Happy(?) To Be Here

[TellTaleHeart]

Greetings. After knowing for 10 years that I would require surgery at some point for my bicuspid aortic valve, I was informed this week that the time has come. It is time to deep-dive, so here I be. Nervous? You bet.
One thing I have already noticed since finding this forum today is that many of you seem intimate with specific measurements of your heart‘s test result, something I need to educate myself better on. I’ve been relying on Mild, Severe, Critical, OMG, etc. Looking forward to learning a lot more. (And yes I recognize I’ve been an ostrich failing to do all this research before now. Didn’t want to believe it based on lack of symptoms, I guess.)

 

[Paleowoman]

Hi TellTaleHeart - welcome to the forum ! The key to the measurements is asking your cardioogist for a copy of your echocardiogram results. I had no symptoms prior to surgery so really everything was based on the increasing pressure gradients and the decreasing size of the valve area, plus left ventricular ejection fraction - though the latter stayed good always. I'm sure there are other 'numbers' that mean something to cardiologists but I could never make sense of them !

 

[TellTaleHeart]

Hi TellTaleHeart - welcome to the forum ! The key to the measurements is asking your cardioogist for a copy of your echocardiogram results. I had no symptoms prior to surgery so really everything was based on the increasing pressure gradients and the decreasing size of the valve area, plus left ventricular ejection fraction - though the latter stayed good always. I'm sure there are other 'numbers' that mean something to cardiologists but I could never make sense of them !

Thank you, PaleoWoman, exactly the kind of info and support I seek!

 

[nobog]

TellTaleHeart,

(a cut-and-paste):
The ejection fraction is usually measured only in the left ventricle. The left ventricle is the heart's main pumping chamber. It pumps oxygen-rich blood up into your body's main artery (aorta) to the rest of the body. A normal ejection fraction is about 50% to 75%, according to the American Heart Association. A borderline ejection fraction can range between 41% and 50%.

Lots of good people with plenty of knowledge to share here, welcome

 

[TellTaleHeart]

TellTaleHeart,

(a cut-and-paste):
The ejection fraction is usually measured only in the left ventricle. The left ventricle is the heart's main pumping chamber. It pumps oxygen-rich blood up into your body's main artery (aorta) to the rest of the body. A normal ejection fraction is about 50% to 75%, according to the American Heart Association. A borderline ejection fraction can range between 41% and 50%.

Lots of good people with plenty of knowledge to share here, welcome

Thanks, nobog

 

[Chuck C]

Greetings. After knowing for 10 years that I would require surgery at some point for my bicuspid aortic valve, I was informed this week that the time has come. It is time to deep-dive, so here I be. Nervous? You bet.
One thing I have already noticed since finding this forum today is that many of you seem intimate with specific measurements of your heart‘s test result, something I need to educate myself better on. I’ve been relying on Mild, Severe, Critical, OMG, etc. Looking forward to learning a lot more. (And yes I recognize I’ve been an ostrich failing to do all this research before now. Didn’t want to believe it based on lack of symptoms, I guess.)

Welcome to the forum!
This forum was a great source of support and information for me and I’m sure it will be for you too.
I am also BAV and had surgery 14 weeks ago. You’ll have some ups and downs following your surgery, but will likely be back to feeling good again in no time. There is some thing that is enjoyable about the incremental improvement, day by day, week by week of recovery.
Please feel free to reach out to the forum with any and all questions that you might have.
Wishing you well in the choices you have ahead and to a speedy recovery.

 

[TellTaleHeart]

Welcome to the forum!
This forum was a great source of support and information for me and I’m sure it will be for you too.
I am also BAV and had surgery 14 weeks ago. You’ll have some ups and downs following your surgery, but will likely be back to feeling good again in no time. There is some thing that is enjoyable about the incremental improvement, day by day, week by week of recovery.
Please feel free to reach out to the forum with any and all questions that you might have.
Wishing you well in the choices you have ahead and to a speedy recovery.

Thank you Chuck, best wishes for your speedy recovery

 

[ashadds]

did the doctor mention severity and gradients

 

[pellicle]

Hi
and welcome

Greetings. After knowing for 10 years that I would require surgery at some point for my bicuspid aortic valve, I was informed this week that the time has come.

you may not see it this way, but that's great news ... out of the waiting room and int preparing yourself

It is time to deep-dive, so here I be.

well firstly I'm going to say "don't" ... no really ... just don't. A targeted approach of "what is within your actual grasp: is the best thing. I mean really, how can you possibly learn sufficient about all the various measurements to even be on the same page as a second year student?

My advice is instead look at your basics and consider what you want to do.

