How bad is my BAV really? Aortic valve index?

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freejack

Hi all. Such a great community here! It's such a relief to be able to read about other people's experiences with BAV.

I was diagnosed with a BAV two months ago during a routine physical. My cardio estimated an aortic valve area of 1.6cm/2 based on an echo done in his office. Had a TEE done afterwards where the only abnormal findings were the BAV of course and mild regurgitation. My aorta looked normal atleast in the thoracic region as all the numbers fell within means (thinking about scheduling an echo to check abdomen eventually).

The doc told me to avoid strenuous activities and prescribed Metoprolol succinate for life.

What I'm wondering is, just how bad is my condition? I did a quick aortic valve index calculation based on readings on the web where my BSA is 2.0 and came up with 0.8. My doctor did not mentioned anything about this index so I have no idea if .8 should be a concern or not. Can anyone provide some info on this value?

Thanks!
 
Hi Freejack. I'm not sure what BSA is in this instance ? My Aortic valve area was 0.5 cm2, so 1.6 seems pretty good. I believe the cross over from moderate to severe stenosis is 1.0cm2 so I'm not sure what 1.6 would be classed as, Mild maybe or moderate.
I'm being little to no help here so I'll just say welcome to you and there'll be some proper help along soon....
Cheers...
 
Hi woodbutcher. Thanks for your response!

BSA stands for Body Surface Area. You need that to calculate the Aortic Valve Index which gives you a better idea of how serious the effects of stenosis will be on your body (I believe that's what it's for). The only guideline that I could find online for the index is that anything under 0.6 is serious.

Although a valve area of 1.6cm/2 is mild, 0.8 is awefully close to 0.6. If my valve area drops to 1.2cm/2, that'll bring my index to 0.6. Does that mean I'll need surgery soon after?
 
I've never heard of the whole BSA or AV index thing so I really dont know? I'm sure somebody'll be along though.
I know they normally talk about surgery on an Aortic valve when it gets down to 0.8cm2, but that's valve area not BSA.
Sounds like you're a long way from needing to worry too much though.
Good luck.
 
Hi,

I think Woodbutcher is correct - anything below 1.0 is considered severe. My valve was at 0.6 cm when I had AVR.

I'm not familiar with the Aortic Valve index but tend to agree with Woodbutcher that you may be a ways from surgery - it's just a good thing your BAV was discovered and now it can be monitored.

Best of luck.

Cheers,
Michelle
 
I guess I'll try not to get so caught up with the news of my 'defect' for now. It's really been stressing me out and I've been scouring the web for info. Not sure how long it will be before surgical intervention is required but that's not really up to me decide anyway.

Thanks again for all the responses!
 
Hello and welcome,
My AV area was at .8 and I was having tons of symptoms....my cardio was furious that I was stalling surgery.
Of course he never felt the need to tell me that I had a BAV. duh.
 
hello, and welcome! I have a BAV with mild stenosis of the aortic valve (area of 1.6 cm2) my BSA is 2.13 m2- this puts my valve area index at .7.. valve area index of below
.40 is considered severe. Most cardios follow the valve area when considering the level of stenosis. 1.6 and above is mild, 1.0 to 1.5 is moderate, .6- 1.0 is severe and below .6 is critical. I am at the point of a yearly echo to watch the valve area, and a ct scan to see if my aneurysm is growing.
It does sound like that you are a ways from surgery. You just need to keep monitoring it. If symptoms change (shortness of breath for instance) then you need to follow up with your cardio.

jjay
 
See The ACC/AHA Guidelines

See The ACC/AHA Guidelines

See the the "2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease" chart on the severity of valve disease in adults:

http://circ.ahajournals.org/cgi/content/full/118/15/e523/TBL413968

As you can see, a valve area index of < .6 is considered severe. For comparison, my "numbers" are: valve area 1.3 cm2 (technically "moderate"), but "severe" - when adjusted for my body size - valve area index = .55.

Even so, my surgeon put me on hold for surgery for the time being. And I have a dialated aorta (aneurysm) and I'm BAV to boot!

Go figure.

Jim
 
I can't remember the exact percentage of blood volume successfully pumped into the aorta from the left chamber (the percentage that is not regurgitated back into the atrium) that is the threshold indicator for valve surgery. I think it is 55%, but maybe someone can correct me. I had "severe regurgitation" at 50% and the opening diameter was 1.7cm, so in my case the recommendation for surgery was definite, by both my primary cardiologist and the second-opinion guy. Hope it's helpful, and good luck.
 
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