Echo says Patient Prosthesis Mismatch

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Roberta,
I'm so sorry you have to go through this confusion and unknown! Your story hit home with me, as, within the last 6 mo., my mother was told her pig valve, which was given to her just 2 years ago is also a mis-match! I don't know all her test numbers, other than she is at the gradient of 44, 6 mo. ago and we get her latest echo results next week. It sure sounds to me from others posts that hopefully in your case their is an error. We keep focusing on the fact that she is feeling well and not having any symptoms. We've seen 2 different cardio. now and both seem confused by her conflicting results also. Did you have your surgery at Mayo in MN also? Best of Luck to you!
 
Thanks Bina and Anne.
Bina, good idea re: calling to get in on a cancellation. I may go that route, but know that because the clinic was cancelled that whole week alot of people have been re-scheduled. It may be worth a try.

Anne, thanks for sharing your story and I am sorry your mom is going through this. Is it your mom's mean or peak gradient that is 44? I am feeling a little relieved as my pressure gradients are marginally on the high side (from what I read) for this type of Bovine valve with the peak being at 33. I am keeping my fingers crossed that this is just a technical error. Of course, I will breathe better when this is all sorted out.
I am glad that your mom is having no symptoms which is a good sign (and hopefully it last that way for a long time!). Did she get a TEE or other tests to confirm this finding?
My surgery wasn't at the Mayo Clinic.
Thank you for the well wishes!
 
Hi Roberta,
Her mean gradient was a 44, 6 mo. ago...but we just got last week's echo results and she is at mean gradiant of 49 now. However, now Dr. thinks her Thyroid med. is too strong and that is causing these numbers to be higher! I sure hope he's right! (see my post under Significant others...failing valve....I just explained her update there.) The Dr. explained it to us as the Thyroid "regulates" the other organs and if her thyroid is over active, it's telling the heart that she is "on the move" all the time, even when she is at rest and therefore pumping more blood through the valve and causing more pressure, so the valve appears smaller in echo's than it may actually be.

She has never had any other tests, I don't even know what a TEE test is?
So, in my opinion, make sure the Dr.s have checked your thyroid function!
Again, my best to you!
Anne
 
Thanks for the info Anne. A Transesophageal Echocardiogram is apparently more accurate than a regular echo, but requires one to have a camera go down the mouth and is more invasive. Here is a wikipedia definition if you are interested. http://en.wikipedia.org/wiki/Transesophageal_echocardiogram

Thanks for the reply and glad that you received an explanation for this situation!
 
Here's an article about PPM, this might be helpful http://circ.ahajournals.org/content/119/7/1034.full

Thanks onset! There is some good info in the reference section as well that I have looked at.
I am still hoping that this echo is inaccurate...now just have to be very patient until my appt. However, I will be mcuh better equipped to ask questions regarding my echo results and the PPM.
 
So, I finally had my follow up appt. with the cardiologist. He reviewed my previous echocardiograms post-surgery, compared them to this echo and concluded that the valve size/prosthetis mismatch was an error. :) Basically what most of you suggested!

He also said they don't normally look at prosthetic valve size to determine how the prosthetic valve is functioning as it is not very reliable . He said that they focus more on pressure gradients of the prosthetic valve. However, he does want to send me for a few more tests such as a cardiopulmonary stress test as I am still dealing with shortness of breath on exertion.
Thanks for all your input.
So, all in all it good news.
 
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