Stenosis VS. Regurgitation

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jumpy

jumpy

VR.org Supporter
Supporting Member
Joined
May 31, 2010
Messages
64
Location
Canada
I always thought my valve would fail due to stonosis but it looks as though I have just "graduated" from the moderate to the severe category for Aortic Regurgitation. Yay for me! :frown2: How many people on here have had their valves replaced through regurgitation and what were your symptoms which precipitated replacement. I went to my family doctor a month ago with Double Vision, feeling light headed, and palpitations. The echo came back as severe. I realize that the echo is interpretive so I now have to wait until May to see my Cardiologist and have another echo before we decide what to do next. I remai in the "holding pattern" until then.
 
I believe that "regurgitation" is the frow of blood back into the heart thru a valve that does no close correctly. I also believe that "stenosis" is when the vale hardens or calcifies and cannot open or close properly. My feeling is that these two terms, reguitation and stenosis, go "hand in glove"......the stenosis causes the regurgitation. However, I have never been one who was/is interested in the nitty-gritty of heart disease. I'm sure some will jump in with a better clinical defination and maybe I'll learn something too.
 
Hi jumpy,

Palpitations and light headedness can both be symptoms of aortic regurgitation. Some other more common symptoms include fatigue upon exertion, shortness of breath, having to sleep upright because you can not breath as well while lying down, and paroxysmal nocturnal dyspnea (which is fancy talk for waking up during the middle of the night, gasping for air because you feel like you can't breath).

I have moderate-severe aortic regurgitation as well, and am monitoring it closely. So I know how you feel! It is scary, but this is a great community with a lot of people who have gone before you and lived to tell about it.
 
My biuspid aortic valve was monitored for many years before surgery. Moderate regurgitation and an enlarged left ventricle were the only things mentioned up until a few years before surgery. Then stenosis started to come into the frame along with the dilated ascending aorta. At the time of surgery my valve was 0.8 cm2 (severe stenosis). The double vision and light headedness were the symptoms even though I did not want to admit it at the time. Also the shortness of breath (especially whist trying to sleep) became more common before surgery.

Martin
 
From my experience, stenosis causes regurgitation. Your day of reckoning is coming, especially as you are bordering on syncope.

When I had these symptoms, my AV was reduced to .6CM and indeed I had regurgitation. Both the cardiologist and the surgeon had me listen to the sound through their stethoscope, which was like a whooshing noise?

Jumpy, give me a call if you need to. You have my work #. If I'm not on shift, ask the boys for my home or cell # and shout me.
 
Will do.....needless to say I've been off work....:frown2: I'm on the first leg of a long-haul journey. I will call you next week...
 
I had aortic reguritation with no stenosis. I was one of the lucky ones (initally) with no symtoms for the first year after diagnosis, then I started getting shortness of breath when doing even light lifting, but still very little impact on my everyday life. My cardiologist told me we could 'manage' it for a while with medications, but it would continue to get worse until I would need surgury in no more thqan a year. I was given the option of management or planning the surgery, I chose surgery, and had it done six months later. Am gald I did and am happy with the results.
 
Aortic Stenosis is usually the result of a buildup of a mineral called apatite on and around your aortic valve. It stenoses the valve mostly just by taking up space that the blood should be flowing through.

Eventually, it builds up in places that cause the valve not to be able to open fully (more stenosis), or that causes the valve not to be able to close fully, so that some blood flows back into the prior chamber instead of being forced ahead into the aorta when the heart beats (regurgitation). Or both.

Regurgitation is also sometimes called Insufficiency, although both AS and AR cause insufficiency (AI), which merely means that there is insufficient blood coming out of the aortic valve to completely fill the aorta.

Best wishes,
 
Thanks for the replies. My Stonosis is mild....2.4cm at the last echo. The Regurgitation is what seems to be getting me. It seems to be getting more symptomatic by the day. I am going to my cardiologist this week. The appointment was supposed to be the beginning of June. They moved it to early May when I told them I have had an Echo which indicated severe. It was moved again to this week after I faxed the Echo to them. I am guessing those are not good signs for where this is going. I was just wondering how unusual it is to go in just for regurg and very little stenosis. One of the reassuring things about this website is the feeling that you aren't going through this alone.

I think I will be frequenting this website in the coming months.

