high pressures across an artificial valve

[msandel]

My apologies...this is my first post here, and I posted this on the "Valves Selection" forum first by accident.

I had an AVR 8 years ago, and have not done much follow-up other than coumadin monitoring. A recent pre-op echo (fo an unrelated minor surgery)revealed that the pressure gradient across the Medtronics valve is too high. My PCP (haven't seen a cardiologist yet, but have an appt) said that he would like it to be under 40, and mine is 59. Not sure what this number actually measures. I remember that the pressure drop was an 89 just before surgery.

Does anyone have any idea what the ramifications of this are? Is there a critical number where they recommend another surgery?

Any info would be appreciated.
Thanks,
Mark, in Texas

 

[Ross]

Hi Mark welcome aboard.

I wouldn't be too worried about it. Echos don't necessarily tell the truth. It depends on the tech doing the job. Your next echo may well be normal, but if they really want to find out, Catheterization is the way to go. See what your Cardiologist says. I'll bet he's not worried about it either.

 

[msandel]

Thanks Ross

Thanks Ross

Thanks Ross. This is my 2nd Echo, and they were the same. I am really curious about the criteria used in determining if another replacement is needed. I'll be visiting the cardiologist soon, and see what he says.

Mark

 

[tobagotwo]

Glad to have you step out of the shadows, Mark. Wish it could have been more on "just visiting" terms.

While your mention is not specific, it certainly sounds like the number you are referring to is a measurement of peak gradient, which would be delivered in terms of mmhg. In general terms, it is an estimate of how much pressure is required to open up the aortic valve. The pressure is generated by the ventricle squeezing, which forces the blood through the valve into the aorta. 59mmhg is a bit high for a normal valve peak gradient, and would usually indicate some stenosis or lack of flexibility of the valve.

If, as Ross points out, the echo is correct.

Next step would be to recheck the original echo. You could have it done again by someone else, go for a TEE (trans-esophogeal echocardiogram, i.e. through your throat), or go for a catheterization.

At 59mmhg, you're not at any magic number for surgery yet. But it might mean a trend toward it over a number of years.

Hopefully, it's just a tech error or a poor quality echo.

Best wishes,

 

[tobagotwo]

I was writing as you were posting, so I didn't realize you had responded.

Sorry to hear that you have some confirmation (not the same tech, was it?).

The peak gradient, if that is what you were referring to, would only be one of the criteria for replacement.

Best wishes,

 

[Peachy]

Hi Mark,

I have a similar problem. At my recent checkup after an echo I was told that my pressure gradient across the valve had increased from 26 to 60. My last echo was a year and a half ago. I am going back for another echo in March. My GP and my surgeon who I saw a month ago re my sternum wires both think that the echo scan is wrong as I have no symptoms and have recently climbed a Munro (a hill over 3000 feet) without any problems. Are you having any symptoms?