Question for tissue valvers. Post surgery echo results

[malibu82]

hi everyone. just curious.......

for those of you with a tissue valve who have copies of your echo's.

im looking for your ejection fraction and valve stenosis results

1.if you had an echo in the hospital after surgery before you went home, what were the results?

2. what were the results from any recent echo's after that one?

just wondering because my echo done in hospital the day i went home from surgery showed an ejection fraction of 60% and some stenosis.

an echo two weeks ago done at a different hospital and 5 1/2 months post surgery showed ejection fraction of 55% and moderate stenosis

thanks for your responses ahead of time!

 

[ALCapshaw2]

Ejection Fraction is usually ESTIMATED by the Technician which is naturally highly dependent on the skill and experience of the technician. IMO, a 5% variation in 'estimates' is not something to be concerned about.

The Major Hospitals all seem to have their own 'special' range of what is considered a Normal Ejection Fraction, but they ALL are in the range of 50 to 70%.

I would ask your Cardiologist "What is the Basis for the 'rating' of the Stenosis"?
(i.e. what were they measuring and what is the range of measurement error / variation)?

 

[Johan]

My EF a month after surgery was 75% but the cardiologist suggested that the heart was still remodeling and that it will probably come down. Six months after surgery it was 60% and a month ago 63%. My cardio said that anything over 50% was normal.

I think we have the same valve and the word "stenosis" never came up in any of the 3 echo reports since my surgery. I agree with Al that you should ask about it. Just remember that, as we know, echo results are notoriously variable and operator dependent...

 

[Duffey]

Ejection Fraction is usually ESTIMATED by the Technician which is naturally highly dependent on the skill and experience of the technician. IMO, a 5% variation in 'estimates' is not something to be concerned about.

The Major Hospitals all seem to have their own 'special' range of what is considered a Normal Ejection Fraction, but they ALL are in the range of 50 to 70%.

I would ask your Cardiologist "What is the Basis for the 'rating' of the Stenosis"?
(i.e. what were they measuring and what is the range of measurement error / variation)?

My echo made no mention of stenosis, and three months post-op, my EF was 55%. They did an echo during surgery but did not run another one while I was in the hospital. I received a bovine valve.
I agree with Al that the difference between echo readings can vary so much that I would tend to dismiss most result variation.

 

[Superbob]

I am a tissue valver (porcine) also. You are wise to keep copies of your reports and to scrutinize them and ask questions. I have in my ever-expanding health care box of papers, unorganized, a batch of my echos; might be able to pull some out and cite numbers later. (I have an echo Monday so this would be a good time to be doing that.) I think Al is right on target as usual. Some modest variations are to be expected. Definitely, check with your cardio also.

 

[kfay]

Malibu, My echo while I was still in the hospital was EF 63%, trivial tricuspid regrug (my new tissue valve) with a gradient of 5, and mild mitral regurg. My last numbers from this spring, which were almost 2 years post op were EF 60%, moderate tricuspid regurg, tricuspid gradient 6 (up from 5, 10 being the trigger point for re-op), and moderate mitral regrug.

So, as you can see, not only is my new valve leaking more, so is my mitral. Plus the gradient has gone up on my new tissue valve. My cardio told me that although the leak was more than they like to see at this point in the game, there isn't a thing in the world they would do about it now, it isn't causing me any harm, and I just need to not worry about it and go out and live my life. So, that's exactly what I'm trying to do. You can drive yourself crazy with this stuff. I used to obsess over these reports, but I finally just put them away and very rarely pull them out.

I definitely think a conversation with your cardio is in order and hopefully, he will be able to put your mind at rest.

Kim

 

[malibu82]

Well my cardiologist from downtown finally called back this morning so I was able to speak to her in person!

I didn't tell her I knew my results - I wanted to see what things she thought were important enough to mention.

She of course said the holter monitor test was fine and metoprolol would help with the PAC's however I reminded her it drops my blood pressure realllllllly low so she kind of just moved on from that topic.

Then she said the echo states that they are questioning the tightness of the valve. She said that she needs to see the CD and I let her know I was already mailing it to her. She said sometimes the angle of the test can change things. She said once she looks at the CD we will go from there to figure out my day long lightheadedness.

Thanks for all of your responses. I feel like a nut job and can't talk to my family about this because I feel like they don't take it seriously because they think since I just had my valve fixed it should be better then new and I shouldn't be having any problems.

 

[neil]

hi malibu i hope you get everthing sorted as am sure you will, am not on about your case now as everbody is different but i remember my cardio saying dont get to wrapped up in the number game,thats there job,we sometimes can get totally immersed in numbers etc,and a lot of the time that can be detremental to our wellbeing,of course that doesnt mean we shouldnt have chk ups etc,

 

[malibu82]

thanks neil! that is true about not getting wrapped up in the number game and to leave it to the doctors. great point!

 

[drivetopless]

Just want to send you a hug. Regardless of the numbers, I hope you FEELING great!

 

[BAVD John]

I had my first echo today since the one in the hospital a few days after my surgery in 2009. I noticed that the tech, the same woman that has done my echo's twice a year for the past 6 years, finished my echo in a lot less time than previous echo's. I guess there is a lot less to look at when the valve looks good. I only thing I noticed today on the report was the valve opening size. Today that was 2.71 cm2 compared to .9 cm2 just before surgery. She also stated my ejection fraction was within normal range. She claimed my ejection fraction was off the charts before surgery. I see my cardio in a couple of weeks to go over the entire report. I'll try and get a copy of the report.

Malibu I hope the doctors get your lighthead episodes figured out. I sometimes get a little lightheaded when I get up quickly.

 

[malibu82]

nice to hear you are doing so well john.

i better not have gotten a bad cow valve!

thanks for sharing !