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ken taylor

Well-known member
Joined
Aug 15, 2009
Messages
152
Location
Boquete Panama
OK, Im 60 years old, Had 5 by pases 5 years ago @tx heart institute, Ive was prepairing to walk 500 miles across Spain next mo. Ive been walking 12 miles a day . My pace was 17 min a mile in hills up and down I feel great. My long walks were 22 miles every two weeks. So I went to the heart doc. And he says my arotic valve was calisified. Im not sure but He says it measures about .68 Im not positive about that but it is well under 1,He told me the walk in Spain was a no and that because I have no other symptions that He is not sure I need the arotic valve replaced now are later, you see
i live in Panama in the mountains, and he is good but I do not know what to do , either I go to St. Lukes in Houston for another openion are wate and see so Please give me some feed back. Ken
 
If he told you not to do the walk in Spain - I'm not sure why he's undecided if you need a replacement or not. Your heart is either compromised by your valve or it's not and one would think that his "No" to Spain means your heart is compromised.

Others will be along soon who know more about aortic valve surgery standards. Be patient - it can be a little slow here on the weekend.

And WELCOME! Glad you found us.
 
Hello and welcome to our community. We are not medical professionals here, so all you will get are "educated" opinions.

You are planning to undertake an incredible journey. I'm sure this news is not what you wanted to hear. Aortic stenosis (calcification of the aortic valve) is a serious disease. It may hover in the same range (your .68) for a long time, but generally, my cardiologist said, once it falls below 1.0 you will need surgery within 3 years. The alternative is not good. The valve continues to close up (calcify) and forces the heart to work too hard to compensate for the lack of proper bloodflow. The heart weakens and is damaged by the overload.

Your by-pass surgeries had nothing to do with the stenosis. If I were you I would contact the surgeon who did the bypass and see if they had any clue that you had stenosis 5 years ago. It might help track the progress of the disease. And then I would definitely get a second opinion. As soon as possible.

Was that measure, .68, determined by echocardiogram or by TEE or angiogram or heart catheterization? Echos are not always a true read of the valve size.

Please keep us posted on your plans.

Best wishes.

Marguerite
 
Thank you for your response. 5years back they were going to replace it with the by pass, But uninformed me thought they wanted to replace the mitral valve, not the arotic but I just found out it was the arotic . Back then and having mitral valve prolapse all my life thinking why re place it so I guess I convenced them not to replace the arotic, I really did not know the arotic had a proublem until last week. I thought the pre mature beats Ive had all my life was from the mitral valve , So I feel great but I need to walk , I love it, And it is for me . So really Im confused. Thanks
 
P. S The only thing that shows up besides the stenoses is the wall of my heart between the two chambers has gone from a normal sizs 12 thickness to a 17 . The heart is still flexiable and working fine. It was a sonigram Ken
 
Welcome.
Sounds like diagnosis was made from an echo and if it were me, I think I'd be heading to Texas for a second opinion........ preferably one from a surgeon. Cardiologists and surgeons do not always agree when it is time. Surgeons prefer to operate before there is permanent damage to the heart while cardiologists try to continue treating medically.

Happy you found us but sorry for the reason.
It's slow here over the weekend but other folks will be around soon and I'm sure will offer opinions.
 
Welcome to our World Ken !

The Doctor that caught your Aortic Stenosis may have just saved your life. The 'usual trigger' for recommending Aortic Valve Replacement is when the Effective Valve Area is 0.8 sq cm or less.

The fact that you are so well conditioned is most likely the reason that you sense that you have NO Symptoms. This is quite common among Athletic Types who experience Valve Problems. Have you heard of Basketball or Football players who just 'keel over Dead' on the field? Two of the common causes of Sudden Death are Failed Valves and Ruptured Aortic Aneurisms. Like I said, that Doc probably saved your life. Forget about walking across Spain until you 'get fixed'!

The Texas Heart Institute is ranked in the Top Ten of Heart Hospitals so my recommendation would be to contact them about setting up an appointment with one of their experienced Valve Replacement Surgeons since you already have 'connections' there . He will probably want at least an Angiogram / Heart Catheterization and perhaps a TEE (TransEsophageal Echocardiogram) to get a complete assessment of your heart. He may even want a Chest CT or MRI to check for signs of aneurisms, just to be complete.

ALL of this is Fixable, just a little 'cutting and sewing' and a Too Long Rehabilitation, with very high Success Rates.

Make that Call to THI. Next Week would not be too soon.