I was on this message board regularly about a year ago when my cardiologist said I should start to think about 5-10 years down the road getting my valve replaced. It looks as though it will be sooner than that. I have had time to think about valve selection and have made a decision in that regard so I am ahead of the game for now. I was hoping to wait a few more years to let technology advance a little but I think I would have had to wait a very long time for that.

Now I just have to prepare for the upcoming pity party when it becomes official....:thumbd:
 
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My valve problem was regurgitation but was mitral ...... short of breath, fatigue, lack of stamina
 
Hey Jumpy

I responded to your PM. Give me a shout, If you are bored on Sunday come on up to MCC and see me.

Very interesting this regurgitation without stenosis, what a pity as your AV opens to 2.4cm2. That is near normal but, she's like the Titanic....a leaker.
 
It definitely seems highly probable that your appointment is getting moved up because your about to be told surgery is necessary now. Maybe they would have other reasons for moving it up to real soon, but given your severe regurgitation and symptoms now too I'm guessing your being told you should get valve changed now. Which will probably be of a standard wait period of your province. If you were of emergency status they would just have you go to the hospital now probably.

Anyway, in Nova Scotia for me that period went a bit like this. Stress echo on Sept 30th. Cardiologist attended mentioned stenosis significanly worsened and to expect follow up appointment sometime in October. That Monday given appointment for October 7th, that Friday.

That appointment was given news about surgery necessary and that it would be several weeks to get a catheritization dye test. A day for pre-assessment for that would be necessary. After that a valve replacement surgery date would be scheduled several weeks later.

What happened was pre-assessment on Nov 2nd, catheritization dye test on Nov 3rd. Nov 10th got a call to check in to hospital about noon on Sunday 13th for surgery on the morning of Monday 14th.
That morning got prepped and was just waiting for them to come and take me to surgery when someone showed up informing me I was getting bumped. They weren't sure yet but it was possible the surgery could be done on that Wednesday. Early Tuesday evening they confirmed that Wednesday morning was scheduled. And on that day surgery went well.

Rather than having a pity party you might want to check out the STICKY thread in the pre surgery forums about the questions you might want to ask:
http://www.valvereplacement.org/for...68-Pre-surgery-consultation-list-of-questions

About the pity party. If there wasn't life saving valve replacement that would be reason for a pity party. Being told you have life saving valve replacement available to you (and paid for) is something to feel good about really.
 
I have been diagnosed with Bicuspid Aortic Valve stenosis and want to meet my cardiologist 1 more time to get actual mesurements and to find out if this transcatheter aortic valve implantation is available in Toronto.I am in about 45 minutes south of Sudbury and here they only do the cracking of the chest. If they can do it through my arteries like the angiogram or through a few small insitions between the ribs, that would be preferable. I have a back injury that lets me live in pain every day but my fear is that because of my back injury, i have to cheat to move around, get out of bed even get off of the toilette. I use my upper body strength to do these things and fear that i won't be able to lift myself and if i throw my back out, i will be screwed. I am not a small guy either which makes this more complicated, 6'1'' and around 380lbs. I have been active all my life and have been gradually slowing down. I thaught i was getting old but now i know it's my heart. I keep to the positive and am greatfull for what i can still do instead of concentrating on what i can't do anymore. If i can get this transcatheder thing done , i think i will go will the Bovine valve but if it's cracking my chest i guess i have to go with the mechanical valve. It's a hard decision and i have never been 1 for taking medication. With my back i have learned that the pain is there for a reason(to stop me from doing stupid stuff) and if i take medication to mask the pain i will just do more damage. I am not crazy about being a slave to the medication or coumadin for the rest of my life. I don't know how to make this decision. I am 40 years old, married with 4 kids, a business to run plus run the house hold. My wifes a nurse but they won't give her time off to take care of me unless i am dying. So i can't go down. I don't know how to make this decision... If they crack my chest i won't be able to push my self off the bed or toiletetc and how long before i will be able to do that after the surgery? With the transcatheter technic I would be completely heeled within 3 weeks and i should still be able to cheat and push myself off the bed, toilet etc.... How do i make this decision?
 
