How often for follow-up?

[Ashley]

Just wondering if anyone has any advice or thoughts on the frequency of follow up for patients like myself who aren't ready for surgery yet, but are possibly starting to get close. My cardiologist has recommended that I be seen every 6 mos., and has assured me that "major" changes don't usually occur within a 6 mos. window. Does that seem about right?
Thanks!

 

[Karlynn]

Ashley, that seems right with me. It's my opinion that if the doctor is wanting follow-ups any closer together, that is when surgery should just go ahead and be done. Some of our members have closer follow-ups, but this may be due to job or family situations that have to be taken care of before they can allow time for surgery and recovery. Weddings, teachers that want to try and finish out the school year, the business owner that has to organize his/her business, all these are reasons they have closer follow-ups - and hope that the doctor doesn't say "Sorry, you need it now." before they get their stuff in order.

 

[Paul_N]

Was the same for me too. When the time finally came, it was after one of those 6 mo. check ups, which I recall to be July of 03'. The local cardio and I talked and he told me that he felt the time had finally come to proceed. From there, went to the U of C about 3-4 weeks later and ran essentially the same tests we did locally in July. After that, met monthly at the U of C with the cardio and surgeon ... surgery was then performed in October of 03'.

 

[tobagotwo]

That seems like the right interval with a 1.0 valve opening.

Each person calcifies at different rates. However, stenosis progresses more rapidly as the valve narrows: "The worse it gets, the faster it gets worse." As such, when you are at 1.0, a year is probably too long in between visits.

Best wishes,

 

[jayaresq]

Ashley -- I'd have to agree on the 6-month interval given my own experience. In 2002, I was told my bicuspid, but otherwise unremarkable, aortic valve would need AVR in 15 years. After becoming symptomatic a few months ago, I was told to have AVR ASAP (7/18/05). If you want the luxury of planning, regular checkups seem best. Good luck. -- Jim

 

[Mary]

Six months sounds about right to me. My former cardiologist thought we could wait a year; that's why he's now my former cardiologist.

 

[geebee]

I agree with the others on 6 months. However, be sure and go to see him if anything pops up that seems unusual for you. An infection could cause things to speed up so be aware of your medical conditions.

 

[epstns]

Ashley,
Another vote of agreement. I, too, have aortic stenosis with a valve opening around 1 sq cm, and I've been on a six-month check-up schedule for about 3 years now. We do echo's once a year, and office exam the other time. Works for me, too. . .

 

[ALCapshaw2]

The 'standard' for followup Echo's seems to be 1 YEAR, which seems too long to me for someone whose valve(s) are deteriorating. A 6 month checkup indicates that your cardiologist is concerned and wants to follow you more closely. That's a GOOD sign.

IF your symptoms take a turn for the worse, be sure to let him know. Most likely he will want to at least examine you and may schedule further tests.

Bob H's famous quote "The worse it gets, the faster it gets worse" pretty well sums it up. As your valve area decreases below 1.0 cm sq, you (and your doctors) need to be ready to GO (into surgery). The usual 'trigger' for surgery is 0.8 cm sq OR 'significant' chamber enlargement that may be a sign that permanent muscle / wall damage is about to occur. Worsening symptoms (shortness of breath or pain on exertion) is another potential trigger.

Keep your doctor informed. He DOES seem to be listening and taking your concerns seriously.

'AL Capshaw'