I'm a little worried! Valve leakage!!

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Update on the mild to moderate mechanical valve leakage that was noted with previous annual Echoes...last week's Echo shows it is the same. mild to.mod., no symptoms....So, the new Cardio MD wants to do a TEE...i have a couple questions for Valvers: 1.) what kind of sedation is used, and 2.) do you have to go off warfarin before the TEE.
 
2.) do you have to go off warfarin before the TEE.
to the best of my knowledge no, but if they request something like that I'm going to say ask about what their INR requirements are, usually its below 1.5

In which case you are far better off going to half doses for a few days prior (do a test and minitor your INR) which will make resuming faster

https://cjeastwd.blogspot.com/2022/05/rapid-dust-off-inr-management.html
resume normal dose the day of the procedure
 
For me for the tee both times they tried to just do it with local anesthetic sprayed in my throat, but I was too gaggy to tolerate the procedure so they gave me a mild sedative - I was conscious but kind of out of it. It made things take longer and I needed a ride home but not a big deal.
 
If the leak is through the valve, it's normal. If paravalvular, not, but mild to moderate is not too significant anyway.
 
From what my MDs have said a trace leak is normal. But it sounds like a mild to moderate is not normally seen....I'm kind of thinking maybe this is my "normal" without any issues. A TEE will give The Cardio MD more info.
 
Update on the mild to moderate mechanical valve leakage that was noted with previous annual Echoes...last week's Echo shows it is the same. mild to.mod., no symptoms....So, the new Cardio MD wants to do a TEE...i have a couple questions for Valvers: 1.) what kind of sedation is used, and 2.) do you have to go off warfarin before the TEE.
I’ve had multiple TEEs. If it’s like mine, they’re going to numb up your throat and then sedate you (fentanyl). twilight anesthesia. Thankful for that - it would be impossible to get the camera down your throat otherwise IMO. On the whole, it’s not so bad, nice afternoon nap but your throat will be a little sore after.

No adjustments to warfarin in my case. I don’t see why they would adjust since there’s no incision, but I can only speak to my case
 
No issues with warfarin for a diagnostic TEE. "Twilight" anesthesia since having a tube stuck down your esophagus is not fun awake. Basically no big deal. I have had a bunch over the years.
 
From what my MDs have said a trace leak is normal. But it sounds like a mild to moderate is not normally seen....I'm kind of thinking maybe this is my "normal" without any issues. A TEE will give The Cardio MD more info.
I agree with you . Mild to moderate will need further investigation . How many months/years after surgery you have encountered this . Where there any signs post ops first echo ?
 
So my recent TEE shows that the paravalvular is moderate and it is from a "slipped stitch" in the sewing ring. It healed over, No symptoms. Just curious, with a moderate paravalvular leak is it wise to continue with my somewhat hard Cardio workouts? or should i scale my Cardio back a bit?
 
So my recent TEE shows that the paravalvular is moderate and it is from a "slipped stitch" in the sewing ring. It healed over, No symptoms. Just curious, with a moderate paravalvular leak is it wise to continue with my somewhat hard Cardio workouts? or should i scale my Cardio back a bit?
Well, it will never get better. The best thing to do is to watch your blood pressure - higher pressure = more leakage.
 
Well, it will never get better. The best thing to do is to watch your blood pressure - higher pressure = more leakage.
Good to know.Thank you for sharing...i'm a bit concerned about long term issues with this moderate leak....but i won't see my Cardiologist for a year so will ask a ton of questions at next visit.
 
Don’t worry about it since you have no symptoms!
Was it the same technician who did your echo in the last year/years or a new one? You may ask your cardio to repeat the test in 6 months instead of a year for peace of min, as it could be a technician’s miscalculations!
Since my surgery in 2008, my echos showed leakage in my mitral, and others showing a leak in the aortic!
 
So my recent TEE shows that the paravalvular is moderate and it is from a "slipped stitch" in the sewing ring. It healed over, No symptoms. Just curious, with a moderate paravalvular leak is it wise to continue with my somewhat hard Cardio workouts? or should i scale my Cardio back a bit?
I think scale it down abit. In my opnion one level below your max. Maintain heart beat below 160 while work outs . No symptoms is great still control BP and pulses. Continue with beta blockers, wafarin, entresto, ( spk to your doctor) if not on these. 6 monthly echo / 8 to 9 months MRI with stress. Best of luck
 
1) they need clearances just to work - you do not want them to stick
and this may not work

family-guy-choking.gif
 
  • Haha
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