Spot on Echo

[attissy]

Hi everyone,
It has been awhile since I posted or responded to a thread, but I am on all the time reading and learning!

I, unfortunately, do now have a question of my own now.........

I had an echo done last week. The secretary from the cardiologist's office called on Thursday of this week to schedule a TEE for me. She thought the physician had already called and talked to me, but he hadn't!! She went on to say that all she knew was that he had seen a "spot" on my valve on the echo and he wanted to get a better look at it with the TEE. He was gone on Friday, so I couldn't get much more information. Does anyone have ideas about what this spot could be.......good or bad?

 

[tobagotwo]

At this point, it could be a technician's error.

Generally, when someone is referring to a spot on a valve, they're concerned that it might be a clot, pannus (scar tissue), an incursion of new tissue growth onto the valve, or vegetation from an infection.

The likelihood of which type is dependent somewhat on the valve type that you have.

However, I would go for the first interpretation at this point. Let them show you something real before any hypothesizing begins.

And rat out the blabbermouth secretary who is ruining your weekend with this pointless worry.

Best wishes,

 

[attissy]

Thanks for the information and for getting back to me so fast....since I am a worrier. I really would have liked to talk to my cardiologist before the weekend, but I hope you are right and I am worrying for nothing. The secretary also said "maybe it is air or something". Could the spot on my valve be "air"? I have known this lady for a long time so I know she talks out of her you-know-what. Could that even be a possibility?

 

[cp172]

Hi Attissy,

99% of the time information like you received from the caller is incorrect. The cardio may want to just take a more detailed look at the valve. The knot head that gave you her advice sure didn't do you any favors.Sorry you are having to worry about this. Enjoy the rest of the weekend and keep us updated.

 

[attissy]

I agree 100% with you gkenney! I actually work in a hospital, so I know exactly what you mean about the dress code standards. This particular "secretary" is normally very nice and very funny, but I think she needs to learn to balance friendliness and professionalism. Thanks for listening and for the pep talk! I just wish I wasn't worrying all weekend!

 

[starrman]

I heard the cardiologist doing the echo that if you have a mechanical valve, it is tougher to see everything because of the shadows. He was narrating my echo for his medical interns. Don't know if that helps or not.

 

[Mary]

Let us know what you find out.

 

[attissy]

Update:

I was finally able to speak to my cardiologist today regarding my echo results. He said that both he and the tech saw a new "space" in front of my valve, where the seam of the stitches from my valve replacement are located. He said this could be just reverberation or could be what he referred to as a "limited dissection". The word dissection of course freaks me out worse. Does anyone have experience with a dissection 1+years after a valve replacement? I am really just wondering what the odds are that this is reverberation. I couldn't get a real sense from the physician about which he really thought this was. Any words of wisdom would be greatly appreciated.

 

[Phyllis]

I have no words of wisdom to offer you, but I am sorry that you have this worry and hope the Tee proves it to be just a reverberation and nothing else. Please keep us informed. Did he schedule the Tee? I am wondering if just another echo would help make the determination.

 

[Susan BAV]

I'm sorry but I have no idea. But I hope it goes well for you and that the TEE clearly shows your true situation. If there is any dissection, however, did the doctor warn you to take things very easy this week and not to lift things and not to allow your bp to elevate, etc? Please let us know what you find out. Best wishes.

 

[marie]

When do you see your doctor again? Sorry I haven't any words of wisdom but wanted to wish you lots of luck and please keep us posted
Take care Earline

 

[attissy]

Hi everyone,
I had my TEE yesterday and I got some good news and some not so good news. I do not have a dissection (yahoo), but I do have an ascending aortic aneurysm ( I have not gotten the official results, but I believe it is only 4.0 cm). I am soo very glad it is nothing that requires surgical intervention right now, but of course now i am worried about this aneurym. I understand 4.0 cm is on the low side, but does anyone know at what size they do surgery for an aortic aneurysm or if there is any other way to treat this problem?

I also wanted to thank everyone again for their quick responses and kind, reassuring words. This site is a lifesaver! Thanks you, thank you, thank you!



Tiff

 

[Phyllis]

Tiff, sorry for the bad news, but happy for the good news. I have no experience or words of wisdom, but I would echo the opinion that you need expert care. Have you had an extensive explanation from your cardio and would you consider another opinion?

 

[ALCapshaw2]

Hi everyone,
I had my TEE yesterday and I got some good news and some not so good news. I do not have a dissection (yahoo), but I do have an ascending aortic aneurysm ( I have not gotten the official results, but I believe it is only 4.0 cm). I am soo very glad it is nothing that requires surgical intervention right now, but of course now i am worried about this aneurym. I understand 4.0 cm is on the low side, but does anyone know at what size they do surgery for an aortic aneurysm or if there is any other way to treat this problem?

I also wanted to thank everyone again for their quick responses and kind, reassuring words. This site is a lifesaver! Thanks you, thank you, thank you!



