Going for check up for decision on Surgery

[bahlvarun]

Hi all,

I am new as a registered user but have been following this site for a while. Have all gone through that depression when I had to think about my surgery, while I was trying to get married .

Well all said and done, my family cardiac surgeon in AIIMS( India's best) was in US for some deputation, and he is now back. I did share the my examination profiles across and said that surgery is due may be not now but the sooner the better.

So, here I am today, I'll be going for the medical exam and deciding what to do next...

Just thought will share this with you folks with a tremendous knowledge on this subject.

Also, In India, doctors really do not have so much time to respond to all sorts of queries by patients, so I'll be shooting most of my queries across to you folks.

I really do not understand what all the report means but would appreciate if some one can decipher it to me in layman terms

Aortic root :4.59cm
Left Atrium: 4.36cm
EF: 85.35%
FS:55%
SV:121.6MI
LVEDV:139.2MI
LVEDS:17.6MI

Doppler measurement:
AV VTI: 21.2cm
AV Vmax:1.75m/s
AV mean:1.08m/s
AV PG Max:12.2mmhg
AV PG mean: 4.7mmhg

Finally, need your suggestions, with the above data what do you folks suggest, would surgery right away would be the best option?

Also, keeping in mind I stay alone, my family is in another city.

Regards,
Varun Bahl
Moderate Bi cuspid AS - Diagonsed Moderate in Jan-09
AVR suggested - Jan 09

 

[laurad37]

I'm not much help when it comes to the report... after I had my Echo done it's kind of a blur and didn't really ask to get the report or what the numbers where. But anyway, wanted to welcome you to our family.

 

[Adrienne]

Welcome Varun,

I am only going to comment on the first three things (I'll let other people comment on the other things since I don't know about them).

Aortic root :4.59cm

That means you have an aneurism. From what I've read here, it's getting to be about the time you want to take care of it.

Left Atrium: 4.36cm

Your LA is somewhat dilated. You don't want it to become very dilated.

EF: 85.35%

Although that may seem good, it is not. It is so high that it means your heart is probably overcompensating, and at a certain point it will no longer be able to compensate, and at that point the EF (ejection fraction) will go way down.

I will let other more knowledgeable people chime in and give you more information.

 

[MissMelis]

Hi Varun,

I am only just learning what all of these numbers as well, so not much help there - but I did notice your aortic root measurement - that is definitely not normal.
What Adrienne is saying makes sense.

In your case I would think they would repair the aneurysm and replace the valve all at once.

Welcome to the site, I hope you can find some answers here!

Keep us posted on your progress!

Melissa

 

[ALCapshaw2]

The Normal Range for the Left Ventricle Ejection Fraction (LVEF) is 50 to 70% (or sometimes quoted as a lower range within those numbers).

Your 85% number is the highest I recall reading on this site over several years.

An elevated EF is typically seen in Highly Conditioned Athletes (such as the Famous Bicyclist Lance Armstrong) or Heart Valve Patients whose Hearts are compensating for Stenotic Valves.

Another option is that the measurement may be somewhat erroneous since Echocardiogram measurements are highly dependent on the experience and skill of the person performing the echocardiogram.

MY best guess is that your surgeon is correct when he told you that "Sooner is Better".

'AL Capshaw'

 

[WayneGM]

Welcome to VR.com. Glad you found. I'm no help when it comes to the numbers so I'll let other more knowledgable answer your question. Just want provide you with best wishes and good luck.

 

[Bina]

Hello and welcome.
It would seem that your heart and root are under some strain.
Do you have symptoms; shortness of breath, chest tightness, coughing, etc.

 

[bahlvarun]

I am totally asymptomatic

 

[Bina]

I had lots of symptoms and still waited.....not a good idea. It's better done sooner than later.

 

[bahlvarun]

I think so too, but my doctor will decide what to go for next.

Just in case the doctor indicates a surgery, I might have to go for St. Jude coz the hospital uses only St. Jude but I feel On-X is better again that means my doctor will not be experienced in putting that valve in?

Kinda stuck in this delima, I am planning to go for same doc. but On-x but don't know if that'll really work..

