Had my 2nd opinion eval today...

[firrone79]

He confirmed that I do have BAV. He said that in general at this point my heart is healthy. He said he did see some mild narrowing of the valve. Told me that my first priority should be to get my teeth fixed, they are in bad shape! He did tell me that I would need to be on antibiotics beforehand. He said that I should exercise to get my weight down a little bit. I couldn't get a copy of the echo report, but they did tell me to call Friday and they can get it for me then. But I did get a copy of the echo from 6 months ago. I don't understand any of it! Can someone tell me the things on echos they watch the most in regards to BAV? The doc also told me that he wants me to come back for another echo in a year then see him every other year. If I understood him correctly.

 

[ElectLive]

Well, no one likes to hear the word narrowing in relationship to a valve, but the key word is "mild" and that is pretty good news in our world. Valve disease progression is classified into three categories - mild, moderate, and severe. An echo usually includes a summary sheet indicating what is measuring normal and what is not - things like evidence of mild stenosis or regurtitation. For a snapshot of everything, if you look on page e14 (page 15 of the pdf) here: http://content.onlinejacc.org/cgi/reprint/48/3/e1.pdf you will find a chart listing many of the key types of measurements done by echo and what specific values apply to those same 3 categories of severity. The valve area and the gradient are two of the most important values. In any case, surgery usually doesn't happen until in the severe category.

The other key thing monitored and measured on a BAV echo is the diameter of the aorta, with sizes in specific locations (ascending aorta or aortic root, for example) usually highlighted on the summary page if there is evidence of dilation or an anuerysm. You may not have either, but would be good to check.

 

[Guest]

Hi, they look for changes to your valve, is it leaking (regurgitation), look at the left ventricle to see it is functioning correctly, if there is regurgitation, how severe is it, is the left ventricle enlarging because of it, and they are looking at the overall functioning of your heart to ensure good blood flow. Browse the pre surgery forum, the bicuspid valve forum, lots of good info all over the site.

Welcome to VR

 

[epstns]

Firrone,

Since the others have pretty much indicated what to look for in your echo report, I'll leave that part of your question alone.

I can, though, speak from many years' experience about what it is like to have aortic stenosis, which is probably what they meant by "narrowing of the valve." I was diagnosed with moderate to severe aortic stenosis in 2002, at age 54. We monitored my valve via echocardiogram for about 9 years before I finally declared that it was time to get it fixed. During those years I lived my life pretty much as I wanted to, doing all the activities I ordinarily would. It wasn't until the last 6 months or so that I really started to slow down. I had been slowing down for years, but the first 8 or so years it was very gradual. I know you didn't specifically ask about this, but I just wanted to let you know that a BAV and aortic stenosis is not the end of a good life. It is merely a warning that surgery is likely to be needed at some point to ensure that you have a full life span.

While many say that the waiting is the hard part, once you've come to peace with your situation life pretty much goes back to normal until things begin to go downhill, which could be many years. By then you will know what you need to do.

 

[firrone79]

Thank you all for your responses! I am hoping that I am one of the ones who plays the waiting game for quite a few years before my number comes up for surgery!

 

[daddysgirl]

Hi, my dad's heart problem started two years ago when he failed a stress test as part of a standard physical, age 59. He's extremely healthy and active, so he hates going to the doctor. Immediately from the failed stress test he then had to have an echo and a catheterization. The only number we focused on was the closing/blockage/hardening of his aortic value. He has congenital bicuspid value with stenosis. Two years ago he was at 43%, last year 60%, and this year 77%. Each year they wanted to see him for the echo and a catheterization. At the first appt. (43%) the doctor told him he would know when it's time for value replacement, probably 5 years or so. Last year (at 60%), they told him VR in the next year or two. We just had the appt. for this year, where he's at 77% and we're planning the surgery date for March or April. I feel an important number for you to know would be your percentage of blockage. The American Heart Assoc. also has a chart on Aortic Value Stenosis. You can see what range you're in: mild, moderate, severe or critical. My dad is at .46 value area, which is "critical"-- a normal value should be 2 cm2 (cm squared). Hope this helps...