Another Surgery...Maybe not?

[Eric]

You may remember my post a few weeks ago ("Another Surgery!??") that so many of you were so kind to respond to and share with me your input. I posted after my echo report (done by my cardio) showed moderately sever aortic regurgitation. I was shocked and so was my surgeon.

Last week, three weeks after that echo, I did an MRI at the suggection of my surgeon. Surprise again - the results contridicted the echo: "No significant change in mild aortic insufficiency from the bicuspic aortic valve" (from my last MRI which I had done 7 onths ago presurgery).

You can imagine how relieved I was to read this on the MRI report, but I'm not sure what to believe. Is an echo more reliable or is the MRI? My surgeon would like to have me go back to my cardio and repeat the echo in the next couple of weeks but my cardio says it's not necessary and to just come back in 5 months to follow up and maybe repeat the echo then. What do you think?

 

[BillCobit]

Not necessary? Just go away for 5 months and then see what kind of result/interpretation we get next time? I wouldn't be satisfied w/ that.

Your surgeon probably has an opinion about where the best echos are performed in your locale. Maybe you want to go there to get a high quality image and a different interpreter of the data.

 

[OldManEmu]

Don't be brushed off

Don't be brushed off

My understanding is that MRI's are good for measuring the size of things such as Aortic size (aneurisms), heart chamber and wall thickness. Echos and TEEs on the other hand are good for measuring the flow characteristics of the valve. If everything is fine what is their explanation of why you are suffering from fatigue, when you?re a guy that was in good shape before all this began and you are now 9 months post surgery.

 

[Phyllis]

Eric, for peace of mind (and good health), I would go back and have another echo. I agree that a suggestion from the surgeon for the best place to have one is warranted. I know you don't want to "annoy" your cardio. but this is too important. Best wishes and I so hope that the first echo was a misreading.
Phyllis

 

[hensylee]

for peace of mind, go get it.

 

[Marguerite53]

Hi Eric. Since you have your surgeon requesting it, and since it is such an easy and risk free exam, I would definitely go back and get the echo now. There is just no reason to wait. You are supposed to be at a very healed place right now, both physically and mentally, and you cannot be your optimum self with questions lingering out in the air like this.

Good luck and please keep us apprised of the situation.

Marguerite

 

[susieq14]

What was MRI like?

What was MRI like?

Hello Eric,

First of all I'm very new at all this cardio stuff but I would definitely urge you to follow the surgeon's advice and have the echo sooner rather than later. As the other wise posters here have said you deserve the peace of mind. Maybe you should compromise with the cardio and suggest a repeat in 3 months - if you are satisfied with that amount of wait time.

I don't mean to hijack your thread but I was wondering if you could do me a favor and share your MRI experience with me. I'm scheduled to have one next Wednesday, May 10 to check my mitral valve regurgitation and am a little concerned about it. I have had an MRI to check my abdomen for digestive issues but my cardio - who did not want me to have the MRI - said it wouldn't be the same or as easy but didn't go into detail and I did not press him on it. He thinks I worry too much which I probably do but at my November 05 6-month exam following my 3rd echo (was just diagnosed with MR in Summer of 2004), I expressed concern to him that there was such a difference in my 3 echos.
(First echo showed moderate-to-severe, second is labeled moderate and the third is mild. Also I asked him what measurements he was watching and he said the LV Systolic Dimension and LV Diastolic Dimension. Well both of mine have been a bit erratic:
LV Systolic Dimension: 2.7 ? 2.1 - 3.0
LV Diastolic Dimension: 4.9 ? 4.5 ? 4.6)

Anyway after reading some old posts here and learning that echos are subjective based on the tech who does it, I asked him if there was a more definitive test to do. And he finally said I could have the MRI because one of his colleagues is doing some research so I?m scheduled for next week. And then I see my cardio on May 31.

All the MRI center told me was that it would take 45 - 60 minutes.


Good luck with your decision making and thanks in advance for any advice you can share.

Sue

 

[Eric]

I agree...

I agree...

I definitely will go with my surgeon's opinion (and all of your's) and do another echo. Both my cardio and the surgeon reviewed the results of my first echo on CD and did not rely on a technicians's opinion. Both saw significant leakage. Dr. Raissi (surgeon) suggested that perhaps my bp was abnormally high during the echo, and/or that I was over-medicated at the time (which my cardio believes) and these factors contributed to the results.

 

[Eric]

Hi Sue,
My MRI was a long one - 2 hours or so. They injected me with contrast but that was no worse than having your blood drawn. It was uncomfortable but not painful.

Looks like you have some discrepency in your test results as well. Interesting how they showed progressively less regurg as time went on. I hope you'll report back on the results of the MRI and which echo they confirm.

Good luck with your MRI on the 10th.

Hello Eric,

First of all I'm very new at all this cardio stuff but I would definitely urge you to follow the surgeon's advice and have the echo sooner rather than later. As the other wise posters here have said you deserve the peace of mind. Maybe you should compromise with the cardio and suggest a repeat in 3 months - if you are satisfied with that amount of wait time.

I don't mean to hijack your thread but I was wondering if you could do me a favor and share your MRI experience with me. I'm scheduled to have one next Wednesday, May 10 to check my mitral valve regurgitation and am a little concerned about it. I have had an MRI to check my abdomen for digestive issues but my cardio - who did not want me to have the MRI - said it wouldn't be the same or as easy but didn't go into detail and I did not press him on it. He thinks I worry too much which I probably do but at my November 05 6-month exam following my 3rd echo (was just diagnosed with MR in Summer of 2004), I expressed concern to him that there was such a difference in my 3 echos.
(First echo showed moderate-to-severe, second is labeled moderate and the third is mild. Also I asked him what measurements he was watching and he said the LV Systolic Dimension and LV Diastolic Dimension. Well both of mine have been a bit erratic:
LV Systolic Dimension: 2.7 ? 2.1 - 3.0
LV Diastolic Dimension: 4.9 ? 4.5 ? 4.6)

Anyway after reading some old posts here and learning that echos are subjective based on the tech who does it, I asked him if there was a more definitive test to do. And he finally said I could have the MRI because one of his colleagues is doing some research so I?m scheduled for next week. And then I see my cardio on May 31.

All the MRI center told me was that it would take 45 - 60 minutes.


Good luck with your decision making and thanks in advance for any advice you can share.

Sue

 

[susieq14]

Thanks Eric!

Thanks Eric!

Thanks for getting back to me with that information.
Good luck with your next echo!

 

[Rivet]

This same sort of thing happened to me last year. I had the echo and said the leak (aortic valve) was severe and I should have surgery. They did a cath and a TEE.
Then, they did an MRA and said the leak was not as severe as seen in the echo. The leak was unsymmetric and could tell this in the MRA as it is 3-dimensional and echo is only 2-dimensional.

 

[Eric]

Thanks for your input. Did you redo the echo?

This same sort of thing happened to me last year. I had the echo and said the leak (aortic valve) was severe and I should have surgery. They did a cath and a TEE.
Then, they did an MRA and said the leak was not as severe as seen in the echo. The leak was unsymmetric and could tell this in the MRA as it is 3-dimensional and echo is only 2-dimensional.

 

[Rivet]

Thanks for your input. Did you redo the echo?

Waited about a year then did another echo. Then had valve surgery shortly thereafter.

 

[Eric]

I agree. I'm seeing him next Tuesday and I'll see what he recommends.

I meant to add as well, that the surgeon's advice is more protective of you.