 

[Bina]

They are both great valves. The OnX requires a slightly different sewing technique.

 

[Superbob]

It seems there is dilation going on, though others more expert than I can comment on that. Just wanted to extend you a hearty (no pun intended) welcome to the Forum, and to wish you well.

 

[bahlvarun]

Wanted to update u all on my visit.

Doc said surgery not req. now, but is definitely down the line.

Regards,
Varun

 

[Marguerite53]

I'm sure that is a relief to you! However, with an aneurism that size, did he suggest any lifestyle changes? Careful on the weight lifting, pushing, pulling (like no moving a piano around!!). Have you been put on any blood pressure meds?

So, did you ask him to please get experienced in the OnX valve??? Then when it is time for you...he will be very adept at the valve you want!!

Anyway, welcome to our wonderful community. Please continue to ask us questions (starting new threads for new questions will get you a broader variety of answers) as you work to educate yourself. And please come here for support. Waiting is very difficult and can twist us up emotionally sometimes. That's what we're her for too! Great listeners and sympathizers.

Best wishes

Marguerite

 

[Bina]

Hopefully the doctor will still be checking on you every 2-3 months.
Sometimes changes and symptoms show up quickly. Good luck.

 

[bahlvarun]

i am really releived...for now....
i have another visit planned monday, will ask abt the aneurysm, i have been advised regular chk up and if symptomatic then early.

Marguerite
this is a govt hospital, so they have process they float tenders and whatever they get they put it.
Experience or quality of valve is not the only parameter, finally i heard on-x has also filled in the tender this time, hope they get it this time.

i am only hoping by time i have my avr they should have home testing....
till that time, i am gonna go bride hunting...

Regards,
varun

 

[Jkm7]

Hopefully the doctor will still be checking on you every 2-3 months.
Sometimes changes and symptoms show up quickly. Good luck.

Good point about frequent check ups when teetering close to surgery.
My valve had been stable for going on three years but my cardio ordered frequent echos and visits with him. Lucky for me as when my valve worsened, it did so very quickly. It deteriorated considerably in three months and I was into surgery barely a month later.

I suppose that was a case of experience showed. He must have sensed my valve, though appearing to be stable, was not going to stay that way much longer.

Lucky for me he cared enough to be that concerned.

Bahlvarun.... You may wish to request frequent checks, just in case.
Good luck with the bride search. You seem like a nice fellow and should have lots of lovely ladies interested in meeting you.

 

[bahlvarun]

Sorry to have missed the updates Off late, I am kinda having a lot of work here...
I forgot to mention here that the doc. did my TEE and here is what he wrote and told me
AV PSG 64mmhg, Mean 38, and in the comments he wrote, Calcific Mod-Sev AS. He also told me the following
1. The nos. are ripe, but since you are asymptomatic, The surgery can wait...
2. Follow up in 6 months unless you feel the need for another consultation

 

[ALCapshaw2]

re: Symptoms

MANY have said "But I do NOT have any Symptoms"

After Surgery, they say, "Well, I guess I did have symptoms but I dismissed them as being out of shape or old age or... I'm MUCH Better now..."

The way I look at Symptoms is that is a sign of DAMAGE to your Heart. What is the Benefit in waiting for the Heart to be Further Damaged???

As I mentioned in my first reponse to this thread, your EF of 85% is the Highest I have ever seen on this board. I would want an explantation. To my mind, THAT is a Symptom that your Heart is compensating for a defective valve.

One more comment. One of our 'Famous Sayings' is:

"The Worse Things Get, the Faster they get Worse".

If I had your numbers, I'd want an Echo every 3 months or whenever 'symptoms' got worse.

Those are my thoughts.

'AL Capshaw'

 

[skeptic49]

1. The nos. are ripe, but since you are asymptomatic, The surgery can wait...
2. Follow up in 6 months unless you feel the need for another consultation

Hummm....I think I'd be camped out at the doc's ...with more frequent check ups...or just push to have it done. What's the advantage in waiting. Getting more "ripe" is not a good thing.

Best wishes,

Jim