AVR Surgery?

[davidwattsjr]

Very glad to have found this board. Appreciate the good information all of you post out here.

I'm 35 years old. Just diagnosed with aortic insufficiency. Probable bicuspid valve.

Am supposed to see a cardiovascular surgeon tomorrow - but wondered if any of you could tell me how my echocardiogram results compared with yours... am I worse, or better? Trying of course to get some sense for how likely surgery will be for me... and how soon if ever?

Echo shows mild concentric left ventricular hypertrophy - 1.3cm. The aortic root is also mildly dilated. At the sinuses its 4.1 cm and 3.9 cm at the annulus.

Interpreting MD says "moderately severe aortic insufficiency - with probable bicuspid valve."

Symptom wise, just having some shortness of breath upon exertion, some fatigue, and a little bit of light-headedness sometimes.

Anyway - any opinions - based on your experiences would be great... anybody have similar echo results - and avoided surgery, or was advised to have surgery?

Many thanks in advance for your thoughts.

David.

 

[Georgia]

Welcome

Welcome

Hi, David! I can't help you with your question, but there are myriad folks around who can. Have patience; they'll post soon.

You've found quite a remarkable site peopled by a knowledgeable bunch who've dealt with nearly experience involved in valve replacement. Keep dropping by, we love to meet new people.

 

[sylviayasgur]

hi david!
welcome to this wonderful site. unfortunately, i can't help with those echo readings either, but as georgia said, someone who knows will come along in no time.
have you had these symptoms long? are they consistent?
i remember that joey had virtually no symptoms, but his cardio set a limit at which he would insist that joey meet with a surgeon. it just so happened that he started exhibiting symptoms right around the time we were going to start looking into surgeons.
have the docs requested further testing? please let us know what happens.
be well, sylvia

 

[Ross]

Hi David and welcome

I can't help with the numbers, but your symptomatic and the key phrase from the interpreting physician pretty much said it all, "moderately severe aortic insufficiency." With this type of interpretation, your heart's left ventricle should be enlarging. It can do this until a certain point, then it will become permanent and unrepairable.

If your seeing a surgeon, it a pretty sure bet that you need this surgery soon. Do Not Fear! Everyone here has or is about to go through it. We will calm a lot of the fears you may be having. In the meantime, read around and arm yourself with all the information that your brain can handle. Many of your questions will be answered this way. If you have any that aren't addressed somewhere in the forums, just ask, we'll be more then happy to assist.

 

[davidwattsjr]

thanks

thanks

thanks to all so far... yes, the possibility of surgery is intimidating. I know its fairly routine but yet its also rather major surgery.

Symptom wise, I'd say they were probably there for the past couple of months - just didn't put the pieces together.

Will see what the surgeon says tomorrow.

David.

 

[Nancy]

Hi David-

Welcome to this fantastic site. You have a lot of built-in cyber friends right here. We all understand about valve surgery and much more.

My husband is the patient here and he's had 3 valve surgeries and a lot of other things.

Your surgeon will weigh all of the data from your echo. And along with that he/she will add in your symptom profile. Everything is highly technical in the formula that is used to determine a go or no-go situation re: surgery. We have a few techies here who can probably give you the "skinny" on your numbers. But if you are symptomatic with a probable bicuspid valve and your echo showing moderately severe valve insufficiency, the time for surgery is probably in your future. Sometimes, things can stay pretty stable for a while, and in other cases, things can develop rapidly. There is no way to predict how yours will progress. So if surgery is not recommended, they will no doubt, be keeping you carefully monitored.

We will be there for you as you travel down this path, and welcome any questions you might have. There's usually someone here, even in the wee hours. I think we have a few night owls.

So, I hope that you will come here often and ask lots of questions. We'll try our best to give you the picture from the patient's point of view.

Ross is right that there is a point when your heart might not return to normal size, once it gets enlarged.

 

[BillCobit]

Hello David -

My first attempt at inserting a picture follows -- let's see if i did this right. If not, go see http://www.acc.org/clinical/guidelines/valvular/f2.gif for a clinical decision chart on aortic regurgitation evaluation. Note that symptoms, cardiac ejection fraction (EF) and ventricular systolic dimension (SD) and ventricular diastolic dimension (DD) are key determinants in the need and timing for valve replacement. In any case, plse be diligent in keeping scheduled follow-up appointments w/ your docs -- if you get to a point where you need surgery, you don't want to miss your "golden window," beyond which outcome is less successful.

Another reference you may be interested in is "ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease" at http://www.acc.org/clinical/guidelines/valvular/

good luck!

Bill

 

[ALCapshaw2]

Welcome to our world David !

I've been where you are and managed to get one more year out of my aortic valve. I'm not sure I made the right choice.

My *guess* is that they will want to monitor you closely for a while. A TransEsophogal Echo (ultrasonic transducer placed down your throat) gives more accurate results and is often used if the standard echo results are confusing or indeterminant.

NOW is the time to 'get your affairs in order' such as a Will, Living Will, Powers of Attorney, etc, because once your reach Severe symptoms, they (and YOU) will want to move FAST towards surgery.

You do NOT want to postpone surgery too long because PERMANENT damage can be done to the heart if it is enlarged for too long.

'AL'

 

[hensylee]

Hey, Bill - you done good - with the picture, I mean. Maybe we should keep this one around. It is very informative and can help answer some questions.

Hey, David - welcome to VR. This is about the best site you could find for help in whatever you want to ask - so many members and all of them are right at your fingertips. and with answers you can't get from a doctor! God bless

 

[davidwattsjr]

results from mtg with surgeon

results from mtg with surgeon

Thanks to all of you for the many helpful posts..., that flow chart on treating aortic regurgitation was very helpful as well. Looks like my docs will be following that chart.

My Systolic dimension is still good... so the surgeon wants me to work with the cardiologist. He says there's no need for a replacement immediately, but I will need one eventually. How soon? He couldn't say.

He suspects the cardiologist will want a follow up echo in 3 months.

Many thanks to all of you.

David.

 

[Lorraine]

Welcome to your new VR.com home David,

We are family here. Come back and visit us anytime with questions or just to chit chat! There is a world of knowledge here!

I'm glad you don't need immediate surgery. Your cardio will monitor you periodically, run test and he will let you know. In the mean time, research with us. Like Ann said, there are some answers we know that a docotr wouldn't unless they have had the surgery! Take care!

 

[Rick W]

Hello David

As others have said, "Welcome" and so do I. Now first thing is to relax. All will work out in time and things from what you said are not as bad as my readings are currently. I was where you are now 4 years ago, but that is me. I am now at 0.8-0.9 cm2 valve area and somewhere near AVR surgery this year. My cardiologist already did the angiogram last week but wants to schedule me for a stress echo for "pulmonary flow" because I mentioned symptoms to him that are exactly like yours. So you see the symptoms are quite important to the treatment as well as the diagnosis. Keep visiting this site and you will become informed, as all of us have done. The fears dissipate with increased knowledge about what is going on with you. Don't be afraid to get more than one opinion when surgery appears emminent.

Take good care of yourself.