Oh man....i just did that chart calc....and I am underweight. So, when I go for my next echo I will fib a bit. ;-)
Small Valve, Big BSA - Issues?
- Thread starter ARGreenMN
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Janie--throw down time I put my 25cm up against your 23cm and we make it ice cream AND Champagne. Then we can dose ourselves with our 7.5 warfarin 
Hey sorry Al-I had no symptoms except , 2 days after my last tri, I got a buzzing feeling in my throat and then a loud squeaking noise which woke me from my sleep(the leaflet tearing)-3 weeks later-bam! surgery. MY films were PERFECT 2 months prior. Besides-dont you have a mechanical???
Hey sorry Al-I had no symptoms except , 2 days after my last tri, I got a buzzing feeling in my throat and then a loud squeaking noise which woke me from my sleep(the leaflet tearing)-3 weeks later-bam! surgery. MY films were PERFECT 2 months prior. Besides-dont you have a mechanical???
Andy, Do you have a link to the chart?
Anyway from what I always understood, the problems are if the "small valve", is too small for you because if the surgeon gave you a smaller valve than they should have, and a bigger one would have fit, then you have the "the mismatch". BUT IF that is the correct size that is replacing another "small" valve you were born with, you wouldn't have the same problems.
Also I would think what COULD make a difference is compared to the rest of your heart, is the Aorta and valve what would be expected OR is the rest of your heart and valves bigger to go along with your height , but for some reason just the Aorta and valve are smaller than what is average for a person your size? That would probably be easy to see from your echos are all of your measurements at the low end of "normal" , you just happen to have a smaller heart, OR does the rest of your heart seem to be average size or slightly above average (since you are 6'2) but you just have a "smaller" Aorta then one would expect. I could see that causing problems with blood backing up into your heart ect, but you would think IF it was small enough to make a difference, at 49 you would ready have problems (beside the ones you just had fixed), and since you don't, I would take that as a good sign
Some parts relating the valve size of BSA don't really make sense to ME. I could see the formula working if you (anyone not just YOU) were the average weight for your height, like it would make sense a 6 foot person should have a bigger heart and valves than a 5 foot person, but It doesn't make sense that if a person is overweight they should need a larger valve area, then if they lost the weight.
I think you have the right idea about asking your doctors their thoughts and anything you should watch out for.
Anyway from what I always understood, the problems are if the "small valve", is too small for you because if the surgeon gave you a smaller valve than they should have, and a bigger one would have fit, then you have the "the mismatch". BUT IF that is the correct size that is replacing another "small" valve you were born with, you wouldn't have the same problems.
Also I would think what COULD make a difference is compared to the rest of your heart, is the Aorta and valve what would be expected OR is the rest of your heart and valves bigger to go along with your height , but for some reason just the Aorta and valve are smaller than what is average for a person your size? That would probably be easy to see from your echos are all of your measurements at the low end of "normal" , you just happen to have a smaller heart, OR does the rest of your heart seem to be average size or slightly above average (since you are 6'2) but you just have a "smaller" Aorta then one would expect. I could see that causing problems with blood backing up into your heart ect, but you would think IF it was small enough to make a difference, at 49 you would ready have problems (beside the ones you just had fixed), and since you don't, I would take that as a good sign
Some parts relating the valve size of BSA don't really make sense to ME. I could see the formula working if you (anyone not just YOU) were the average weight for your height, like it would make sense a 6 foot person should have a bigger heart and valves than a 5 foot person, but It doesn't make sense that if a person is overweight they should need a larger valve area, then if they lost the weight.
I think you have the right idea about asking your doctors their thoughts and anything you should watch out for.
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Janie--throw down time I put my 25cm up against your 23cm and we make it ice cream AND Champagne. Then we can dose ourselves with our 7.5 warfarin
Throw down time fooey..:biggrin2: I betcha I can force down more Blue Bell than you can and chase it with champagne..! :biggrin2::thumbup::biggrin2:
I would bet most folks with bi-cuspid valves are tall.....at least the ones I've met here are tall...starting at 5'9" to 5'10"....me, Sherry, Gina and our Mizz Rain towers over us all at 6.2" along with Melissa also at 6.2"...!! And then there's little bitty Mizz Bina...:angel:
Hey Andy,
Sorry to hear you have a small one, but most males do not brag about that though :biggrin2:
Did surgeon mention anything about you having a smaller heart?
I remember you saying something about a really slow pulse 40-50 a few months back and have to wonder if you a have tendancy towards higher BP, I would think you would?
Gil
Sorry to hear you have a small one, but most males do not brag about that though :biggrin2:
Did surgeon mention anything about you having a smaller heart?
I remember you saying something about a really slow pulse 40-50 a few months back and have to wonder if you a have tendancy towards higher BP, I would think you would?
Gil
No, my BP is ok - usually about 110-120 over 70ish. He didn't say anything about my heart being small, just my aorta (if I understood right). I liked Lyn's explanation and am gonna go with that My old valve was small, so my new one is small too, and won't cause me any issues LL, I do have a mech. valve, so doubt a leaf would tear. I think the potential issue has to do with tissue growth on the valve. Sheza - I'm tall too, 6'2", so maybe ther is a link. You girls have fun with that throw down, and may I suggest tequila instead of champagne (I hear it makes your clothes fall off)! Bina, did you do the one that starts by measuring your index finger, or the other one?
My old valve was small, so my new one is small too, and won't cause me any issues LL, I do have a mech. valve, so doubt a leaf would tear. I think the potential issue has to do with tissue growth on the valve. Sheza - I'm tall too, 6'2", so maybe ther is a link. You girls have fun with that throw down, and may I suggest tequila instead of champagne (I hear it makes your clothes fall off)! Bina, did you do the one that starts by measuring your index finger, or the other one?
Well, I figured since we are measuring body parts.....
Andy-Did your surgeon know about your small valve size/aorta before surgery or was it a surprise when he got in there?
Lynn- I had asked my surgeon should I be concerned about creating a mismatch issue as I am historically a yo-yo dieter. I have thyroid issues and a love of southern cooking and really positive body image no matter what my size. My weight fluctuates +/- 50 lbs. (or at least has my whole life so far--good time to stop doing that, huh?). He said current weight wouldn't make much difference in the valve size selection, though losing weight would make the valve more efficient.
Andy: i say yea-it doesnt matter your'e a tall drink a water if your aorta is a shot glass right? Sounds like you'll be a ok. The only thing Tequila does to me is make me puke-so i'm sticking to champagne (or Kettle one Vodka)
Laura
Laura
I am chipping in when this issue is COLD. It seems we should not look at the manufacurer's chart anymore post surgery. Is isn't the orifice area as measured by echo divided by the BSA should determined the iEOA index?? After implant, the gradients and velocity are the true measurements. If the cardiologists say these are within limits, fine. If not, we need to find out what needs to be done to keep the valve and the old heart muscles as long as we can. Keeping our weight down, I think is something to strive at, irrespective of PPM, but I suppose easier said than done. Avoiding strenous exercise ?? What about diet and supplements?? I read CoQ10 and Omega 3 are something to look into, of course we need to tune warfarin accordingly??
