Most Recent Echo Reports

[MaryG]

Following the good advice of many people on this forum I got copies of my most recent Echo reports for my records -- here are some of the highlights.

AVA

2007 1.5 cm2
2008 1.4 cm2
6/2009 0.9 cm2
12/2009 1.0 cm2

GRADIENTS

2007 12/18 mmHg
2008 ?/29 mmHg (no mean listed)
6/2009 18/33 mmHg
12/2009 21/36 mmHg


Ejection Fraction 60% all four Echos

6/2009 states: mildly dilated ascending thoracic aorta at 4.0 cm

12/2009 makes no mention of dilated ascending thoracic aorta

Any comments on what this all means would be greatly appreciated.

 

[ALCapshaw2]

Have you interviewed any Surgeons yet?

This would be a good time to "Be Prepared" so that you will have someone lined up when the time comes. We have a saying that goes:
"The Worse it Gets, the Faster it gets Worse"
That seems to be especially true for Aortic Stenosis.

Many Surgeons use 0.8 sq cm as their "trigger" for recommending Aortic Valve Replacement.

With BAV and an Aortic Aneurism, you would be well advised to find a surgeon with considerable experience dealing with Surgery of the Aorta and Aneurisms. Such surgeons are typically found at the Major Heart Hospitals (Such as Duke University or Dr. Chen at Emory in Atlanta ).

It would be expecially good if he knows how to recognize signs of Connective Tissue Disorder and how to deal with it. I'm not sure who the Aorta Specialist is at Duke but I expect they have one (or more).

Have you begun to notice symptoms of Shortness of Breath or reduced Exercise Tolerance?

'AL Capshaw'

 

[Lily]

I'm just a patient and don't know about the .08 measurement, having thought .07 was often a "special" number, although there may be other measurements to consider too I think.

But the previous comment made me also think of how some of us here have found that some cardios, for some unknown reason(s), may hold back on recommending surgery, while other damage to the heart may occur, rather than referral for surgery.

(I had a former cardio who gave me inept and dangerous advice along that line.)

You certainly would want, when the time may come, an excellent and successful surgeon, who has performed many of whatever procedure(s) your may need with roaring success, and I don't think that a surgeon like that would perform the surgery unless it was necessary. In fact, I don't believe I've read here about a heart surgeon ever needlessly performing valve surgery.

Also, when the time may come for you to have surgery, from what I've read here, excellent heart surgeons seem to want to fix the problem before further damage occurs, rather than how some cardios may desire to manage symptoms with medications, which in themselves can cause other issues.

 

[Bina]

when my AVA was at 1.0 cm, the symptoms were there but I was too scared to book surgery...a few months later my echo showed .8 cm and I had surgery a few weeks later.
My ejection fraction seemed to stay at 60% also.

 

[drivetopless]

I was at 1 cm for years. Then I went from 1cm to .7 cm in 1 year and was told to get ready for surgery "soon."

 

[MaryG]

Thank you all for your comments.

Since my numbers didn't change very much in the six months between the last two Echos, I have been trying to get some idea of how long it might take to get to the time when surgery is really needed. From reading the posts here, I guess that it's a pretty individual thing and can't really be predicted.

At my last cardio visit I made the statement that I was not eager to have surgery, but I also did not want to wait until there was damage to my heart from waiting too long. The cardio said that waiting was only a problem with the mitral valve -- that's sure not what I have been reading and that comment really had me confused.

 

[Adrienne]

The cardio said that waiting was only a problem with the mitral valve -- that's sure not what I have been reading and that comment really had me confused.

The only thing that I can think of that he might have meant is that because the mitral valve can be repaired most of the time, it is better to do it before things get too bad, not that they should get too bad with the aortic valve, but it's just that I think they are more conservative rushing into surgery when they know the valve has to be replaced.

I could be completely wrong about thinking that that's what he meant. It's just a thought.