Question Re: Multivalve Insufficiency

[KimC]

Hi, everyone.

Does anyone have info on what might cause two valves to leak, specifically the aortic and tricuspid valves? And did most of you have just one valve leak?

I read a stat that patients undergoing AVR have poorer outcomes when two valves are bad. (Shame on me for worrying about this).

Thanks,

 

[Karlynn]

Kim,
I don't know a whole lot, I'm sure there's more here that do tho'. I had an MVR, but one of my other valves had begun to leak some prior to surgery. It's been too long for me to remember which one. I was told that was due to the fact that my heart was under so much strain from the MVP.

Karlynn

 

[Nancy]

Valves leaks can come in various degrees of severity. Do you know the severity of both of the leaks?

It is fairly common to have more than one valve leaking. Lots of times the other valve is leaking in the trace of mild category, which isn't much to worry about.

My husband has an aortic and mitral valve replacement, and he also has a severe leak in his tricuspid, but it doesn't seem to be something that any of his doctors want to do surgery on. It is apparently related to his pulmonary hypertension, and he also has pacemaker leads going through that valve, which can cause some leakage too.

There are a lot of things that can happen inside the heart. Not all of them have to be surgically addressed. That's why close cardiology monitoring is so important. Knowing you have a watchful professional eye on the problem should give you some peace of mind.

Take care.

 

[bvdr]

Hi Kim,

Going into surgery it was unclear if I was going to have one, two, or three valves replaced/repaired. The results of my first echo last December showed moderate insufficiency of both the aortic and the tri-cuspid valves. It showed mitral stenosis with mild insufficiency. An echo 6 months later showed Moderate MS and moderate MI, but the AI and TI were then rated as mild. The TEE during surgery showed about the same. I only had my mitral valve replaced during surgery.

I had my first post-surgery echo on Monday and today I go in for a follow-up appointment and to get the results.

I have read that sometimes myxoid degeneration can occur in more than one valve although it is most common in the mitral valve. On my surgical report it lists my mitral valve as rheumatic but the path report also states myxoid degereration was present.
So I guess it's possible that even without having had rheumatic fever I would have eventually had some valve problems.

One thing is for sure. The way one valve functions can certainly affect how others work.

 

[KimC]

Gut Check

Gut Check

Thanks, Nancy, Betty and Karylnn.

Nancy, you're right -- I'm under the care of a couple of good docs and rest easy most days. I have trace MI, which I understand is nothing of concern. I also have moderate AI and TI which is being monitored. I'm still adjusting to the diagnosis and learning to live with the uncertainties. It's helps to talk through some of my fears.

Emotionally I feel good, but physically I'm having a hard time keeping up. I know I have sinus bradycardia, and am wondering if low BP can be treated with meds. My avg. BP reading is 95/55; pulse 45. My last EF was 55. Normal, normal, normal ... but on the low side.

My cardio said he'd expect my low BP given that I walk 2 miles, 3-4x week and am a thin female, (his words). I'm not fainting, although I often feel lightheaded and tired.

Here's the thing. If I lay on my back while sleeping, I frequently wake up suddenly, feeling and hearing a forceful expulsion of air from throat. I know this sounds weird. It's not a snort ... I know what that feels like, (I don't snore according to my spouse).

I've never experienced anything like the "apnea" in my lifetime, and it only started happening after the pregnancy. I've wondered if it's a bi-product of my BP dropping or breathing stopping during deep sleep, and whether it's worth a phone call or if I'm overreacting.

I've heard of nocturnal dyspnea, but I don't wake up breathing fast or short, just a loud GASP, then I go back to la-la land.

It's not a pleasant experience ...

Best,

 

[bvdr]

Hi Kim,

I got my post-op echo report today. My mitral valve has trace to mild insufficiency. The aortic valve is slightly narrowed (1.4) and has insufficiency but they couldn't determine how much since the new mitral valve was interferring some how. The tricuspid has mild insufficiency, and the pulmonary valve now has moderate insufficiency. My left atrium is down from 5.5-6.0 to 4.6 but I still have a mean pressure gradient of 11 and significant pulmonary hypertension which was something I really was hoping was corrected by now.

So as to your question of having multiple valves affected....yes, I've got 4 affected but as my cardiologist said, " It could be alot worse."

 

[KimC]

Hi, Betty.

Thanks for helping me keep things in perspective!

I'm sorry that your most recent report wasn't exactly what you wanted to hear. Hopefully time will heal the stress that has been put on your system.

I always look forward to your posts! Your assertiveness, insights and proactive attitude are inspiring.

Thanks again.

Best,

 

[Nancy]

Hi Kim-

Have you told your doctor about the nocturnal "gasping"? That's something he/she should know. It can be a symptom of several things. Maybe you should have a sleep study done, or some nocturnal measurements of your oxygen level, just to be safe.

I have heard several other people mention this on other boards.

I think you need to find out exactly what's going on there.

 

[fdegranville]

Multi-valve Insuffiency

Multi-valve Insuffiency

Hi Kim,

Like many here I had rheumatic fever which caused both stenosis and insufficiency. I have had 3+ AI and mitral stenosis for about 25 years. I had only mild MI and had a mitral valvuloplasty to open up the valve last April that had to be stopped because the mitral valve began to leak more. When you have mitral stenosis you usually get some tricuspid involvement as well.

fdeg

 

[KimC]

Thanks, Nancy.

Did I say lately how sick I am of doctors? I'm trying the inhaler and nasal spray for a month, then will complain if the gasping continues. I know it's abnormal. I've never experienced anything like it. As always, I appreciate your concern. You are such a blessing on this board!

Thanks for sharing, fdeg. It amazes me that you had 3+ AI for 25 years! Good grief! You must have a very strong heart, or I'm ignorant about how long the heart can compensate at that rate of insufficiency.

Warm regards,

 

[fdegranville]

multi-valve insufficiency

multi-valve insufficiency

Kim,

It really is a long time to go with that amount of leaking, but I think as the mitral valve got smaller and smaller, there was less blood going into the LV, so even though a significant amount was regugitating back in from the aortic valve there wasn't too much of an overload. Now, because the mitral valve is so tight th LA is really starting to grow and I'm now in A-fib from time to time and have to be on Coumadin. The LV has started to really grow as well, so one of these days I will leave the waiting room (where Steve is the host & boss).

In all the years I've had this, I've had two children (they thought I was going to die after the second, but fooled them) and I work full time at a pretty demanding job. Things could be much worse, so I'm grateful.

Francesca

 

[KimC]

I fooled them, too and hope to continue to do so! Thanks for sharing.

Happy Thanksgiving!!!