Tiff

Greetings Tiff -

To the Best of MY Knowledge, Surgery is the Only way to 'Fix' an aneurism. This would be a good time to go "Surgeon Shopping" to find someone experienced in "re-do's" and Repair Surgery of the Aorta. Such surgeons are most likely to be found at Major Heart Centers such as Mayo Clinic, Cleveland Clinic, and wherever Ross's favorite, Dr. McCarthy, went in Chicago.

Ask your Cardiologist for his recommendation(s). Or ask our fellow VR.com members who they used / recommend in the midwest. There should be several good surgeons within commuting distance of Wisconsin. Don't be afraid to simply call Surgeon's Offices, tell them what you need and ask about the experience of their Surgeon(s) in those areas.

It would also be a good idea to find someone who can explain or determine the reason for your aneurism. Connective Tissue Disease is something that should be checked for.

The "Rule of Thumb" for surgery on Aortic Aneurisms is 5.0 cm BUT people (such as our moderator ROSS) have had their Aneurisms Rupture or Disect at SMALLER Sizes. (Ross's blew at 4.7 cm if I remember correctly). Also, it would seem that Body Size would / should be factored into that number.

Good Luck in your Quest,

'AL Capshaw'

 

[Alex]

Spot on Echo

Atissy,

For aorta I was told that one of the best in the world is Dr. Miller in Stanford ( Marfan Center, they do hundres of aorta jobs there) , there is also Tirone David in Toronto and some other guy in Germany...those are the ones with more surgeries in their CVs. Miller is excellent.

Good luck...you two look cute in your picture !!

 

[attissy]

Thank you again to everyone for all the info. I am still really very overwhelmed by all of this.

I was 34 at the time of my AVR and chose a mechanical valve because although I was not sure if I wanted to have children...the one thing I did know was that I did not want another surgery. So, now I will have to have another OHS anyway!!!! I am just really bummed out and feeling sorry for myself at the moment. I know others have gone through much worse than what I am going through, but I am still trying to cope with this whole concept. Once I am more focused, I will start "shopping" for a surgeon near to home that hopefully has some specialized aortic surgery background (including in the Chicago area).

I have not had a chance to talk to my cardiologist directly since the TEE. He relayed the information to my sister (who is a nurse) since I was pretty out of it after the procedure. I plan on checking in with him on Monday if I don't hear from him directly.....but I would sure hope he would take the time to call me with the details.

Thanks again for letting me vent and for all your guidance.

Tiff

 

[attissy]

I just want to send a big thanks out to you Oaktree. You have been a great support through all of this and have helped me take a deep breath and relax a bit! It sounds like you have been through a great deal and have dealt with it very well! You give me hope. I will keep you posted as I get more information. Thank you again !

Tiff

 

[njean]

Just wanted to say to Tiff & Oaktree that I too can relate only too well to your scenarios.

When I had the 1st OHS in 1975 for a double-valve implantation, I had to go back for the 2nd OHS to re-sew the mitral valve back into place because some of the sutures had torn loose. Talk about sheer fright --- I know the feelings all too well!

And then, in 2006 I had to go for the 3rd OHS to have the AV re-oped & replaced w/another artificial valve! And NOW, I sit on the sidelines awaiting a 4th OHS to re-op the mitral mechanical valve! But I don't give up & I don't give in & perhaps my theme song ought to be: "White Flag - I won't go down with this ship......"

So you hang in there Tiff & I'm keeping you in my prayers that all goes well with you!

P.S. HAPPY BIRTHDAY TO YOU & MANY MORE!

 

[attissy]

Uh-oh

Uh-oh

Hi everyone,
I thought I would send an update. I just had my followup CT scan done and the results are confusing. I have an ascending aortic aneurysm now measuring 4.3 cm (previously 3.8 on TEE in March - not 4.0 likely I had originally thought). I also have aneurysmal dilatation of the brachiocephalic artery of 16 mm(?). What do you make of these findings? I know they are not great results, but how bad are they and what does anyone know about the brachiocephalic aneurysm? Your wisdom is greatly appreciated!

Tiffany

 

[Susan BAV]

Hi Tiffany -

What has your doctor told you? Did he/she say if 16mm was considered to be an aneurysm?

I did a quick Web search on the term brachiocephalic aneurysm from your post and hardly understood what I found--and don't know if 16mm is considered to be an aneurysm state--but one undated Mayo Clinic article, based on cases from 1950-1990 (which would seem to me to be old information), indicated early recognition and repair was important, stating, "Early elective isolated surgical repair remains the optimal therapy." I kept trying to pull up some percutaneous repair articles on the brachiocephalic aneurysm but they were no longer available and I don't know why.

Regarding the different sizes from the tests of your ascending aorta, I have read that different tests can read different sizes but I don't know which test is considered to be the most accurate or how much the accuracy is dependent on the tech administering the test. Does your doctor think your aneurysm has grown that much since March or does he think the difference may lie within the tests?