just had my MRI scan

[pekster11]

had my MRI scan earlier today, was quite a weird experience ! Especially when they inject the dye into your bloodstream and you can feel the cold dye pump through your heart ! :tongue2:

Also received a letter from my cardiologist summarising the finding of my echocardiogram last month:

Here is the summary:

max speed through the valve = 3.8 m/s (previously this had been just over 3 m/s for many years)

fractional shortening = 40%
LVIDd = 5.8 cm
IVSd = 1.2 cm
LVPWd = 1cm
ascending aorta = 4.9 cm :frown2: (has increased significantly since my last check up in 2009 )

aortic valve appears to have fusion of 2 of the 3 leaflets, making it functionally a bicuspid valve
mild leakage of the mitral valve..long standing and not significant

surgery probable within 5 years..have to wait for MRI scan to verify echo results especially the ascending aorta result !

given my age (37) mechanical valve would be recommended, which he wrote would mean no further surgery at least for several decades ( I thought they lasted for 100s of years) and I would not need further OHS

Let me know what you guys think about my results and whether I'll be under the knife alot sooner than 5 years

 

[pekster11]

how dangerous is it to be walking around with an aortic root dilated to 4.9 cm ??

 

[Bryan B]

Pekster,

To answer your 2nd question first, they usually start thinking about surgery at 5.0cm so you are about there. As far as dangerous I can't answer that specifically but obviously it gets more dangerous the larger it gets. My ascending aorta at the top of the root measured 5.8cm when I had a pre-surgery CT scan. When he got in there he said it was actually 6.0cm yet the tissue still looked stable. I did not have a bicuspid valve, but it is not uncommon for people with bicuspid valves to also have tissue disorders. This would put you in a higher risk category than I was.

Given the size of your dilation and the size of the opening of your valve I would be looking for a surgeon to get his/her opinion. It sounds like you are right at the edge of needing surgery. You said that the dilation has increased significantly since your last check up in 2009. If that is the case my non-medical opinion is that you will be having surgery sooner than 5 years. Mine also increased at a rapid rate so it was not a matter of if but when. I went from a 4.0 to a 4.7 to a 5.4 in 3 years. The first and third reading was done by echo (the second reading was done by MRI after an echo showed it at 4.4). Three months after the third reading (5.4) the CT reading was 5.8. An echo is less accurate at reading the size of the ascending aorta so I would not be surprised if the MRI showed a slightly higher reading. I hope I am wrong, but if it needs to be done surgeons tend to want to take care of the problem sooner rather than later because you will be healthier thus less chance of complications.

 

[WandaW]

Well my surgeon said they operate when AA is 4.5 to 5.O. Mine was 4.7 when they found it in Feb 2011 and I was born with the bicuspid valve. I guess I agree with getting your ducks in a row. Find a surgeon, hospital, details for work, insurance. I felt much better and more in control when I got things set up. Good luck to you. I am grateful that I do not have this hanging over my head. For me it was easier to get it taken care of.

 

[Bryan B]

I forgot to mention that I actually had a surgical consult over a year before I had surgery, but because I didn't have health insurance and my condition wasn't considered "emergent" at the time I was unable to have the surgery. If I had been able to he said there was about a 70% chance of saving my autograft valve. So if it wasn't for lack of financial assistance I probably would have had my surgery before I hit 5.0cm in hopes of saving the valve. When my next surgeon did the CT scan and got a reading of 5.8cm he said we are doing the surgery now and will work out the financial aid later. Luckily the financial aid came through before the surgery and it wasn't an issue. Like I said...surgeons want to do it sooner rather than later but my case was different because surgeons also like to get paid sooner rather than later.

 

[DanielB]

pekster,

I was first diagnosed with a leaky Aortic valve just over a year ago with better numbers than what you posted and was told five years as well. Same prediction at six months out. As you may have seen in a post by me earlier in the week, when I visited my Cardio to review my annual echo, though my numbers were still 'stable', I had new symtoms that led to being referred to s surgeon to have the valve replaced in the coming months. Not to say you won't have a similar experience, as many have shown in this forum, the wait can be long or very short, you just can't predict for sure. I believe the predictions be Cardios are based on the statistics that show a certain percentage of deteriorization each year in the grand mass of people thay have studued, but exceptions occur on both sides of the predictions, longer and shorter waits can happen as it has for me.

Best of luck to you, it's a good thing they know about it and can keep a eye on you for the best care.

Dan

 

[pekster11]

thanks for the reply folks ! As I live in the UK and am using the NHS, I don't need to worry about financing the surgery. However, on the downside I wont get a choice of surgeon or heart valve !

Seems to me from what I've read the MRI scan seems to give larger readings for dilated aortas than the echo...which could well mean my dilated aorta is alreafy over 5cm in diameter...I'll find out soon enough when the MRI scan results get interpreted by my cardiologist

 

[Jason]

Let us know what your cardiologist reads on the MRI. My personal history was that my ascending aorta expanded to 4.5 in 2001 or so, and then was stable there until this year. In a little over a year it went from 4.5 to 5.4, and after checking the figures with a CT, I was signed up for surgery. I also had BAV, so that might have had something to do with the rapid dilation. Visit with your cardio about your particular situation, and let us know what comes out of it!

 

[pekster11]

Jason...just read your last post...your ascending aorta stayed stable at 4.5cm for 10 years ! Didn't realise it could stay stable at that figure for so long !

To be honest I was never aware or told before my last appt in April that I had ANY dilation at all !

I haven't had my MRI scan results back yet..but will also ask about how dilated (if at all) my aorta was in the past

 

[Jason]

Yes, that was my experience. I don't know if this is common, but mine was stable for 10 years after expanding the first time. I was very happy for that ten years, as we had just had our first child at the time that the first dilation occurred.