postpone my AVR by taking medicine

[avshalom]

hi,

my name is avshalom. i am 33 years I have bicuspid aortic valve with severe aortic regurgitation, mild lv dilatation(62 mm), mild of aortic root-sinuses (42 mm),very mild of ascending aorta(37 mm)
and good lv function .
but I am a symptomatic patient. I suffer from shortness of breath very frequently.
my cardiologist suggests me to postpone my AVR and to take medicine from ABR (angiotenzin receptor blocers) - CANDESARTAN.
but i still suffer from shortness of breath and chest pains.
Did someone try taking medicines before avr? did it help?

 

[hensylee]

Mornin, avshalom. Nice to see you again. I think many here took medicines before the final decision of surgery, but they will be along to tell you their experiences. Trying to make things better via medicines is always preferable to surgery, if it works. Surgery is always the last resort.

 

[PJmomrunner]

Welcome Avshalom. I'm posting because I can't stand the thought of you wondering when someone is going to come along and post! Others with experience will, no doubt ,be along with lots to say.

If your cardiologist is the only doctor you have talked to, I would seek another opinion, probably from a cardiothoracic surgeon, and most desirably from an aortic specialist. With severe regurg and any kind of dilation it's worth at least talking to surgeon even if it is not yet time to operate. It's best to have a plan before it's time.

Take care.

P. J.

 

[epstns]

Hi Avshalom,

My situation is slightly different than yours. Although I have a bicuspid aortic valve like you do, mine is presenting itself as aortic stenosis -- a narrowing of the valve outlet, rather than regurgitation or leakage like yours. My cardiologist has me on an ARB (Avalide -- Irbesartan and Hydrocholrothiazide), but only to reduce mildly high blood pressure. There was no mention of the medication having any effect on the timing of my future surgery. Are you sure the doctor is expecting to delay surgery with a medication? I don't think my cardio ever suggested that this (delay) would be possible. Maybe for your condition but not mine? Maybe others know. . .

 

[ALCapshaw2]

My cardiologist put me on an ACE Inhibitor in hopes of postponing my AVR for 3 to 5 years. ONE year later, my valve area was down to 0.8 sq cm measured by BOTH an echocardiogram and heart catheterization.

The danger in postponing surgery is that in compensating for a narrowed valve, the heart works harder, the muscle wall builds and chambers enlarge. Eventually this results in PERMANENT DAMAGE to the heart. IMHO, it is best to have surgery BEFORE you reach this threshold. Also IMHO, a SURGEON is best qualified to make the call on when to have surgery.

As one of our astute members stated, "When you have a condition that can only be repaired by surgery, get a surgical opinion"!

'AL Capshaw'