Patient-prosthesis mismatch? Anyone?

[Jane]

Following a stress echo, (for which I had to wait 14 months) it has been discovered that I have patient-prosthesis mismatch on my AV. My consultant thinks this is reponsible for my worsening symptoms of tiredness and poor exercise tolerance. My Medtronic Hall AV was only a size 20, but was the biggest they were able to fit without an aortic root graft. My consultant does not think I need repeat surgery at this stage.

It appears that the Tricuspid Reurgitation I had before is now only mild.

I was just wondering if anyone else had experience of this? and if so, could they offer any advice or support.

(As I do not have the internet at home, I can only get online a few times a week at the local library.
Would welcome any thoughts. Thanks.

 

[CCRN]

Miss-match

Miss-match

Following a stress echo, (for which I had to wait 14 months) it has been discovered that I have patient-prosthesis mismatch on my AV. My consultant thinks this is reponsible for my worsening symptoms of tiredness and poor exercise tolerance. My Medtronic Hall AV was only a size 20, but was the biggest they were able to fit without an aortic root graft. My consultant does not think I need repeat surgery at this stage.

It appears that the Tricuspid Reurgitation I had before is now only mild.

I was just wondering if anyone else had experience of this? and if so, could they offer any advice or support.

(As I do not have the internet at home, I can only get online a few times a week at the local library.
Would welcome any thoughts. Thanks.

Get in touch with your surgeon anyway and discuss this with him/her. The prosthetic valve should be sized not only according to root size, but also by taking your body surface area into consideration. Unfortunately, this happens.....your surgeon should be in on the loop here. What happens is the small size afftects your out-flow tract and can eventually lead your heart to respond as if you had aortic stenosis again. I recently attended a cardiac workshop and this was one of the topics and what understood. Get your surgeon to explain in detail this "syndrome" as well as what he expects to see in the future with this new problem. Hope this helps.

 

[hensylee]

Hey, Jane - it's been awhile. Glad you are still checking in. I am so sorry to hear this news. Please keep us posted - the rest of the crowd will be along before the day (your night, I guess) is over to add their comments. Hope there is something good from them.

 

[Nan]

Hi Jane, That's me! a mismatched valve/patient person! I have a St. Jude's size 17 (which apparently has an effective opening of 19) and I am not a small person! It was the only one they could fit in even after enlarging my aortic root. The surgeon was concerned about my survival if he tried to do a root replacement by the time they realized the problem ( a long time on heart lung etc.)

It does cause problems. May have increased my mitral valve regurgitation, exacerbated a-fib and CHF. However, it is over 5 years now and I am still here and have not had a re-surgery (although it was advised at one point).

If you have a small body it may not be too much of a problem.

So, you may want to talk to your surgeon and cardio again to see what the long term prognosis is. There are some sites that discuss this if you put in patient valve mismatch in your search engine. They are sort of discouraging.

I would be interested in what they say to you....please either pm, e-mail me or keep on with this thread....thanks.

And good luck,

Nan

 

[Jane]

Thanks for all replies to date. I know the cardiologist has notified the surgeon of the mismatch, but he (cardiologist) said he didn't think I needed more surgery). I don't know my official prognosis, but I can tell from how I feel that things do not look good: very breathless, exhausted with a lot of visible pulsation in the right side of my neck. (ie I actually FEEL worse than before surgery). At the moment they are "keeping an eye on me." In the meantime I am trying to lose weight as I am about 40 pounds too heavy. Jane x