3 month post-op Echo not too good

[coryp]

Hello All,

Just thought I would look for some insight as I am confused at best.

Did my 3 month Echo last week and got the results.

The two concerns are;
1) It seems like my Aortic valve (which was replaced) is still moderately leaky
and now my Mitral valve is mild to moderate as well. I never knew I had an issue with the mitral. It was documented during my surgery that the Mitral was mildly regurg though.

2) This is concerning me more, The calculated Ejection fraction and myocardial fiber shortening of the left ventricle based on M-mode is estimated at 55%, which the report says is below normal limits and suggests CHF??????

Please help with some clarification!!!!
My cardio is out this week and my internist says things seem to be ok as 55% is the low of the limit.

Does this happen all the time after surgery? Everyday another issue? I feel so fragile but feel so good. I am only 4 months out and thought I was way out of the woods.

 

[Phyllis]

Don't panic. Others I'm sure will chime in, but from what I have read a normal ejection fraction is between 55 and 75%. The fact that you feel "good" must be good. Calm yourself, use this week to gather your questions and then have a good conversation with the cardio when he returns.

 

[Karlynn]

I know it's hard, but do try and pause for a moment. I had the same type of shock after an echo that said my aortic valve was leaking (12 years past my mitral valve replacement). To hear the news sets you back.

You are 3 months post-op and it's my uneducated opinion that you still have some recovery ahead of you and the leak of your aortic could get better and the regurg of the mitral may be due to the stress of OHS on your heart. Or it might be due to a poor echo too.

There are many reasons you could be having the report you are and most of them are not as frightening or discouraging as you first initial shock leads you to believe. Take it from someone who immediately thinks the worst first!

Best wishes.

 

[tobagotwo]

The ranges vary by medical centers, but 50% to 75% is a common interpretation of normal. I believe that unless you're extremely fit, anything 70% or above is suspect. However, 55% is definitely in the normal range, in all of the published ranges I have seen.

The aortic regurgitation can be one of several things:

- a bad echo

- an unstabilized aortic root which is growing or deforming, causing the valve to close unevenly

- use of a valve that is too large and thus deforms on closing

- a paravalvular leak (a leak around the edge of the velve), if the area it is attached to is not holding it properly, such as might happen with myxomatous heart tissue

...Or something else entirely, although the above would be my top candidates.

As the mitral leak was rated mild, the surgeon and cardiologist probably didn't feel it warranted the further intrusion into the heart at this point. It's a judgement call.

Did you have an earlier echo, shortly after surgery? If so, were the results similar?

Best wishes,