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D

dsouter

Well-known member
Joined
Oct 1, 2009
Messages
92
Location
Ottawa, Ontario , Canada.
I got the Valve clinic to fax me the results of last summers (July 2008) and last weeks Echo:

July 04, 2008
Interpretation Summary:
Sinus Rhythm
The heart rate was approximately 65 bpm.
1. Aortic Valve homograph. At least moderate aortic Regurgitation.
2. Mildly Dilated aortic root and ascending aorta.
3. Normal left ventricular size and systolic function.
4. Mildly dilated left atrium.

Left ventricle:
The left ventricle is normal in size. There is normal left ventricular wall thickness. left ventricular systolic function is normal. The left ventricular wall motion is normal.

Right Ventricle:
The right ventricle is normal in size and function.
Atria:
The left atrium is mildly dilated. Right atrial size is normal. The Inter-atrial septum is intact with no evidence for an atrial septal defect.

Aortic Valve:
An aortic valve homograph is present. The prosthetic aortic valve is well seated. The prosthetic aortic valve appears to open well.

Mitral Valve:
The Mitral valve is normal. There is mild (1+) mitral regurgitation.

Tricuspid Valve:
The Tricuspid Valve is normal. there is mild (1+) tricuspid regurgitation.

Pulmonic Valve:
The pulmonic valve is normal in structure and function. trace pulmonic valvular regurgitation.

Pericardial / Pleural effusion:
There is no pericardial effusion.

Great Vessels:
Mild aortic root dilation. Mildly dilated ascending aorta. There is no pulmonary artery hypertension. Right atrial pressure is estimated at 10 mmHg .

MMode 2d Measurements:
IVSd: 0.98 cm
LVIDd: 5.4 cm
LVIDs: 3.1 cm
LVPWd: 0.94 cm
FS: 42%
LV mass (C)d: 195 grams
Ao root diam: 4.0
LA dimension: 4.1 cm
asc Aorta: 4.3 cm

Doppler Measurements and Calculations:
MV E point: 53 cm/sec
MV A point: 39 cm/sec
MV E/A: 1.4
MV dec time: 0.22 sec
Ao MaxPG 23 mmHg
Ao Mean PG: 13 mmHg
LV V1 max :94 cm/sec
RVSP: 30 mmHg
Click to expand...

December 04, 2009
Interpretation Summary:
Sinus Rhythm
The heart rate was approximately 78 bpm.
1.Well seated Aortic Valve homograph. Moderate to severe (3+) aortic Regurgitation.Elevated trans-valvular gradients.
2. The left ventricle is mildly dilated with normal systolic function.
3. The right ventricle is normal in size and function
4. Mildly Dilated aortic root and ascending aorta.

Left ventricle:
The left ventricle is mildly dilated. There is normal left ventricular wall thickness. left ventricular systolic function is normal. The left ventricular wall motion is normal.

Right Ventricle:
The right ventricle is normal in size and function.
Atria:
The left atrium is moderately dilated. Right atrial size is normal. The Inter-atrial septum is intact with no evidence for an atrial septal defect.

Aortic Valve:
An aortic valve homograph is present. The prosthetic aortic valve is well seated.Moderate to severe (3+) regurgitation.

Mitral Valve:
The Mitral valve is normal. There is trace mitral regurgitation.

Tricuspid Valve:
The Tricuspid Valve is normal. there is trace tricuspid regurgitation.

Pulmonic Valve:
The pulmonic valve is normal in structure and function. There is no pulmonic valvular stenosis. Trace pulmonic valvular regurgitation.

Pericardial / Pleural effusion:
There is no pericardial effusion.

Great Vessels:
Mild aortic root dilation. Mildly dilated ascending aorta. There is no pulmonary artery hypertension. Right atrial pressure is estimated at 10 mmHg .

MMode 2d Measurements:
IVSd: 0.87 cm
LVIDd: 6.0 cm
LVIDs: 3.2 cm
LVPWd: 1.0 cm
FS: 46.5%
LV mass (C)d: 234.1 grams
Ao root diam: 4.0
LA dimension: 5.1 cm
asc Aorta: 4.4 cm
Aortic Arch: 3.3 cm

Doppler Measurements and Calculations:
MV E point: 88.7 cm/sec
MV A point: 71.7 cm/sec
MV E/A: 1.2
MV dec time: 0.14 sec
Ao MaxPG 60 mmHg
Ao Mean PG: 28.8 mmHg
LV V1 max :163.8 cm/sec
RVSP: 31.3 mmHg
Click to expand...

My average blood pressure has risen from a usual 120-130 over 70-80 to 150 over 90.

I have been constantly tired , out of breath and frequently dizzy, almost constant palpitations since about early October. Started a few weeks after my last visit with Valve clinic to go over the July 2008 results.

I wasn't sure if I was making up how I felt because of the appointment and finding out I am Moderately regurgitating or I actually feel like a sack of crap for a reason.

What's your take on the results. Echo's are 17 months apart.

