Heart remodelling

[heartstream]

I am having my second OHS to put a mechanical tricuspid valve in place.

The right side of my heart is extremely big so although I don't feel to bad apart from very tiered at times my surgeon says we need to do my valve before my heart starts to fail.

I hear lots about heart remodelling after surgery

Is this a standard process after a new valve has been put in or does it only happen sometimes.

My cardiologist did not seem that confident it would remodel but he was confident it would not get worse.

Does anybody have any info on this or experience?

Thanks

Ron

 

[pellicle]

Hi

a tricuspid huh ... I guess that puts you in a smaller group (statistically speaking) than us plain jane Aortic valvers.

Well to your question, I could be wrong, but I suspect that's a fancy name for what happens naturally.

If the valve is defective then there is more resistance to pumping (if stenosis) or your heart needs to pump more (if leaking). Essentially the heart is a muscle ... so just like going to the gym it puts on muscle bulk.

When I was about 9 XRays showed that my heart had enlarged to about adult size due to my stenotic aortic valve.

Just like when you stop going to the Gym your muscles resize to the demands they are under.

So essentially the extra bulk of your heart is a result of the valve problem. Your cardiologist is saying that when the valve is fixed that your heart will return to what it would look like without the extra stresses.

 

[heartstream]

Thank you for your reply.
No my cardiologist is not saying that it will go back to size it should be without the stress. He is saying he is not sure but he is sure it would not get any bigger.

It does make sense that less pressure/ work on the right side of the heart will mean it will reduce in size but he is not confident.

 

[Eva]

Heart remodelling process differs from one person to another, depending on one's heart condition before surgery, one's physical shape, and other aspects. So, for some, the process might be quick while for others it might take a few weeks or months and up to a few years.

Your surgeon is correct. Faulty valves cause stress on the heart, which over time may cause damage to the muscle due to its hard over-working. The sooner the surgery takes care of the valve, the better chances for the muscle to improve (or at least stop further deterioration).

In my case, my enlarged left ventricle shrunk to normal size right after surgery! Unlike my right atrium--the improvement has been going on at a slow rate.

Here is one of threads posted about this subject: http://www.valvereplacement.org/forums/archive/index.php/t-39650.html

Goos luck and hope all will go well.

Keep us posted.

 

[clay_from_nj]

This topic touches on the big problem I have with my cardio. He has maintained that my reduced heart function and LVH will not get any better and may yet still get worse, even after my AVR. I am determined to prove him wrong. A year after surgery (next week), I spend an hour a day, five days a week, in the gym and am up to running a mile in under 10 minutes, down 40 pounds, and even working on a nice six-pack. I would bet that my heart function has improved in this time and that a year from now, at my next follow-up, my cardio will have to admit to seeing measurable results.

Sorry for the rant, but this subject gets me going, and I sincerely believe that reverse remodeling is possible and that I'll prove it to my cardio or find a replacement for him.

 

[pellicle]

...I sincerely believe that reverse remodeling is possible and that I'll prove it to my cardio or find a replacement for him.

I tend to agree with you, but from what it sounds like the heavy gym work would go against the muscle reduction IMO.

but I'm not an expert by any means

 

[clay_from_nj]

Muscle reduction? No way! I want more!

 

[Jkm7]

Muscle reduction? No way! I want more!

Not necessarily.
An oversized heart muscle is not always a good thing.

 

[Debster]

My mom's heart remodeled quite nicely in the year after her surgery. I believe it is due to the surgery and possibly the medications she is on-especially the Coreg and digoxin. Her heart is now down to normal size. I am thinking yours will do the same Best wishes!

 

[dwhist]

I read somewhere, and I can find it if needed, but the sooner you have surgery the better. The article explained that the heart was like a balloon. If a balloon is inflated and then deflated after a very short time, it will go back to it's original size. If the balloon is inflated and left that way for a longer time, when deflated, it will not go back to it's original size.

In my case the cardiologist said mine had gone back to it's original size at the 4 week echo.

 

[Debbrn]

After both of my pulmonary valve replacements and tricuspid valve repairs I have had some decrease size of my right ventricle. My right ventricle was about twice the size of my left ventricle. It has gone down some, but it has never been normal size.

Along with the balloon being enlarged for a long period of time, the size of the balloon matters also. If the right ventricle is stretched to far it will not decrease in size.

Debbie

 

[carolinemc]

It took about a year for mine to get back to normal size. Mine did get to CHF stage before surgery, heart murmur due to heart defect of the aortic valve. Replaces valve with St. Jude's and got better. Remodeling sound more like just the heart muscles get back to normal size. Sounds great to me. Hugs for you today.