4 leaflet aorta valve?!?

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M

michellep

Ok, just back back from the cardiologist with a new echo to find that I have 4 leaflets, not two. Cath is scheduled for Thursday, AVR scheduled for mid-January. Things are moving fast but I feel really good about the doctors I am working with. I am coming to piece with this.
I have decided on the tissue valve since I am a worrier. Now I need to deal with the scar...:eek:
 
Don't let the scar worry you. I was concerned at first, I thought I would have to buy all new clothes as most of my shirts and tops would show the top of the scar. Now it is not a worry, I show it off with pride.
 
Michelle,

I'm glad you're actually moving fast, waiting is such a pain! I've never heard of a 4 leaflet valve, that is interesting :) Mine was bicuspid and one side was jammed shut, the other side wasn't much better.

Remember, the scar just means you've done battle and won! It'll fade!
 
Ok, I meant 'peace'. I like Lynn's quote, "it is what it is". It's my new mantra.:)
 
Ha....that's what my hubby tells me everytime I have another surgery (7 in the last 4 years :eek: )

It is what it is!!
 
About the neckline problem, my husband said before the surgery that he would buy me a necklace that hid it for Xmas (because I kept mentioning trying to find one). So, a few weeks after the surgery I found this absolutely beautiful necklace that does a fantastic job hiding it. My husband bought it, wrapped it up and gave it to me for Xmas 2005. I have bought some other more casual necklaces and pendants also. I don't mind showing the scar when I'm telling my surgery story, but it's true that a scar like that distracts people otherwise.
 
Michelle
I know it is easy to say don't be bothered by the scar but it really is the truth. My first OHS was 27 years ago when I was 29. I was so worried about it and tried to hide it. Well how I have had 4 surgeries and it has not bothered me in, oh, 25 years. I used to work the front desk of a busy law office and wore whatever I chose to. Often people would talk to my incision but I generally would lean down and catch therir eye again. One gentleman came in once and said hey, hey, and promptly opened his shirt and said we match. I have lovely diamond open heart necklace that actually attracts the eye to the scar. It will get better after you accept it and make peace with it. Check out the link to photos of members scars.
 
A four leaf clover is exactly what it looks like! However, while it was moving it looked a little like the predator's mouth from Alien vs. Predator. The technologist who was doing my echo thanked me for coming in. Crazy!
I just hope the scar doesn't scare my little 6-year-old students.
Sidenote...husband isn't doing well. I think he is terrified. He'll make it, he just needs time.
 
4-1=3

4-1=3

Hey, Michellep! Lets make a deal: you have one leaflet more (quadro) and I have one less (bi), so... give me yours and we are fine! :D ;)
 
Re. Quadricuspid Aortic Valve

Re. Quadricuspid Aortic Valve

Dear Michelle,

I read your original post, and I am concerned that you mention chest pain. I want to encourage you to have an evaluation of your aorta.

Malformations of the aortic valve include unicuspid (one leaflet, looks like a donut); bicuspid (two leaflets, sometimes called a "fish mouth" valve); and quadricuspid (four leaflets).

All of these abnormal forms of the aortic valve may be associated with abnormal aortic tissue also. You need to have your aorta evaluated for enlargement/aneurysm - this could be the source of your pain. The entire aorta can be scanned with an MRI or CT (with contrast) and accurately measured in a center with expertise in the thoracic aorta. Also, has anyone counseled you about blood pressure?