Thanks,

Dugald
 
Looks to me your about due another AVR and being that the ascending aorta is enlarging, replacement of that also.
 
I also would be thinking surgery quite soon. One thing I did notice is the rather rapid enlargement of your left atrium. I am thinking that with your left atrium now enlarged (5.1) you could quite easily be going in and out of atrial fib. I would find that out for sure since it could radically change what valve you choose. If you are going to be on warfarin anyway then the more logical choice would be mechanical.
 
Bina said:
Have you been prescribed a Beta Blocker or something else to control the BP and HR ?
Your gradients are indeed increasing......
Click to expand...

Nothing yet. I asked quite assertively that I get an appointment soon. I don't think any are available until after Christmas though.

Ross said:
Looks to me your about due another AVR and being that the ascending aorta is enlarging, replacement of that also.
Click to expand...

bvdr said:
I also would be thinking surgery quite soon. One thing I did notice is the rather rapid enlargement of your left atrium. I am thinking that with your left atrium now enlarged (5.1) you could quite easily be going in and out of atrial fib. I would find that out for sure since it could radically change what valve you choose. If you are going to be on warfarin anyway then the more logical choice would be mechanical.
Click to expand...

Thanks guys. Gives me more to talk to the surgeon about and also more info for choosing the valve.

I pretty strongly suggested that I need to talk to a surgeon and complained that my echo's are done 3 months after an appointment so I don't get results looked at for 9 months. Suggested that perhaps an echo be done before a yearly check up so the Doctor has current information.

The lady was nice and said that she gave the results to Dr.Lam with a note about my concerns and said something about putting me on the list for the rota of surgeons.

Will call back Monday if I do not hear back from her.


p.s. This forum is a blessing.

Cheers!

Dugald
 
I have a technician come from Ottawa to do my echos here at my local hospital, and the results are available to my docs (and myself) within 2 weeks. Put your foot down about the delay in results being sent out, and most definitely call your doc back on Monday to at least book you in somewhere, even if it's in January.
Maybe your GP can prescribe a low dose of BB med in the meantime. Mine does it for me, and I have a home BP monitor to keep an eye on my numbers.
(avoid bungee jumping and marathons for now) :)
 
Have an appointment at the Valve Clinic Tuesday 9:15.
Chest x-rays , EKG and a talk to go over the results and plan the next steps.


My GP is semi-retired now so only works 2 dyas a week and is booked solid 8+ months in advance.
 
Sounds like it's time to find a New GP who would be more available.

When was your first surgery?

EDIT - AH, I see from your profile that it was in 1999.

If you only got 10 years out of your homograft,
why would you want to sign up for another one,
with the high liklihood that it would also (might/probably) need to be replaced in a relatively short time (10 years)?

'AL Capshaw'
 
ALCapshaw2 said:
Sounds like it's time to find a New GP who would be more available.
Click to expand...

Almost impossible is Canada. Severe shortages of GP's .

When was your first surgery?

EDIT - AH, I see from your profile that it was in 1999.

If you only got 10 years out of your homograft,
why would you want to sign up for another one,
with the high liklihood that it would also (might/probably) need to be replaced in a relatively short time (10 years)?

'AL Capshaw'
Click to expand...

11 years in February.
I have nose bleeds regularly and irritable bowel.
My brother has Collitus and sister has Crohn's.

I wasn't ready for coumadin yet the first time as I wanted to make sure I didn't have the above. They had just been diagnosed when I went in for surgery.

I initially planned on the 3 rd AVR to be the one I went mechanical but now am not sure.

I am seriously considering mechanical now.
 
East of Ottawa several GPs have retired and so the government is sending some new docs to the area. Yay.
My own (super nice) GP is working 6 days a week and must be tired by now.
Good luck on tuesday.
 
Good luck with your appt. on the 23rd Dugald (I hope its this month). It will be good to get some answers. Are you meeting the surgeon or cardiologist?
 
ottawagal said:
Good luck with your appt. on the 23rd Dugald (I hope its this month). It will be good to get some answers. Are you meeting the surgeon or cardiologist?
Click to expand...

Yes, Christmas Eve Eve.

I am meeting with Dr. Lam. He is a Surgeon, I think, but not MY surgeon. He is just the follow up DR. after my AVR as my Surgeon, Dr. Brae, retired or went elsewhere.

Will know more in a week.
 
dsouter said:
Bumped again till January 05th.
Click to expand...

Jan 5th? THAT was the date we had to wait thru the holidays for Justin's MRI in 06-07 to see if he needed surgery. I know it is tough but try not to think of it over the Holidays (too much anyway) , I'm trying to do the same thing with Justin's upcoming surgery and enjoy the Season.
 
Thanks guys, I have 3 Christmas parties in the next 4 days and am planning to have a great time. The people holding them are really great at lifting my spirits.


Cheers!
 
Glad that you have some Christmas parties to keep you 'occupied' and good support. This is when 'living in the moment' is worth its weight in gold.
I hope you can enjoy yourself.
All the best,
 
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