High Gradients with mechanical valve in the first year.

[clfhangr]

Just want to share with the community my experience of a very confusing time and stressful as well. I am 11 months post op with a total root and avr replacement taking place on May 7th 2012. It was my second valve replacement. A baseline echo was taken right after the surgery and the valve looked good. At 6 months another echo was taken and it was then that I was told that the gradient across the valve was climbing. At this time the max gradient was 79 and the mean was 46 :eek2:. Right at the level of severe stenos-is My cardiologist decided to take a wait and see approach and check again in 5 to 6 months.

I just had the echo again and my gradients are in the high end of normal. Check these numbers out for size. Max is at 41 and mean is at 22. For my valve size those are good numbers. My cardiologist did a little digging and looked at my history as well. I am also a renal transplant patient and I have an issue with anemia as well. Well at 6 months I was pretty anemic and it was found that anemia can reek havoc with an echo cardiogram readings across a mechanical valve. It has to do with the blood not having the same density as it would when it has a normal range of red blood cells.

I just wanted to share this in case someone else runs across a high gradient in the first year. It might be wise to mention or check to see where your red blood cell count is at.

Thanks all and I hope everyone is well. Thanks for your support in the past. God bless everybody.

 

[epstns]

clfhangr - That makes some sense to me. When they state measurements from an echo, whether they are gradients or valve areas, etc., the measurements are all extrapolated from measured velocities of blood flows. Their calculations assume a "normal" viscosity of the blood flowing through the valve. If the blood is not within the normal viscosity range, their calculations may be thrown off quite a bit.

Thanks for bringing this up. It may also explain why some valve patients seem to have only mediocre valve performance immediately post-op, yet somehow improve dramatically within a few short months of recovery. The initial echo results may have been impacted by post-op anemia, as many of were anemic right after surgery.

 

[Duffey]

Thanks for posting your experience. It makes sense!

 

[ALCapshaw2]

Gradient measurements from Echocardiograms

Gradient measurements from Echocardiograms

I've been told by Doctors (Surgeon and Cardiologists) and Nurses that gradient measurements from Echocardiograms are Notoriously Inaccurate. The only GOOD way to measure gradients id directly which requires some sort of catheterization.

'AL'