Surgery on hold/TEE set for 6/27

[Dianne]

My results from the cardiac catheterization I had on the 14th showed that my aortic valve wasn't leaking as badly as what the echocardiagram showed. My cardiologist said he thought an eccentric jet was shooting blood off to one side so it would appear worse on the echocardiagram than what it might really be. So he is holding off on setting a surgery date until he performs a TEE to see how much my heart is enlarged. He said he was unable to determine that from the cath. Prior to the cath., I asked him if the cath might show that I wouldn't need AVR afterall. And he said no, the echo showed that the heart was enlarged and that it was now time for AVR. Yesterday, he implied that if the TEE showed enough enlargement, I'd probably still have surgery now. If not, I could sit on this side for awhile longer and be monitored.

I guess I'm confused hearing the conflicting information from appointment to appointment, exam to exam this past month and don't know what to think. (I also recall a year ago that the echo didn't show the leakage to be as bad as what the TEE showed it actually was.) Anyway, any input/advice on this?? Has anyone else experienced surgery delay or no surgery needed after a cath? And did anyone else have to have a TEE after a cath?

Also, I posted some replies to those of you who answered under cardiac cath. See that thread.
Dianne

 

[Zazzy]

I was just the opposite! They did a TEE first and then a cath.

Geez... can this guy make up his mind?

My surgery to repair my mitral valve was delayed but because of a high white count... six months later.

They performed a cath because I was an ex-smoker and they wanted to make sure that my arteries weren't clogged... seems they were the only thing on me that weren't fat! lol

Zazzy

 

[srwieland]

Well, at least you are going to get the full battery of tests before deciding on surgery. You want to be sure as you can, so what the heck. If the results are still ambiguous after the TEE, though, I'd get another opinion. You might want to do that in any case. At least have another surgeon review the reports of all the tests once their done. Good luck and we're praying for you.

 

[Dianne]

Zazzy

TEE first then a cath does seem to be the logical way.

I hear you on the ex-smoker, slim arteries, fat elsewhere. My arteries looked great even to my untrained eyes.

Was it hard waiting 6 months after your surgery was delayed?
Dianne

 

[Dianne]

Steve in Florida

Thanks for input about getting a second opinion if TEE is questionable. I think many of us don't take advantage of that option. Me included.

I appreciate the continued support and prayers from you and everyone else on this site.
Dianne

 

[Diana]

Hi Dianne

I am like you and have had a lot of tests, angiogram, echoCG
TEE etc. As far as I can make out the TEE is the one that gives the more detailed picture. It was after that that my surgeon decided he would try to repair my MV saying that the AV will need doing in time but that I am "not having any symptoms from it" at the moment. Although it is confusing having to have all these tests and hear different things I am glad that I have taken my time and found out more. My GP doesn't like the idea of surgery but I think the best any of us can do is trust a surgeon who is doing this work every day in a respected hospital. Diana

 

[Dianne]

Diana

Glad to hear your thoughts and experiences concerning having a TEE and lots of other tests. Yes, it is important to take the time to find out as much as you can. I think I'm impatient and was just ready to hear something definite--preferably like no surgery needed at this time! I'm guessing there is a lesson to be learned in my experience.
Dianne

 

[ALCapshaw]

Hello Dianne,

I had a TEE after having a catheterization and they decided to postpone surgery based on the more accurate results from the TEE. They also discovered a moderate Mitral valve regurgation and slight Mitral stenosis which had been undiagnosed previously so I highly recommend following up with a TEE.

They used conscious sedation (VERSED) so I was totally unaware of the procedure. Afterwards, I had a very slight sore throat for the rest of the day but no other effects. You WILL need someone to drive you home and to remain fairly inactive for the rest of the day. One side effect of Versed is that even though you are conscious and even talking to people after you come to, there is a high liklihood that you won't remember anything from the first hour or so, so it is definitely best to be home and safe until the Versed is fully dissipated.

If there is still confusion after your TEE, I would definitely go for a second opinion.

Good Luck and Best Wishes,

'AL'

 

[Dianne]

Hi, 'AL'
I mistakenly thought my TEE was for today, but it is scheduled for tomorrow. I'll let you all know about the results.

I'm glad to hear about your experience of having a TEE after a catheterization. I didn't realize the TEE revealed so much. How long were they able to postpone surgery, or are you still being monitored? (I hope this question makes sense.)

Thanks for the info on TEEs. I've had them before but had forgotten what they entailed--the Versed working maybe?! I hadn't gotten around to looking any info up yet about TEEs. Good reminder about the need for a driver, too, as I have to travel about 1 hour 20 minutes to get to my cardiologist and like to drive it myself.

By the way, I've been looking at the websites you recommended, in early June in a reply to a post of mine. I have also gotten a hold of one of the books you suggested, the Cleveland Clinic one. All of the info has been very helpful.

If anyone reading this post is new to the site and wants your recommendations, these were posted in response to my " New to all of this--Dianne" post around 6-04-01 and 6-05-01.

Thanks again, 'AL'.
Dianne

 

[ALCapshaw]

Hi Dianne,

I'm glad some of my information was useful to you.

My understanding of the TEE is that it gives a better picture of valve operation because they can get the ultrasonic transducer right next to your heart without the waves having to go through your sternum.

I'm still being 'monitored' to see how rapidly my valves deteriorate. Both the mitral and aortic valve are rated "moderate" and therefore do not yet require replacement. I am assuming that my symptoms are agrivated by the combined effects of the two valves since they operate in series. The confusing thing to me is how much my symptoms of chest pain and shortness of breath can vary from day to day or even with time of day. I really notice them after eating for an hour or so.

'AL'

 

[Dianne]

AL
Can you relate any of your symptoms back to how active you've been or what type of activity you've been doing on that particular day? Also do you experience much fatigue with your valve problems? I also have chest pain and shortness of breath which seem, in my case, to be related to activity, weather conditions (extremes) and overdoing it. As well, I have much fatigue and even need to nap during the day and have swelling of the ankles.
Do you experience any of the latter symptoms?
Dianne

 

[ALCapshaw]

Dianne,

I push mow my large country yard for exercise. Sometimes after mowing for an hour or more, I take a nap. Other days I don't feel the need, especially if I only mow for less than an hour.

Shortness of breath is more pronounced after eating, especially dinner. Some days are better than others. I don't know why. Since my Aortic Stenosis and Mitral Regurgitation are both rated only 'moderate', the doctors are reluctant to proceed with surgery but I can tell my capacity is greatly reduced from a year ago, and even down from 6 months ago. Sometimes I wonder if the tiredness is caused by the combination of ACE Inhibitor (5mg Zestril) and Beta Blocker (100 mg Toprol). I will ask my cardiologist when I see him next month.

'AL'

 

[Dianne]

Al
Sorry I'm a little late in replying.

Somewhere I thought I read that there is pooling of blood in the heart after eating meals which can contribute to some heart symptoms. What symptoms/ conditions I don't remember. I will try to find this source and let you know. Has anyone else on this forum read along these lines?

I can't say that my SOB relates to eating but I can sure relate to fatigue/SOB after exertion. I think I take more naps than my dog! Seems like a year or so ago I felt the unpredictablitity of symptoms, too.This was frustrating because one never knew how to plan for things. Budgeting energy became important. For the last 6 months, it's been pretty much a constant, getting worse each month. Glad to hear that you see your doc next month, since things can change quickly.

As far as the TEE went. You were right! I don't remember the procedure after the point of getting sprayed/ gargling. I remember before and after just fine. This is a procedure I don't mind "signing up for" again! As you might have seen on another post, I am back to having surgery and see the surgeon July 10th.
Dianne