Stenosis VS. Regurgitation

[JeffM]

Good question. I think the symptoms can be quite different between the 2 conditions and, of course symptoms vary among patients even with the same conditions. In my case, I was diagnosed with BAV with regurgitation at age 30. I had NO SYMPTOMS UNTIL AGE 52 and never developed any stenosis. From monitoring, the changes I was seeing were my BP - Systolic began to rise slightly toward the end but diastolic had been dropping for years. Just prior to my surgery at age 53, my resting BP was averaging 125-130 over 40 - 50; my left ventricle was gradually increasing in size and my aorta was beginning to enlarge. Also, I had developed such a strong pulse, that my head would bob slightly. The first and only symptom I had was Afib. Initially it was brought on by extremely hard efforts on my bike, but after that happened maybe 5 or 6 times, each time lasting longer, it started to happen without exercise. At that point, everything was deteriorating rapidly and it was time for surgery. But again, until several months prior to my surgery, I had no symptoms, even though all my echos were showing severe aortic regurgitation. My surgeon's and cardio's opinions were that by being very athletic, my heart and vascular systems were compensating extremely well. It points out the importance of close monitoring with regular echos.

 

[normofthenorth]

1) In simplest terms, any valve has to do two opposite things: It has to open and it has to close. A healthy heart valve does both very close to 100%. Failure to open fully (or to create a normal big-area opening) is stenosis; failure to close fully is regurg.

2) Bob/Tobagotwo interpreted insufficiency as when "there is insufficient blood coming out of the aortic valve to completely fill the aorta." I'd stop at "there is insufficient blood coming out of the aortic valve." The aorta is alway full of blood, the issue is how far and how fast it MOVES -- and net of any "backsliding" from regurg.

3) I can easily believe that the two problems show up differently on BP tests, as well as fancier scans, but I can imagine them causing pretty similar symptoms -- the symptoms of insufficient circulation and excessive heart effort.

4) @chris.c: At least when I had my AVR (& MV repair) done at the Peter Munk Cardia Centre at Toronto General aka UHN (and Peter Munk is the industrialist donor, not a heart doctor), my highly-placed surgeon indicated that they are generally reluctant to do minimally-invasive valve replacements, mostly reserving them for young women who think their lives would be ruined if they had a scar "there". Maybe they'd do it for you, but maybe you'd be better off going somewhere where they do a lot of them, and I don't think that's TGH. I think Ottawa definitely does a bunch, and maybe London does. Somebody here had robotic surgery (one kind of minimally-invasive) in maybe Waterloo?

5) Also, I was using my arms to help me out of bed and chairs a week or two post-op (the details are on the multi-post thread "Norm's story so far. . ."), though I'm nowhere near your size. In 6 weeks, the bones of the sternum have more-or-less completely re-knit, so this part of the recovery is far from forever, even if you do have OHS.

Good luck!

 

[Kitty]

If Stenosis is narrowing of the valve, why wouldn't they just stick a balloon in the valve to widen it back up as opposed to watching it? I've always wondered that in terms of replacement to that procedure.

I was told my son could do the balloon procedure right off the bat if needed. I assume that's to prevent regurgitation over time.

Glen

I have a bicuspid valve with as and ar. Mine is congenital. I've had 2 balloon procedures when I was younger and they were both nothing more than a tempory fix