mph for at least 1 hour per day
        27mm St Judes Mechanical Valve
        Coaguchek INR Monitor (Self Monitor & Self Dose)


        • #5
          Originally posted by Julian View Post
          DOESN'T HURT TO PRAY AND BELIEVE IN MIRACLES contrary to popular belief. :thumbup:
          I've had holes and leaking valves for 52 years. After several years of struggling with A-Fib and getting a second opinion, a botched ablation and matters made worse by a second HOLE from that, then a THIRD opinion...and a final FOURTH from which I heard again I did indeed need surgery, I can say that even MY heart size is shrinking according to my NEW Cardiologist, one I trust, after my very recent OHS.

          Congenital: Cleft MV, BAV, ASD. First OHS 8-3-11: MVR, TVR: Edwards MC3/4900 AS, ASD (2), MAZE, AVR: St. Jude. Dr. James Tweddell/Herma Heart Team and Wisconsin Adult Congenital Heart (WAtCH) Disease Program, Dr. Earing and Bartz, Children's and Froedtert of WI...YAY!


          • #6
            I saw my cardiologist a few days ago and he said my heart had returned to normal size - it was very large before surgery. I have exercised every day since leaving hospital after the AVR but I am not sure whether this was a contributing factor.
            Last edited by RunMartin; September 25th, 2011, 09:49 PM.
            Martin. Surgery 9th Feb 2010 at age 48 - AVR and root replacement. 25 mm CarboMedics mechanical valve. Bicuspid Aortic Valve with severe stenosis and regurgitation
            Location - Pendle Hill, North West, England


            • #7
              My left ventricle was way big before my surgery as well. If not mistaken it was 8.0centimeters. Most of the remodelling took place within the first year but it has continued to remodel to the point where it and everything else that was abnormally large, including my left atrium, which my cardio thought would not remodel because it hadn't in the first year, is now a normal size. So....ahem...take heart. I beleive an exercise regimen and healthy diet are strong contributors to helping the heart remodel. Good luck with your long term remodelling project!
              AVR - Medtronics 29mm
              porcine valve and partial Maze
              9/12/08 at Fairfax Hospital/Dr. Alan Speir[SIZE="2"][/SIZE]


              • #8
                Mine has been enlarged for the last 25 plus years. It has gone down some after a yeaar post op, but not much hope of a full recovery. A feel great and do what I want with it enlarged. The point here being you can go a long time like this; not the end of the world.
                Todd Taylor
                Mitral Valve Replacement - Mech St Judes 5/26/2010
                Dr Michael Petracek, Vanderbilt Heart Institue
                [B]"he's more machine than man now" Obiwan Kenobi[/B]


                • #9
                  My left ventricle shrunk a lot right after surgery, and back to almost near normal after a year. In my case, it is my left Atrium that I hope it shrinks one day back to normal.

                  As for exercise, my cardio advised me today to only exercise as I feel without the necessity to reach a certain heart rate. He advised me to go as far as I can push myself, and to stop when I cannot keep rules, no limitations!

                  With time, your LV may continue to shrink slowly as long as you do not have any hypertophy.

                  Good luck.

                  Aortic & Mitral valves replaced with St. Jude Mechanical valves @ age 57 on 9/2/08

                  INR home tester/Coagucheck

                  Forum Rules: " .... medical opinions expressed in this forum are the personal opinions of individuals. No person should at any time
                  act on the information contained herein without the express consent of your own physician."


                  • #10
                    same here

                    my LV was moderatetly dilated, it took me about 6 month to return to normal and stayed like that ever since then.

                    Three times a week I exercise, but dont push my max HR much over 140, mostly in the 120-ies average (Polar HR monitor ALWAYS on duty)

                    all the best
                    SJM AVR April 2005, back on track!