Valve size and progression

[Eva]

Well I'm still in the waiting room..? But as far as I can' tell from most studies as long as your not experiencing any symptoms your survival rate is pretty good. Its when you start experiencing symptoms that the death rate shoots up to 2% a month.

Best of luck to you when your time comes up.
In the past doctors, unfortunately, preferred to wait. Every time I asked a cardiologist to recommend surgery while I was fit and strong...they all had same answer: “avoid the knife as long as you can”! I’m glad this is no longer applicable, as yes one has better chance when one‘s heart and health are better.

 

[Chuck C]

"My thinking was that having surgery when I was still feeling okay was better than having an operation when I had deteriorated or the aneurysm leaked or worse. "
This is my thinking exactly Annie. My valve area is 1.1cm2 and I have no symptoms. My local cardiologist believes that I am years away from needing surgery, as I set an office record on the stress test, and no structural issues. But, I tell him, as I've told the other cardiologists that I have sought opinions from- I'd rather get it 6 months early than 6 months late. I think once my valve area is under 1.0cm2 and peak jet velocity and pressure gradient agree with the level of severity, I'm getting the surgery regardless of whether I have symptoms.

 

[Chuck C]

"In the past doctors, unfortunately, preferred to wait. Every time I asked a cardiologist to recommend surgery while I was fit and strong...they all had same answer: “avoid the knife as long as you can” "

Eva, this is exactly what my local cardiologist tells me- put off surgery as long as you can. And he thinks I can put it off many years. But, I do my own research, as we all should and it is clear that outcomes are better if one does not "avoid the knife as long as you can" Setting aside if a person has symptoms, at which point it is urgent, or structural issues that would trigger surgery, such as the diameter of aortic aneurism, the question becomes when. I have sought other opinions from cardiologists at larger clinics. I think my cardiologist at Scripps has it right. I briskly walk up to the top of a 1,200 foot mountain every day and feel great doing it. He says that at some point, I will notice my time going up the mountain dropping significantly and I just can't keep the same pace. That is probably the right time, regardless of symptoms.

 

[vitdoc]

The main thing you want to avoid is irreversible heart damage. With a high gradient your left ventricle works overtime in pumping blood through a narrow aortic valve. The heart is monitored by measuring the wall thickness and by EKG features. One can be relatively asymptomatic and have these changes going on. Ultimately if the heart is too stressed there are permanent changes in the muscle that are not reversible. You don’t want to get there.
When I was 29 I was scheduled for aortic valve surgery since I started to have these type of changes. I was still playing very competitive basketball until I fainted during a game.
The surgery was pushed forward since my cardiologist freaked out. He was worried about sudden death from an arrhythmia.
So I am not so sure that you will know from symptoms when the right time is.
Careful monitoring of the heart will tell you when.
Bye the way for insufficiency symptoms are significantly more important.