I have had a bicuspid valve my whole life...

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brunoandbear

Well-known member
Joined
Feb 17, 2009
Messages
78
Location
Atlanta, GA
For the past five years, the doctors have been following an Aneurysm of my ascending Aorta. It stayed at 4.5cm for the last four, jumped up to 4.65 and in the last eight months has grown to 5.6 cm. I have had a lot happen in the last eight months - my dad passed away in August (who had his valve replaced in 98), my company was sold, my business imploded for a while and I'm just wondering if any of that had to do with the sudden increase. My eating habits certainly went downhill during all of this.

Regardless, I got the CT results last Monday, a week ago, and they didn't even have to tell me when reading the numbers what would need to be done. I knew when they said them that I'd have to have surgery soon. I have been going to Emory University's clinic since I was a child - I am 33 now, and learned about my bicuspid valve when I was three years old. I have known all my life I would have to have surgery at some point, although I assumed it would be in my 50's, not my 30's - and it still would have been that if it were not for the Aneurysm that has formed.

For the last eight years I have been in pain off and on, usually for a few months at a time and sometimes bad pain, sometimes very mild. Typically I'll feel burning down my left arm and in the hand, stabbing in my chest, a dull pressure or burning feeling in the middle of my chest, a pulsing stab on my left and right side and occasionally a burning in my neck. This has been going on for years - and recently, I developed some sharp pulses through the sides of my neck of pain, along with squeezing that comes and goes in my neck as well, especially when I am more active than sitting still. I was expecting when I went in for this CT scan for things not to be that good, although I was telling myself that I was going to see it shrink rather than grow due to taking copper supplements for the last 5 months. A friend of ours has aneurysms and he said that taking copper helped shrink them considerably. Well, I don't know how much benefit it gave me but mine has grown.

I'm at the point where I am meeting with the surgeon next tuesday - Doctor Edward Chen, and getting a second opinion from Doctor James Kauten. Chen specializes in Aortic repair and my cardiologist highly recommends him. The surgeon, in our very brief conversation said I need to have surgery in the next two to three months and does not think I need to have it right now. He also wants to keep my bicuspid valve in and put in a dacron tube to remove the aneurysm. It starts at the root and goes up to just before or where my arch starts. I would like to get the surgery done now and the waiting is really hard on my anxiety. He said my valve looks good and is leaking by a small amount, and it should last me 10 - 20 more years.

The thing that I'm curious about is the pain. Is it normal to experience pain like I have with this kind of aneurysm? The doctors have not placed me on blood pressure reduction medicine but I am not sure if they should or not. I am 5' 10, 162 lbs, I haven't exercised much in the last eight months so I am out of shape, but do not drink, do not smoke and have modified my eating
habits (thanks to my great wife) in the last week to small portions, several times a day. I've read about the surgery on many different places on the net and this one seems like a warm, kind hearted place filled with good people. I wanted to share with you what I am now facing and perhaps seek your thoughts and ideas about it.


- Brian
 
Hi Brian,
First welcome to this looney site. I don't have much that I can share regarding your pain. My Bi-Cuspid valve did cause me some stinging pain in my left jaw area and shortness of breath. I didn't have an Aneurysm so I have no input. But I am very confident that others will chime in soon with their experiences. Good Luck To You.:D
 
Welcome to the VR site, Brian. I understand your disappointment about having to have surgery in your 30s rather than your 50s, but we don't get to choose the timing, unfortunately. As for the pain, my experience is a tightness in my throat on exertion (sometimes into my jaw and face) which has gotten worse over the years. It stopped me from jogging a few years back and now I get it if I climb two flights of stairs or walk up a hill.

There will be many others who will add their comments, so please continue to post your questions or just to vent.

Best wishes,

Jim
 
I've heard that Dr. Chen is a good Aorta Surgeon.

If I had a 5.6 cm aneurism, my first Question would be:
How Soon can you FIX this (before it blows)?
(Can you do it tomorrow? or Next Week?)

My personal GUESS is that diet and Copper Supplements have absolutely NOTHING to do with increasing or decreasing the size of your aneurism.

Have you read through the posts on this (BAV and Connective Tissue Disease) Forum? MY (non-professional) Guess is that your Connective Tissues have weakened and need attention ASAP.

Not to scare you, but are you aware of the Mortality / Morbidity statistics for a ruptured or disected aneurism? (MOST people don't live through them.... Our Moderator Ross is one of the Rare Exceptions... and they got him to the Cleveland Clinic in a hurry. His BLEW at 4.8 cm)

'AL Capshaw'
 
Hi Brian, and welcome!

If they've been following the aneurysm by CT scan, and it has shown such a dramatic increase in size, I would really push for surgery now, rather than two or three months from now.

I would also consider whether the valve should stay or whether it should be replaced now. Is the surgeon confident that the valve won't cause problems a few years down the road?

I had my stenotic bicuspid replaced in 2005. One son has a bav that is being followed, as does our 10 week old grandson. You might check out the bicuspid aortic valve disease website for more information before you make a final choice.

Good luck, and once again, welcome.:)
 
That is what bothers me the most - I want to get it done now but both my Cardiologist and Doctor Chen both think, after looking at the latest CT scan, that I don't need it done hastily. It doesn't help my anxiety at all though, not one bit. I worry about it all the time. The pain and other symptoms have lessened over the past number of days though.

I don't know what to do - the second opinion doctor isn't available until March 2nd and I've run this by a total of four doctors and a nurse so far.
 
