P
Phyllis
I'm wondering what the concensus is on the frequency of echos, post surgery. Dick has his yearly cardio appt. coming in August (it was canceled by the cardio twice in the last 3 weeks). He is balking at the idea of having another echo (last one was a year ago) and claims, that if the heart sounds good, ekg is good, no symptoms, there is no need. I found this guidline on the AHA site- any opinions?
. Follow-up Visits in Patients Without Complications
Patients who have undergone valve replacement are not cured but still have serious heart disease. They have exchanged native valve disease for prosthetic valve disease and must be followed with the same care as patients with native valvular disease.
"The asymptomatic patient without complications needs to be seen only at 1-year intervals. The frequency with which 2-D and Doppler echocardiography should be performed routinely in patients without complications is uncertain, and there are no data on which to base this decision. The committee did not reach consensus on this issue. The majority recommended no further echocardiographic testing after the initial postoperative evaluation in patients with mechanical valves whose condition is stable and who have no symptoms or clinical evidence of LV dysfunction, prosthetic valve dysfunction, or dysfunction of other heart valves in keeping with the ACC/AHA Guidelines for the Clinical Application of Echocardiography.2 The committee also failed to reach consensus about serial echocardiography in patients with bioprosthetic valves, who have an increasing risk of structural deterioration of the valve after 5 years in the mitral position and 8 years in the aortic position. A minority opinion recommended annual echocardiography, whereas the majority recommended detailed histories and cardiac physical examinations with echocardiography when dictated by clinical circumstances, such as a regurgitant murmur or a change in symptoms. Once regurgitation is detected, close follow-up with 2-D and Doppler echocardiography every 3 to 6 months is indicated. The committee agreed that echocardiography is indicated for any patient with a prosthetic heart valve whenever there is evidence of a new murmur, there are questions of prosthetic valve integrity and function, or there are concerns about ventricular function."
. Follow-up Visits in Patients Without Complications
Patients who have undergone valve replacement are not cured but still have serious heart disease. They have exchanged native valve disease for prosthetic valve disease and must be followed with the same care as patients with native valvular disease.
"The asymptomatic patient without complications needs to be seen only at 1-year intervals. The frequency with which 2-D and Doppler echocardiography should be performed routinely in patients without complications is uncertain, and there are no data on which to base this decision. The committee did not reach consensus on this issue. The majority recommended no further echocardiographic testing after the initial postoperative evaluation in patients with mechanical valves whose condition is stable and who have no symptoms or clinical evidence of LV dysfunction, prosthetic valve dysfunction, or dysfunction of other heart valves in keeping with the ACC/AHA Guidelines for the Clinical Application of Echocardiography.2 The committee also failed to reach consensus about serial echocardiography in patients with bioprosthetic valves, who have an increasing risk of structural deterioration of the valve after 5 years in the mitral position and 8 years in the aortic position. A minority opinion recommended annual echocardiography, whereas the majority recommended detailed histories and cardiac physical examinations with echocardiography when dictated by clinical circumstances, such as a regurgitant murmur or a change in symptoms. Once regurgitation is detected, close follow-up with 2-D and Doppler echocardiography every 3 to 6 months is indicated. The committee agreed that echocardiography is indicated for any patient with a prosthetic heart valve whenever there is evidence of a new murmur, there are questions of prosthetic valve integrity and function, or there are concerns about ventricular function."
