aortic valve question

[rosewynds]

I hope this isn't a silly question, I am probably having wishful thinking, but here is my question.

When you are diagnosed with mild aortic stenosis, does it ever just stay mild, never causes any trouble? What are the odds that it won't ever require surgery?

Lisa

 

[JimL]

The mild aortic stenosis I was diagnosed with at age three or four stayed mild for four decades. In fact, when the valve was finally worn out, I didn't even think about valve problems when it became so hard to breathe. It must just be old age, I thought.
In my case, the very fact that it didn't change for so long became a danger, since I didn't recognize the change when it did come.

 

[wlaldridge]

No honestly asked question here get treated as "silly". You are probably visiting the "wishing well" as reqards stenosis not progressing. It is usually a progressive thing with age. 'Depending on the cause of the stenosis. One of the most common problems is the bicuspid (2 leaf) valve. It is present at birth in 2-3 percent of the population. They do not know why but these valves tend to calcify and become increasingly stenotic (stiff or sticky, if you will) and the only treatment is replacement at the proper time.

Have you been instructed to take antibiotics prior to invasive medical procedures, especially teeth cleaning and such?? This is recommened to most patients with defective valves. Bacteria tend to "seed" on these valves and cause infections of the heart and valves. Nothing to mess with.

The advice many gave you in your first thread is still the best. Find a cardiologist to monitor your situation, they know what they are doing and will get you on track.

The person I credit with saving my life this year is the GP who first told me I had a murmur back in 1995. I had always had a "funny" sounding heart, but no one had it checked. This guy sent me to a cardio who diagnosed stenosis but I did not take it seriously. Oh, I took antibiotics etc but nothing else.

As an after thouhgt during a physical this Feb. I SUGGESTED an echo to follow up (this was a new PCP who did not seem to hear anthing unusual) I was now in severe range.

My PCP got a consult from a cardio who said "wait for symptoms", I wanted more tests. The PCP sent me to a different cardio who said after just listening to my heart "you can have all the tests you want, but I tell you from listening, that valve is loud and severely stenotic-you need to plan surgery, not next year but within the next two months" End of story. Never got symptoms, per se but the surgeon said 'boulder of calcium' and very stiff valve'. No doubt it saved my life and proved that being PRO ACTIVE in most things beats 'sticking your head in the sand" which I really wanted to do.

You will rest easier with a Cardiologist following your development what ever the path and velocity it takes.

Sorry for getting on my soap box, I just think I have experienced a miracle and am more sure than ever that "God helps them that help themselves"

My very best wishes to you

Bill

 

[gary]

Depending on your age, you could get by

Depending on your age, you could get by

without surgery, theoretically, depending on the load you place on the heart, how you manage your physical activity and the nature and origin of the stenosis. (disease or heredity)


But it would be rare for a young person or in their teens with normal longevity (their late 70s) to avoid surgery, but you could have 4 decades as I did before it becomes essential.


A stenotic bicuspid valve, (as opposed to a 'loose' or floppy regurgitant one), has distinctive disease characteristics, the main one being that the two leaflets 'chatter'. The stenotic bicuspid valve has to work extremely hard never actually opening and closing tightly. The velocity and force of blood being expelled by the left ventricle which is substantial, into the outflow tract, will age the valve leaflets and annulus much faster than a normal or slightly regurgitant aortic valve.

The leaflets on a three leaflet stenotic valve, as the blood rushes by them, do not perform the free, simple motion of "open", "close" that a normal valve does efficiently, with little apparent effort in a singular natural reflex. The valve leaflets are constrained by calcification and scarring, which ages several layers of the leaflet tissue that give them their resilience and flex so they will do much more work, per beat, over a lifetime than a normal valve or a 'loose' one, eventually getting ever more rigid.

Stenosis, particularly in bicuspid, also carries a greater risk for seizure then a floppy valve or normal one.


AVR; 4/00; CCF; Cosgrove