Nervous? You bet.

understandable, but don't let it rule you.

I myself can't say much to you without knowing some basics:

• your age (approximate is sufficient)
• your activity levels
• male / female

The other thing I'd suggest is to read my blog post here (why write it twice right?)

http://cjeastwd.blogspot.com/2014/01/heart-valve-information-for-choices.html
I wrote that in 2014 and to my mind not much has really changed about the points I raised in that.

Lastly when evaluating things I think this is sound advice

What is critical thinking?
Critical thinking is not about being negative. The term critical comes from the Greek word kritikos meaning discerning. So critical thinking is a deeper kind of thinking in which we do not take things for granted but question, analyse and evaluate what we read, hear, say, or write. It is a general term used to identify essential mindsets and skills that contribute to effective decision making.

What mindsets and skills do critical thinkers possess?
With respect to the first question above, you may respond by describing critical thinkers by the mindsets they possess. These could include being:

• inquisitive and curious, always seeking the truth
• fair in their evaluation of evidence and others’ views
• sceptical of information
• perceptive and able to make connections between ideas
• reflective and aware of their own thought processes
• open minded and willing to have their beliefs challenged
• using evidence and reason to formulate decisions
• able to formulate judgements with evidence and reason.

Critical thinking experts describe such people as having “a critical spirit”, meaning that they have a “probing inquisitiveness, a dedication to reason, and a hunger or eagerness for reliable information” (The Delphi Research Method cited in Facione, 2011, p. 10).

and naturally shoot off questions here

Best Wishes

 

[TellTaleHeart]

did the doctor mention severity and gradients

No gradients discussed. He told me it was severe enough to warrant surgery soon, and the news was enough for me to lose enough focus that I didn’t press him on specifics. That was Friday. Now it’s Monday. I’ll be requesting those specifics today.

 

[TellTaleHeart]

Thanks, Pellicle. All insight and experience-sharing is welcome, and my brief time on this site shows you have plenty of both. Much obliged, mate!

 

[Wiles Darkwinter]

68 years with your bicuspid is a good effort mate! hopefully this surgery will see you through til you're 100!
Seek whatever is going to put you at ease and make you feel comfortable going in to the surgery, but also allow the epiphanies to come when they may.

Take it easy
W.

 

[BillDaThrill]

Maybe you were an ostrich, but you can make up time quick as really there is only so much to know. Besides learning about the results of your valve, put in some time on the big 3: replacement valve types, hospitals, and surgeons. When surgery is near, these are the things are some of the few decisions you get to make going forward. I see your other post now asking about hospitals and surgeons in New England - well done. I was one of those who traveled to the Cleveland Clinic, 1600 miles away. It was well worth the trip, for me. Wishing you the best!

 

[pellicle]

Thanks, Pellicle. All insight and experience-sharing is welcome, and my brief time on this site shows you have plenty of both. Much obliged, mate!

My view is that its a team. You and the surgical / recovery team.

Since you can't do the surgery (but that would be fun to watch someone try) you have to leave that to them, and since even the surgeons rely on someone else to give them the measurements (Surgeons typically can't interpret the medical imaging, and at this point (maybe an AI in future) all such interpretations are done by specialist radiologists or sonographer (the ultrasounds). This is why when they get to see it with their own eyes they are able to make more decisions (you'll find that written here a lot as well as some on the outside, as your sugeons {meaning add that to your list of questions}).

What is in your ball park is how to manage post surgery and how you manage post surgery in some ways comes down to valve choices. You see you now have valvular heart disease. We can not treat valvular heart disease. Instead we do surgery which swaps out a diseased valve for a prosthetic one which gives us: Prosthetic Valve disease.

https://www.ahajournals.org/doi/full/10.1161/circulationaha.108.778886

Despite the marked improvements in prosthetic valve design and surgical procedures over the past decades, valve replacement does not provide a definitive cure to the patient. Instead, native valve disease is traded for “prosthetic valve disease”​

Prosthetic valve diseases comes in two flavours (which I'm sure you're aware is bio and mech). These have two different managemt strategies:

• watch and wait replace as needed with a redo surgery
• treatment with anticoagulant therapy

Thats the nub of it. There are of course some details, but those can be thrashed out here depending on which you feel you align with. The "replace as needed" type has merit if you don't anticipate needing it for more than 20 years (due to natural or anticipated life expectancy).

You will already find much of that written here and the short answer is: choice depends on your parameters and your willingness to be compliant with the requirement of life long anticoagulation therapy. Myself (after my 3rd surgery) I prefer the second (and pretty much another surgery runs a very high risk of a severely impaired life after surgery. So far I've managed the AC Therapy well.