Aortic regurgitation causing mitral regurgitation??

[JustinD]

I am 32 years old and, other than the following, relatively healthy. I have gone from having moderate aortic regurgitation 6 years ago, with an apparent tricuspid aortic valve, to now having moderate-severe aortic regurgitation with moderate mitral regurgitation with evidence of prolapse. I consider my self asymptomatic and my echos show no signs of aneurism. I am now having echos every 6 months with no change over the last 3. My cardiologist has been telling me that the mitral regurgitation is probably due to the worsening of my aortic valve and should get better once the aortic is replaced. However, I recently consulted a surgeon who tells me that the "evidence of prolapse" could mean that there is a structural issue with chordae tendineae of the mitral valve which would need "repair" at the time of surgery. He says he would need to see a TEE to know for sure and it usually isn't done until just before the surgery.

Does anyone have experience with a similar scenario, one way or the other? Anyone had both valves replaced? Anyone around my age have a valve problem that, like me, is not BAV related?

Thanks!

Justin

 

[Rick]

Some eccentric regurgitant streams stemming from the aortic valve happen to be directed toward the mitral valve. If they have sufficient force, the regurgitant blood may over time affect or damage the mitral valve. This was explained and shown to me during an echo.
Best of luck with everything.
Ric

 

[epstns]

Rick has a point, but it is also possible that the abnormal blood flow from your aortic valve is disturbing the flow pattern around your mitral valve. It is extremely difficult to be very precise in an echo, so their assertions may be drawn from indirect flow data. Your mitral regurg may be caused by the aortic valve, and may lessen once the aortic valve is repaired or replaced. I'm not sure how a regurgitant aortic valve will affect mitral valve performance, but I have been told that a stenotic aortic valve may cause such high flow velocities from the aortic valve that it upsets echo measurements around the mitral valve.

Maybe you should push for the TEE sooner, rather than later, to have more facts at hand.

 

[chaconne]

During the echo that revealed I needed heart valve surgery, the echo tech, who happened to be a good friend, saw what he thought could be a problem with the mitral valve caused by a jet coming from the leaky aortic valve (just like Rick described). After discussing it with the cardiologist, and having surgery, it seems like there is no mitral valve problem now. Hopefully the same will be true for you!

 

[AgilityDog]

I've had both valves replaced. My mitral valve prolapse caused beaucoup additional damage all around: a-fib, atrial enlargement, congestive heart failure, subaortic stenosis, aortic valve insufficiency, etc. etc. Why wouldn't the same work in reverse? Bad pressure backing upstream certainly makes sense to me.