Leak around Mechanical Valve

[HeartDawg]

Yep ... we got a leak folks. I did track down some old posts related to the topic of leakage and they were interesting ... thought I'd still post this and see what our experts have to say!

Here's my scoop:

I had an echo a couple days ago (about 4.5 months post surgery). I've been feelin' just dandy. Super. Fantastic.

I'm scheduled to meet with my cardiologist next Friday, so was surprised to get a phone call from him today.

I didn't get too much out of him ... wasn't even sure what questions to ask, but he says there is a leak. He asked a couple times about my INR levels (which have bounced around a bit, but have almost always been within acceptable levels), and asked a couple times if I had been having any fevers (none here). Do you think he was trying to confirm that there wasn't a clot there?

The fact that he called led me to believe he was concerned.

He said something about this sort of leakage not typically being seen in younger (I'm 40 ... guess age is relative) patients like me.

My surgeon is on "vacation" until July ... which usually means he is out of the country doing free surgeries for folks in 3rd World countries.

The good news ... I think ... is that the cardiologist said something about doing a few more specific tests next Friday, and then needing to do a follow up echo in three months (which left me feeling a tad better about it ... maybe not too urgent?).

Sounds like ... from previous posts ... that this could be relatively no big deal to a REALLY big deal. I'm hoping for the former!

What do you think?

 

[Arlyss]

Questions about fever are probably related to concern that endocarditis might have damaged the tissue around the valve, causing a leak.

A "regular" echo through the chest wall will not show enough detail. I suspect if there is a concern about a perivalvular leak a TEE (tranesophageal echo) will be needed to show more clearly what is happening.

A TEE was the only test that showed the problem with my husband's mechanical valve - the strands. So I have become a great advocate of the TEE when it comes to investgating problems with the valve.

Here is a paper about the appropriate use of TEE in checking any type of prosthetic valve (mechanical, tissue) problem

http://www.bicuspidfoundation.com/Evaluation_of_Prosthetic_Heart_Valves_Van_den_Brink.pdf

I will hope for you that this is just a false alarm .... but do have the right tests, to be sure there is no doubt about what is happening....

Best wishes,
Arlyss

 

[PathFinder]

infections...

infections...

Becouse of my fevers, they took a probe of my blood "cultures". This is also a good method for observing the body's condition. The first infection, which has to be concerned is endocarditis.

Wish all best!

Ivo

 

[Karlynn]

You are 4.5 months out - correct? If the leak is around the valve - the sewing area, my guess is that your cardio is wanting to do more tests to see how much of a leak and then do follow ups to see if it seals/corrects itself. As you probably already read, it's not unusual for a little leaking to occur in the sewing ring until the valve gets well seated in the heart.

I'm sorry you've received this disconcerting news. Hopefully it's a case of just waiting for the valve to seat.

 

[Susan BAV]

Hi Tom - Sorry to read about the leak and hopefully further tests will give you better news. In the meantime, did he give you any physical restrictions/limitations? Take care.

 

[Cooker]

Hi Tom,

Sorry you got a call like that. I'm sure it was a little unnerving. As others have said a little leaking is not unheard of.

Hope all will settle down and be well.

Tom

 

[Nancy]

Scar tissue most times seals up leaks that are small. Joe developed a leak around the sewing area when he fainted and dropped to the floor on his chest shortly after having his mitral replaced. He did end up having another surgery to close the leak, but they watched it for quite a while until he absolutely wouldn't put up with the symptoms anymore, and insisted on getting things corrected (cardiologist was dragging his feet, since it would be Joe's third open heart surgery). Surgeon said it took just a couple of stitches. Everything was fine after that. That surgery was done through the side using the Heart Port method.

 

[HeartDawg]

Thanks for the replies. They are all VERY helpful.

It does sound like it's a bit of a waiting game for me until they do some more tests.

Regarding limitations ... he didn't give me any. My wife asked me that same question last night.

He did vaguely mention "another sort of echo," which I am taking to be the TEE.

I'll post back at this thread when I know more ... let you folks know what's happenin' on my end.

Thanks, again. You guys are great.

 

[LUVMyBirman]

Hi Tom,

During my post op echo....had a peri-valvular leak detected @ about 2 o'clock on the sewing ring. They reinforced the dx with a TEE. It was watched for a few years. Did seal itself up just fine. Can't be detected on an echo. It's been 8 years.

My guess is you will do well. Given the fact you are asymptomatic.

Wishing you all the best.

 

[HeartDawg]

Hi Tom,

During my post op echo....had a peri-valvular leak detected @ about 2 o'clock on the sewing ring. They reinforced the dx with a TEE. It was watched for a few years. Did seal itself up just fine. Can't be detected on an echo. It's been 8 years.

My guess is you will do well. Given the fact you are asymptomatic.

Wishing you all the best.

Now, THAT'S what I like to hear!!!