Here is one reference from the literature regarding aneurysm with a quadricuspid aortic valve

http://www.ncbi.nlm.nih.gov/entrez/...uids=15514607&query_hl=15&itool=pubmed_docsum

The quadricuspid apparently is very rare. I can only tell you if this were in my own body, I would seek out expertise in a major center. Even then it will be difficult to find someone who has seen and treated very many of these. For example, here is a paper regarding replacing the quad aortic valve and techniques that may help avoid complete heart block. There is some risk with AVR in coming too close to an "electrical" node, and it can result in needing a pacemaker after surgery. This paper from Brigham and Women's describes special considerations when it is a quad aortic valve.

http://www.ncbi.nlm.nih.gov/entrez/...uids=16731182&query_hl=14&itool=pubmed_docsum

Many centers still are unaware of the full range of complexities with the quite common bicuspid aortic valve. The special considerations for a quadricuspid aortic valve, which is much more rare, will be even less understood. The best chance of getting state of the art knowledge and avoiding complications now and surprises later is to actively seek expertise. Reading this post, the plans for you as described are what is typically done for a "routine" valve assessment. Again, if it were myself, I would not be comfortable with that.

If nothing else, insist that your aorta be checked for an aneurysm. You want to avoid aortic dissection or rupture at all costs.

Best wishes,
Arlyss
 
Thank you for your information. Each response gives me more questions to ask and more information.
Arlyss, I researched my hospital after reading your reply and it was ranked 25th in the nation in 2006. It has a cardo research and treatment facility newly opened in 2004. My surgeon is the chief of cardiology. Washington Heart Center is ranked higher (I think it stated 12 in the nation) but I feel very secure that my doctors are the best for me. I only feel this way because I have had so much support from this websight and know which questions to ask.
Thank you for your links. I love reading the technical reports and spent hours last night learning how "special" my heart is.
There will be 2 procedures done during my cath tomorrow, one will send a probe down my aorta to check the leakage, but I am sure they will also be checking for damage. Fun!
 
You really should feel "special"! I had never heard of this so I did a search and found the following sentence.

Quadricuspid aortic valve not associated with truncal abnormalities is rare with a reported incidence of 0.008% to 0.033%. (European Heart Journal 1988;9:1269-1270) In a surgical/pathological series of 225 patients with pure aortic insufficiency the incidence was 1%. (Mayo Clin Proc 1984;59:853-841)
 
Thanks! AFter my cath today I feel very special. Several professions commented on my condition and two nurses came into listen to my murmer. Unfortunately, my cath wasn't as easy a procedure as I would have liked. The actual cath went well, recovery was long. Too much lightheaded, queazy, sweaty moments. Ugh!
I gave me just a small taste of what is to come.
Discovered that my aortic root is dialated.
Fun!
 
Regarding the aortic "root" - in medicine the term "aortic root" is not always used consistently or correctly. Sometimes the term "root" (which applies to only a short segment of the aorta just above the aortic valve) is used for the ascending aorta also. (It is important to know where the "dilatation"/ enlargement is as there are some options, depending on the techniques the surgeon is comfortable with.)

You will want to know that the aorta has been accurately imaged and measured. A cath is not the test of choice for this. You may find it helpful to view this slide presentation by Dr. Isselbacher of Mass General on pre-surgical aortic assessment.

Here is the link http://www.conferencearchives.com/aats2006/sessions/1500.PGAC.10/session.html

And since you do have some aortic enlargement, blood pressure medication can be used to reduce stress on the lining/walls of the aorta with the intent of protecting from tearing. I hope someone has worked with you on that in view of your chest pain.

Best wishes,
Arlyss
 
Thank you Arlyss. The cardiologist who performed the cath was not my usual dolctor so I didn't learn very much during the procedure. I have an appointment with him on Friday next week. After reading your post a few more times I have decided to visit 2 more cardiologists. I believe that my doctor is good, but I do want to see what other opinions are and if they are different. Too much rides on this.
Next step-Tuesday with a new cardiologist. I'll keep you "posted". :)
 
Michelle,

You are quite special indeed! Glad to see you are getting the information you need. Innova and Wash. Hosp. Ctr. are the two top hospitals here in our area for heart procedures, we're lucky to live so close to excellent care. I'll be at Wash. Hosp. Ctr. for my upcoming MVR, I'll let you know what it's like there, I've seen members on the board who speak highly of Innova.

Hope hubby is adjusting.....
 
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