As I understand, transcatheter valves are only for those with a higher risk of morbidity during surgery. They have some serious compromise in order to fit through the arteries and thus are not designed for greater than 5 year life. In patients where there are no other choices, this is more of a life extension than a real choice to improve your quality of life. As opposed to the transcatheter route there are four hospitals in Canada that do minimally invasive replacements, Ottawa, Montreal, Toronto and London. They are hard to find and may be an alternative for a shorter recovery.
 
If Stenosis is narrowing of the valve, why wouldn't they just stick a balloon in the valve to widen it back up as opposed to watching it? I've always wondered that in terms of replacement to that procedure.

I was told my son could do the balloon procedure right off the bat if needed. I assume that's to prevent regurgitation over time.
 
Thanks jumpy, I have no problem with driving to Toronto to get this done if they will take me. Do you know the name of the hospital in Toronto that does this minimally invasive replacement. I am going to see my cardiologist on April 11, 2012 and plan on discussing this with him.....
 
chris.c said:
I have been diagnosed with Bicuspid Aortic Valve stenosis and want to meet my cardiologist 1 more time to get actual mesurements and to find out if this transcatheter aortic valve implantation is available in Toronto.I am in about 45 minutes south of Sudbury and here they only do the cracking of the chest. If they can do it through my arteries like the angiogram or through a few small insitions between the ribs, that would be preferable. I have a back injury that lets me live in pain every day but my fear is that because of my back injury, i have to cheat to move around, get out of bed even get off of the toilette. I use my upper body strength to do these things and fear that i won't be able to lift myself and if i throw my back out, i will be screwed. I am not a small guy either which makes this more complicated, 6'1'' and around 380lbs. I have been active all my life and have been gradually slowing down. I thaught i was getting old but now i know it's my heart. I keep to the positive and am greatfull for what i can still do instead of concentrating on what i can't do anymore. If i can get this transcatheder thing done , i think i will go will the Bovine valve but if it's cracking my chest i guess i have to go with the mechanical valve. It's a hard decision and i have never been 1 for taking medication. With my back i have learned that the pain is there for a reason(to stop me from doing stupid stuff) and if i take medication to mask the pain i will just do more damage. I am not crazy about being a slave to the medication or coumadin for the rest of my life. I don't know how to make this decision. I am 40 years old, married with 4 kids, a business to run plus run the house hold. My wifes a nurse but they won't give her time off to take care of me unless i am dying. So i can't go down. I don't know how to make this decision... If they crack my chest i won't be able to push my self off the bed or toiletetc and how long before i will be able to do that after the surgery? With the transcatheter technic I would be completely heeled within 3 weeks and i should still be able to cheat and push myself off the bed, toilet etc.... How do i make this decision?
Click to expand...

Hi as jumpy said right now Trancatheter aortic valves are only approved for higher risk patients. I would certainaly ASK if you would qualify, since you hve a few things going on that could make you higher risk, but chances are you will need OHS. FWIW the transcatheter valves themself, the leaflets are pretty much the same as tissue valves, so i'm not sure where it came up they are only meant to last 5 years. They do have to be sqished to be deplyed and in place by stents not sewn in but They already not only use percutaneous valves in children/young adults for the pulmonary position and last year about half the tissue valves implanted in europe were done by cath, and i doubt ALL those people planed on now lasting 5 years.

I would certainly ask about different kinds of incisions and also different things used in closing the sternum like glue or talons since beside your back/mobility you are also a larger person who are one of the groups these newer things are reccomended for, IF you do end up needing your sternum opened. Then again when they dont use the sternum sometimes it can be more painful in the beginning since they have to cut thru layers of muscles. so i dont know how that would affect your mobility

I have a bad back too, one of my questions would be do you get spinal blocks for the pain? They are one of the time if you are on coumadin (or any "blood thinnner") you have to stop for a few days and start back up. I dont need a valve, but have thought about it since both my Mom and son and dad had valves/or annuerisms etc) and since i get spinals every couple months i would be stopping and starting every couple months and that is when things are riskiest. also i would worry about the vitamen K2 being blocked that is needed to help bone density
 
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My Nurse practisioner is willing to refer me to Southern Ontario for a second opinion, now which place is better equipped for less invasive valve replacement, Toronto General and doctor Peter Monk or London's Health Sciences? I want to have the best doing this.....Also found out that my vavle measurement is 35mil or 3.5 cm. I noticed i post above that said they had 2.5 cm and that was concidered mild, so what does that make mine?
 
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