How much to wait to get the surgery?

[Jack Julles Jackson]

Hi there.
Im here for some months now. So Ill tell the story all again.

Im 37 now, and have a bicuspid aortic valve. I got a faiting in december last year, but I did not think about the valve, now, in last 29 jule I got another faiting while running with a heavy backpack while trying to cach a travell bus. I got nothink but that.

Long story short, I got ecos and my ejection fraction is 64% and valvar area of 0,7 cm2. The rest is Ok. My heart is in the right size, other stuff Ok too. Beside anxiety, no other symthoms.

And Im waiting to do the surgery untill since august now and nothing.

My doubt: I dont want to get this surgery on the hollydays. But Im thinking to do it on the first days of february.

Do I run to do it now? Can I wait? What would you do in my situation?

Thanks you all.

 

[Chuck C]

Your valve area is 0.7cm2. You have symptoms. You should not delay. Get your surgery. Push them if you need to.

Less than 1.0cm2 is considered severe. Assuming the data you are presenting is accurate, you are well below that. But, even more significant is that you are having fainting episodes. Get your surgery now. Don't wait. Every guideline in the world calls for surgery once the patient is severe with symptoms.

The graph below shows the risk a person faces once they become severe with symptoms. Disregard the age on the X axis. the important point is the steep drop in survival once a patient is severe with symptoms. You should not panic, but it is not time to put things off until after the holidays.

 

[pellicle]

my view is to always get it done on the slightly early side of things not the slightly past the due date side of things.

destroy your anxiety, you command your own ship, don't let some irrational fear do that

Follow Rule#2 in dealing with anxiety

first one barrel, then the other with your foot on its chest ... just to make sure

 

[pellicle]

cool graph

 

[Jack Julles Jackson]

Thanks.

 

[Chuck C]

Beside anxiety, no other symthoms.

Fainting is also known as syncope and this is a primary symptom of aortic stenosis. See below.

"The cardinal symptoms of AS indicating a need for intervention are angina, symptoms of heart failure, and syncope."

https://pubmed.ncbi.nlm.nih.gov/30553685/

 

[Protimenow]

I understand not wanting to get the surgery before the holidays -- but -- consider how much better you'll be feeling once the holidays are here (with just four weeks left, you'll probably still feel a lot better than you do now) -- and consider how much happier those who love you will be when they know you're over that hurdle and getting much better.

Sometimes just relieving the fears of others is one of the greatest gifts you can give.

 

[Bionic Orange]

Long story short, I got ecos and my ejection fraction is 64% and valvar area of 0,7 cm2. The rest is Ok. My heart is in the right size, other stuff Ok too.

I was 64 when I had these same measurements. That was November 2022. I live in a country where the medical system is very stressed and medical procedures move very slowly.

At that time my cardiologist told my wife that I should not be hiking the mountains in the wilderness anymore unless she knew CPR. She did know CPR, but that advice was enough to make me hold back on my physical activity until I got the surgery. I was active (walking) but cut back on my physical exertion by 90% until I got surgery this past August 2023.

You will feel better after surgery and will be able to run with a backpack again without fainting. Fainting means that when you are exerting yourself, you're not getting enough blood to your brain. This is not good.

I would do it now if I were you. I'm glad I had it done.

 

[Bionic Orange]

my view is to always get it done on the slightly early side of things not the slightly past the due date side of things.

I agree with pellicle. My cardiologist who I have always respected, told me for 20 years, that I needed to have the surgery done at the 11th hour.

 

[LondonAndy]

Hi @Jack Julles Jackson . I agree with most others, and say get it done soon. Whilst your valve area is so small, your heart is having to pump harder to get the blood through it. This means the heart wall will be getting thicker, with more muscle. This is a bad thing: my symptoms were severe, and because the operation was done quite late I have some heart failure - my heart is not as good as it should be. This means I am weaker, and have less stamina now.

 

[Jack Julles Jackson]

Thank you all for the advices.
I will do it asap

 

[3mm]

I should not be hiking the mountains in the wilderness anymore unless she knew CPR

Bionic Orange - I'm glad you've had your surgery and are doing well!

Everyone should remember that emergency medical services take time to reach your location even in the best of circumstances. Do you have cell phone service to call for help? Also, performing proper CPR is HARD WORK. People who are in good shape can only perform CPR correctly for perhaps 20 minutes. However, I will still go hiking alone, or use an isolating shooting range alone. I just acknowledge the risk I'm taking.

 

[Protimenow]

I agree with pellicle. My cardiologist who I have always respected, told me for 20 years, that I needed to have the surgery done at the 11th hour.

I've mentioned this before.

My murmur was first detected when I was 22 (or so). I was told that I would have to have heart surgery when I was around 45 (I don't know what they planned to do about the bad valve at that time - possibly bovine or porcine), but I knew that I would need surgery eventually.

My symptoms worsened over the years. When I was 40, I asked my cardiologist how sick I had to be before I had the surgery. (Better health, faster recovery, etc.) and he agreed that I didn't have to wait. I had my surgery a month or so later.

While you wait, you certainly won't feel better -- today, the surgery is much less exotic than it was when I had mine done in 1991,

If it was me, I don't think I would have much of a reason to wait.


I may have also waited too long - I have significant cardiomyopathy and congestive heart failure -- if I had the surgery done earlier, my cardiomyopathy may have been less, and I may have avoided some of the issues I'm now dealing with.

 

[Chuck C]

Thank you all for the advices.
I will do it asap

Excellent.

Wishing you the best of luck and please keep us posted on how things go. At your young age, you'll pull through this just fine

 

[carolinemc]

Hi there.
Im here for some months now. So Ill tell the story all again.

Im 37 now, and have a bicuspid aortic valve. I got a faiting in december last year, but I did not think about the valve, now, in last 29 jule I got another faiting while running with a heavy backpack while trying to cach a travell bus. I got nothink but that.

Long story short, I got ecos and my ejection fraction is 64% and valvar area of 0,7 cm2. The rest is Ok. My heart is in the right size, other stuff Ok too. Beside anxiety, no other symthoms.

And Im waiting to do the surgery untill since august now and nothing.

My doubt: I dont want to get this surgery on the hollydays. But Im thinking to do it on the first days of february.

Do I run to do it now? Can I wait? What would you do in my situation?

Thanks you all.

Get it done asps. No delay. You need this surgery like yesterday. No running.

 

[Former B-52 gunner]

I waited to get mine done for 20 years, ended up having cardiac arrest and required 15 minutes of cpr, get it done asap.

 

[Jack Julles Jackson]

Thank you all for the advices! I'll have the knife encounter in 12/12.
Whish me luck

 

[Survived03]

Good luck! For what its worth, I think you are making the correct decision to go for surgery sooner rather than later. You will do fine at your age.

 

[Chuck C]

Thank you all for the advices! I'll have the knife encounter in 12/12.
Whish me luck

Best of luck Jack! Please keep us posted on how things go.

 

[Croooser]

Best wishes for a successful surgery and a rapid and complete recovery.