A medical opinion on AVR for BAV

[MrP]

Meghan,
Like Aussie, timing of my surgery was driven by the need to resect my ascending aneurysm (5.1cm diameter as measured by 64 slice CT scan, and I had aortic symptoms). If I did not have an aneursym, surgery to replace my BAV would have been necessary at a later time and perhaps a few years later (regurgitation ranked 2 to 4 on a scale of 5). My cardiologist and surgeon told me flatly that the BAV needed to be dealt with at the same time as the aneurysm.
With respect to your husband, Eric, I am sure he'd prefer not to have two operations when replacement of his BAV and resection of his aneurysm can be performed with a composite valve and Dacron prosthetic. His aneurysm size is of greatest concern, and especially given his history.
My best,
MrP

 

[chrisgreen500]

Thanks PJMomRunner,

This is a most useful study. It shows that the medical professionals are still asking themselves the same questions! What it does clarify is that there is awareness that something is going on, and that a lot more research needs to be done. The fact that you have had to post this study more than once reinforces the idea of a designated BAV resource area on the site, as it appears to be a particularly complex area of CHD.

The things I take from it, from this thread, and from my other research are this:
- Ensure you have a cardiologist who is up to date with the latest in BAVD.
- Be aware of the other potential ailments (aneursym, dilation, dissection), and ensure they are being checked.
- Make your family aware of the possibility that they are at an increased risk.
- Make sure you are informed, and able to engage your cardiologist, and have input into the clinical decisions made about you.

If anyone has anything to add to this list, please do so.

Once again, thanks to everyone for their input. This thread has been enormously productive for me.

Chris

 

[OldManEmu]

Another article

Another article

Here is another article on aortic aneurysms in normal patients and those with BAV. I will let others read the article and form their own opinions. I look forward to member?s feedback.

http://www.cardiothoracicsurgery.org/content/1/1/7

 

[MrP]

OldManEmu, excellent article! Thank you very much for posting this, as I learned a great deal. In addition to answering the question of whether or not to replace a moderately dilated ascending aorta at the time of AVR, this article provides in-depth clarity of current knowledge of BAV, pre-operative management of aortic dilation using b-blockers, ACE inhibitors, and others including statins, as well as updated research findings and areas requiring further research. Thanks again.
MrP

 

[chrisgreen500]

I agree with MrP,

That is a great article OldManEmu, thanks so much for posting that. It also has many links to full versions of its sources, which is going to be most useful for research.

Rachel, thanks for that advice. Living in the UK, our health service is constantly stretched, and cardiology is approaching crisis point. When my previous cardiologist left a few years back, they had to bring a guy out of retirement to 'temporarily' cover him. He is still doing the job! This does not fill me with optimism, but at least now I shall be able to quiz him, and discover his depth of knowledge, and ask for a second opinion if I am not satisfied.

Hank and Ross. What is the chance of a dedicated area for BAVers? We already seem to have plenty of resources, and I get the impression there are plenty of people ready to offer input. It truly would be a great resource for all BAVers, but in particular to all recently diagnosed BAVers, to help them through that initial tricky adjustment period.