Report Numbers

[cbdheartman]

I was wondering if anyone can help me drill down a little bit more on the numbers I have in front of me. I am still leaning (99% there) toward surgery, but I wonder what to make of the numbers of the report I received back from the Cleveland Clinic. I did a CT there and the radiologist also evaluated my cardiac MRI. I am a little confused by the numbers because they give two different widths. Does that change the calculus at all?

On the cardiac MRI (April 2009) the report says this: "It shows a bicuspid aortic valve with fusion of the left and right coronary cusp and unrestricted, oval-shaped opening. The aortic root measures 5.0 x 4.6 cm. There is eccentric posterior directed jet of likely moderate aortic insufficiency. There is left ventricular dilation (5.9 cm) with normal left ventricular function."

The report goes on to say that the chest MRI from March 2008 is of inferior quality but shows similar measurements of the root and ascending aorta.

Then this is what it says with regard to the CT study: The aortic annulus measures 3 x 3.6 cm. The aortic root measures 4.9 x 4.5 cm at the sinues of Valsalva (cusp to cusp 4.9 cm). The sinotubular junction measures 4.5 cm. The aorta measures 4.0 cm in the mid ascending segment, 3.0 cm proximal arch, 2.5 cm mid-descending thoracic aorta, 2.2 cm at the diaphragm.

The aortic valve is notable for mild thickening of the central leaflet margins, without evidence of leaflet calcification.

Also, this was weird and I wonder what to make of it, kinda freaks me out a little: "The visualized lung fields are notable for a 4-mm noncalcified pleural-based nodule most consistent with scar/atelectasis." I have no idea what to make of it other than I don't really like what comes up on google.

Any help or thoughts based on this background, would be appreciated with full recognition that no one is a doctor here, but many of you have been through this.

Thanks,

cbdheartman

 

[Ross]

In short, your aorta doesn't sound all that bad, but your showing signs of heart damage and the lungs are paritally collapsed which could mean your diaphragm is rising. All signals I see say not to wait for further damage. I'll admit you could wait a bit, but dude, it's only going to get worse and more damage is going to be done by doing so.

 

[Jkm7]

What do you perceive to be a benefit of waiting?

 

[Ross]

What do you perceive to be a benefit of waiting?

In his mind, he's not convinced that waiting will be a problem (Fear of death prematurely? Death doesn't hurt, surviving does!). Were all working diligently to keep him from the worst possible case scenario. The longer he waits, the worse the outcome will be.

 

[cbdheartman]

I don't see a benefit of waiting really.

I wondered about the diameters. What do you mean Ross that the aorta doesn't sound all that bad?

Is the heart damage the enlarged left ventricle?

Also, when you say the lungs are collapsing is that where this "4-mm noncalcified pleural-based nodule most consistent with scar/atelectasis" comes from?

You guys really are so good to me. Because I read that and was thinking, shoot, maybe I have a lung tumor on top of all of this?

I don't see any benefit to waiting, but I want again to make sure I am not missing something. If I am 5.0 x 4.6 or 4.9 x 4.5, do those second numbers indicate that my aorta is actually smaller than I thought? Just curious. It seems like I am there at the 5.0 cut-off or will be soon unless something dire happens, but I want to know more.

Thanks so much!

 

[cbdheartman]

Ftr

Ftr

I do have one surgery scheduled tentatively for July 30!

And if I like the doc at Hopkins may try to do one there earlier.

 

[Ross]

What do you mean Ross that the aorta doesn't sound all that bad?

Is the heart damage the enlarged left ventricle?

Also, when you say the lungs are collapsing is that where this "4-mm non calcified pleural-based nodule most consistent with scar/atelectasis" comes from?

The measurements of the aorta do leave some play room, but don't leave that to mean that it can't suddenly and unexpectedly grow to an unsafe level. I'm living proof that it can happen!

Yes, your ventricle is enlarged because of this issue and left untreated, will continue to enlarge and may or may not return to normal size after surgery. If not, your looking down the same double barrel shotgun I am of life time Congestive Heart Failure.

atelectassis is just a fancy word of saying collapsing lung. If your diaphragm is rising, which I do believe it is, it's causing this and is reversible if acted upon swiftly. Mine was not and I'm left with paritially collapsed lungs and a paritially paralyzed left diaphragm. Can't stress is it enough. Don't wait because they say too! I don't want anyone to live like I have too. I'm not joking. This sucks more then anyone knows.

Just so you know, I was 2 years older then you when it happened to me. I've been screwed ever since. I'd love to go to a reunion of Vr.com. It's not going to happen unless it happens within 10 miles of my house and there is nothing here to see. I'd love to just go camping again, fishing again, just about anything again, and I cannot do that. Do you want to live like this?

 

[cbdheartman]

The measurements of the aorta do leave some play room, but don't leave that to mean that it can't suddenly and unexpectedly grow to an unsafe level. I'm living proof that it can happen!

How do you mean? It seems like the one reading shows that I am at 5.0 cm and that is a basic cut-off for most surgical recommendations. Is the other number 4.6 where the play is?

 

[Ross]

How do you mean? It seems like the one reading shows that I am at 5.0 cm and that is a basic cut-off for most surgical recommendations. Is the other number 4.6 where the play is?

All tests combined, after looking again, there is no further point in waiting for the statistical versions of what may or may not happen. I just don't want to see you end up wearing my shoes.

 

[MissMelis]

I'm terrible with these numbers. No idea what they all mean.
But you are listening to experience (aka Ross) talking, and there's a lot to be gained from it.
By all means, get it done before things go south.
It's YOUR health, not the surgeons and doctors', and no one can tell you what to do with your body (well, except us )

Hang in there. When do you see the surgeon at Hopkins?

 

[cbdheartman]

Hang in there. When do you see the surgeon at Hopkins?

Tomorrow! I am looking forward to it.

 

[MissMelis]

Well, definitely keep us posted. All this is really difficult, we all know what you're going through. We will be eagerly awaiting news from your visit with the Hopkins surgeon!

 

[ALCapshaw2]

MY (non-professional) interpretation of your Aorta Numbers is that the further up the aorta you go, the smaller the diameter. It will be interesting to see what your Surgeon decides to do about your ascending aorta and what his evaluation is regarding 'connective tissue disorder'.

Again, MY interpretation of the 4.9x4.6 (or whatever they were) is that the Shape is Oval, not circular, at that point and those are the widths of the two major axis'. You may want to get a clarification from your Cardiologist.

I agree with Ross. Any sign of enlargement means that damage is being done. Why let it continue? I see NO benefit in waiting.

'AL Capshaw'