Vince
Member
Hello. I have been a quiet observer of this site for a while now and feel like I know many of you. Thank you all for your helpful insight.
I am 60 years old and was diagnosed with Aortic Valve Stenosis in April of 2011 with a valve opening of between 1.1 & 1.2 cm2. Another echo was ordered for 6 months later and that echo showed little change so the next echo was not ordered until 1 year later.
So here we are at 1 year later and this latest echo shows a valve area of .9 cm2, a peak gradient of 49 mmHg with a LVEF of 60%. Main symptom is fatigue, but there is some shortness of breath after a brisk walk around the block and some dizziness from time to time. Aside from the fatigue, the other symptoms (dizziness, shortness of breath) have been so gradual that it is hard to decide whether they are real or psychosomatic.
Anyway, the cardiologist tells me we are at a point where we could consider surgery at any time and he feels fairly certain it will need to be done within the next calendar year. My first reaction to immediate surgery was no way! Let's delay this thing! But after giving it some thought, I called him back to ask if it would be OK to just go ahead and do it in late January next year. He was agreeable so we moved forward with the angiogram and TEE which were done last Wednesday and then the appointment with the surgeon was last Thursday.
The angiogram showed no arterial blockages which was great news! But the TEE showed a valve opening of 1.1 cm2 which is much better than the .9 cm2 indicated in the previous echo of late October. The gradients were also slightly better (mean 25mmg and peak 44mmg). The ejection fraction was 55%. The TEE also showed thickened Mitral leaflets and mild regurg, something the previous echo did not show. Makes me wonder which echo to trust, but I think it is assumed the TEE is the most accurate.
When meeting with the surgeon he explained that in terms of risk management we were at a point where the risk of surgery versus the risk of waiting was about equal. He and the cardiologist are both in agreement that we can go ahead with the surgery in late January as originally planned. But they also say that given what the TEE shows, I could delay the surgery for a year and maybe even two years with the idea of keeping a close watch on symptoms.
The surgeon did not seem concerned about the thickened Mitral leaflets or the regurg. He did say that on some patients Mitral regurg improves after Aortic valve replacement.
It's a real tough choice! But at this time I am leaning towards just going ahead and getting it over with. But my mind changes on an almost hourly basis.
My final decision will be made at my next appointment with the surgeon on January 17 at which time we will discuss valve choices and set (or not set) a surgery date. As many of you have indicated, the waiting room and the decision to proceed or not to proceed may be the toughest part of this whole ordeal. . .
I am 60 years old and was diagnosed with Aortic Valve Stenosis in April of 2011 with a valve opening of between 1.1 & 1.2 cm2. Another echo was ordered for 6 months later and that echo showed little change so the next echo was not ordered until 1 year later.
So here we are at 1 year later and this latest echo shows a valve area of .9 cm2, a peak gradient of 49 mmHg with a LVEF of 60%. Main symptom is fatigue, but there is some shortness of breath after a brisk walk around the block and some dizziness from time to time. Aside from the fatigue, the other symptoms (dizziness, shortness of breath) have been so gradual that it is hard to decide whether they are real or psychosomatic.
Anyway, the cardiologist tells me we are at a point where we could consider surgery at any time and he feels fairly certain it will need to be done within the next calendar year. My first reaction to immediate surgery was no way! Let's delay this thing! But after giving it some thought, I called him back to ask if it would be OK to just go ahead and do it in late January next year. He was agreeable so we moved forward with the angiogram and TEE which were done last Wednesday and then the appointment with the surgeon was last Thursday.
The angiogram showed no arterial blockages which was great news! But the TEE showed a valve opening of 1.1 cm2 which is much better than the .9 cm2 indicated in the previous echo of late October. The gradients were also slightly better (mean 25mmg and peak 44mmg). The ejection fraction was 55%. The TEE also showed thickened Mitral leaflets and mild regurg, something the previous echo did not show. Makes me wonder which echo to trust, but I think it is assumed the TEE is the most accurate.
When meeting with the surgeon he explained that in terms of risk management we were at a point where the risk of surgery versus the risk of waiting was about equal. He and the cardiologist are both in agreement that we can go ahead with the surgery in late January as originally planned. But they also say that given what the TEE shows, I could delay the surgery for a year and maybe even two years with the idea of keeping a close watch on symptoms.
The surgeon did not seem concerned about the thickened Mitral leaflets or the regurg. He did say that on some patients Mitral regurg improves after Aortic valve replacement.
It's a real tough choice! But at this time I am leaning towards just going ahead and getting it over with. But my mind changes on an almost hourly basis.
My final decision will be made at my next appointment with the surgeon on January 17 at which time we will discuss valve choices and set (or not set) a surgery date. As many of you have indicated, the waiting room and the decision to proceed or not to proceed may be the toughest part of this whole ordeal. . .