I can tell you Dr. Chen is great! He did my surgery back in 2006. I would recommend him to anyone in your position. When you see him tell him I said hi.
As far as pain everyone is different. I had no pain associated with the aneurysm. I did had an irregular heart beat that was a bit disconcerting along with some loss of balance when looking up.
I was back driving a car in 6 weeks after surgery, slept for a couple months in a recliner because it was easier. I would have been in the hospital 4 days and out if not for afib raising it ugly head, but that only delayed me a couple days.
I di lose a good bit of weight afterwards, went in at 168 fell as low as 152 because food tasted like crap for a good while. I have since gained it all back though lol

Who is your cardiologist? Mine is Dr. Wendy Book.
 
I've been seeing Doctor Gerre Lutz as my Cardiologist for years. I am pleased to hear that Dr. Chen did good work for you. From what I've heard, he does more Aortic repair than anyone else in the southeast. I wish he'd get me in sooner, but I am sure he has a reason for not wanting to do it right now.

Did you have any symptoms prior to your surgery?
 
Like I said I had some problems with an irregular heart beat and I was having some problems with balance when i looked upwards, which may have been due to blood pressure. Other than that I had no pains or anything like that. When i went in they told me I needed something in the next 6 months, I had it done about 2 months after they told me. Which gave me time to get affairs in order and make up my mind on which valve etc.
 
I'm not having the balance issues, I assume you must have had very high blood pressure? I read your profile and noticed yours was 5.8 cm and 4.6 at the arch, mine is 5.6 cm at the root and the proximal arch measures 3.3 cm. I am not sure what the proximal arch is but I believe it is the junction point where the ascending aorta joins the arch. How is Wendy Book as a Cardiologist? The only other one I know at Emory currently is Doctor Alan Dollar and he is a great guy.
 
I had what you have now! Go get it fixed now! Do not wait, get it both done it is called the Bentall Procedure. I had mine done at 50 I would have loved to have been 30! I would not wait if I were you! That is just my opinion, because I have been there, why fix one and not the other problem. You don't want to go through OHS twice! Good Luck! Let us know! God Bless
 
My husband had a BAV and never knew it until an aneurysm was found during a routine exam. An x-ray revealed an "enlargement" of the heart which led to further testing revealing a 5.1 ascending aortic aneurysm and BAV. We were told not to have surgery to "let the aneurysm get larger" before surgery. We went to Cleveland Clinic for a second opinion, and surgery WAS recommended by their standards. I am certainly not a medical provider but I wouldn't wait any longer for surgery. I know you are disappointed that you are just in your thirties and not in your fifties........please get the surgery done so you can get to your fifties!

I think you are getting an excellent surgeon but I don't understand the hesitancy for surgery. In the cardio-thoracic journals.......5.0 in the standard for surgery.
 
The only thing I can think of is that I have no stenosis. As soon as I can schedule surgery, I will pick the soonest date I can.
 
My son dissected before they figured out why he was having so much chest pain. The dissection caused a massive MI, he very nearly died and now has permanent heart damage. I am a bit paranoid about dissections now :rolleyes: so my advice is to have the surgery tomorrow. At the least I would request BP meds until the surgery and I would avoid heavy lifting. And yes, I believe the stress you have been under probably exacerbated the heart problems you already have.
 
I would get it fixed asap.. I wish you the best of luck.. gosh, stuff like this scares me to death, my son has BAV :(
 
Frankly, I'm surprised that Dr. Chen is comfortable with waiting a couple of months before doing your surgery.

Does he know that you would like to "get Fixed ASAP"?
If not, tell him, and ask how soon he could do it.

If he still wants to wait and you are uncomfortable with that idea, see if you can find another Surgeon who has lots of experience with the Aorta who would take you sooner.

If you want a second opinion, there are Several CT Surgeons at Peachtree Cardiovascular in Atlanta (see their website and click on the "our surgeons" button to view their profiles).

Good Luck !

'AL Capshaw'
 
I told his nurse today I wanted to shedule it as soon as I can - she said I need to wait to meet with him next Tuesday. The thing that is keeping me from meeting with the surgeons is a large doctors convention in Florida this week, all the surgeons are at it.

Doctor Kauten works at Peachtree Cardivascular and I got him my records last week, though I do not know if he has taken a look at them or not yet. I am close to calling them and having another one of their surgeons look at it for me.

I did not go to work today so I can stay here and rest.
 
Hi

Go see your GP and ask for some Valium or similar to calm you down if you are overly anxious as that will be sending your blood pressure up which is not good in your position. It really helped me and others on here.


Just something for you to consider this week...
I had a BAV and an aneurysm and I sacrificed my BAV in an effort to try get out of this with only 1 open heart surgery. A few extra years on warfarin did not bother me and my surgeon and cardio agreed that this was probably an easier option than lining up for another heart surgery in 10 or so years. I have had no problems with anything and am happy to think I dont need to go have my valve replaced in a few years time (hopefully).

Good luck...sounds like Dr Chen comes with excellent recommendations.
 
I tend to agree with the rest here, get the surgery asap. The rule of thumb for a BAV is fix the aneurysm at 5.Cm. The non rush by Dr Chen could be because the aortic arch is close to normal at 3.3. I am at 4.6 and about 4.4 at the start of the arch. Surgery is usually recommended when the aneurysm grows at more than 5.Cm in a year though. Still, if it was me I would try to get it fixed sooner that later.

Jjay
 

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