'AL Capshaw'
 
Hello, Ken, I'm 59 and although I have known about the stenosis for a while It hasn't been bothering me until recently. In June my business partner and I spent several weeks in China where we walked a lot every day. In July I began having symptoms - shortness of breath, dizziness, and heart palpitations. My Cardiologist ordered an echocardiogram which surprised him with an unexpected low valve area of 0.74 cm2 with a pressure gradient of 61 mmhg. His response was to order a heart cath and make an appointment for me with a surgeon. The heart cath is more accurate in calculating valve area and pressure gradient and showed my numbers to be 0.7 cm2 and 57 mmhg. Aside from the valve, I have no other heart disease.

It is important for you to know these numbers (1.) Valve area in square centimeters and (2.) Pressure gradient in millimeters of mercury. The pressure gradient is the difference in pressure between the inside of the left ventricle and on the other side of the valve in the aorta. Normally an adults Aortic Valve area should be 3-4 cm2. The pressure gradient should be close to zero. As the valve becomes more degraded, its area is reduced and the left ventricle has to work much harder to compensate. This compensation drives up the pressure inside the ventricle and causes a pressure gradient to form across the aortic valve.

I can only tell you that the Doctor who performed my heart cath a few days ago said that my surgery should be planned for the next 4 - 6 weeks and no longer. If your valve area is truly at 0.68 cm2, perhaps, you should do as Al says and have it looked at soon. Below 0.7 cm2 the possibility of sudden death increases substantially for people with aortic valve stenosis.
 
Hi Ken,
Well, first of all welcome. This site has been a source of some great information and support for me.

I would have to agree with everyone else....make that call to get a second opinion ASAP. I have bicuspid aortic stenosis which is progressing very quickly. My valve area has gone from 1.06 in early June of this year, .97 in July and between .63-.70 two days ago at my heart cath. Even my cardio was shocked with what he was coming up with in the cath and spent two hours confirming with others calculating and another echo, which showed the same. He would prefer surgery within the next two weeks, but we are waiting on the surgeon to get back to us on Monday. I do not know how common this quick rate of progression is but I would make that call on Monday if I were you.

I wish you the best Ken and keep us posted.
Lori
 
Hello Ken,
Just wanted to add a warm welcome and sorry for the circumstances. This is a great forum that will help you every step of the way in your journey. I do not have anything to add, but do echo and agree with what the others have said.

Mentu: Just wondering if you would have access to the site where you gathered this information "Below 0.7 cm2 the possibility of sudden death increases substantially for people with aortic valve stenosis". I have been walking around with a valve area of .56 cm2 since June and the surgeon seemed comfortable with an end of Sept. surgery date (which now has to be changed). Just curious, as I wasn't aware that sudden death risk increased with below .7cm. Kind of makes me nervous...
__________________
 
We have a saying here which has been true for many of us:
The worse things are the faster they get worse.
 
ottawagal, here is the reference you requested.

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1729928&blobtype=pdf

What it actually says, is that in non-asymptomatic patients, like Ken, with a high pressure gradient there is increased risk when the valve area is equal to or less than 0.6 cm2. It becomes important now for Ken to know what his numbers are which of course means that he needs to get tested.
 
Thanks for the info, Mentu. Well, based on this study, it looks like I am in that category. .56cm2 and a peak pressure gradient of 98mmhg (based on last echo).

All the best, Ken. Let us know how things go.
 
Welcome Ken...

It sounds like you have been given alot of good information already. The magic number is 1.0 for aortic stenosis. Mine measured .9 when I had my surgery and I was considered to be "severe", so it sounds like you need this sooner rather than later.

I also wanted to comment on the thickness you posted. The thickness change can be directly tied to your stenosis. Since the valve is smaller the heart is working harder to pump blood to the upper chamber. The heart is a muscle so like any muscle when you work it harder it grows. My heart was also thicker because of my stenosis. My cardiologist called it an "athletic" heart. He also told me that it would return to normal size after the surgery because the heart would not be working as hard.

Best of luck...
 
also...my peak gradient was 115. Ottawagal I thought you would want to know that someone else was in the same ballpark your currently in.
 
BIG THANKS to my new family! Im off to the Panama Embassy for a visa for my wife. I have an apointment with the surgeon at St. Lukes Heart Institute of Texas in Houston on tuesday Sept. 1- I was Scared to death . But after finding you folks I feel confident. Now it is in gods Hands. Thanks again and Ill keep you posted. Ken
 
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