T.E.E. Results Need opinions

[RandyL]

I got the results of my TEE from Friday I would like some of the valued opinions that come from this forum if at all possible.
Thanks

Impression:
1. Normal left ventricular systolic function
2. Evidence for mild mitral valve prolapse involving the anterior leaflet.
3. Mild mitral regurgitation.
4. Trace tricuspid reguritation.
5. At least moderate aortic insufficiency (approaching severe) with a
wide regurgitant jet noted and also a smaller regurgitant jet which seems
to originate from the attachment site of the valve.

They cleared me for back surgery Wednesday so I guess noone is alarmed. My Cardiologist is haveing me schedule a meeting with my surgeon who to see what he thinks next week.

Thanks again

 

[charly]

I got the results of my TEE from Friday I would like some of the valued opinions that come from this forum if at all possible.
Thanks

Impression:
1. Normal left ventricular systolic function
2. Evidence for mild mitral valve prolapse involving the anterior leaflet.
3. Mild mitral regurgitation.
4. Trace tricuspid reguritation.
5. At least moderate aortic insufficiency (approaching severe) with a
wide regurgitant jet noted and also a smaller regurgitant jet which seems
to originate from the attachment site of the valve.

They cleared me for back surgery Wednesday so I guess noone is alarmed. My Cardiologist is haveing me schedule a meeting with my surgeon who to see what he thinks next week.

Thanks again

If you don't feel right about it, please hold off on the back surgery and get other opinions. You know yourself better than doctors. 6 months before I had my first valve re-replaced, my HMO cardiologist was telling me that according to a TEE, my old valve was "functioning," so he wanted me to quit complaining about my symptoms. Truth was, I was way overdue to have the surgery, and could have dropped dead at any time. Thank heaven my Mom made me seek another opinion.

After what you've been through, a good doctor will understand your concerns.


Best to you,
Charly


So,

 

[davidfortune]

Randy,
Did they clear you to have surgery Wednesday as in day after tomorrow. Or was it last Wednesday when the said you could have surgery?

If you are feeling unsure, seek a second cardio opinion. I'm not sure if moderate aortic regurgitation significantly increases your risks during non-heart related surgery.

I would be also interested in comparisons of Left Ventricle size today vs. historical. This would tell more if aortic insufficiency is causing myopathy. Not really related to the risk analysis of current back surgery but useful nevertheless.

I think I would talk with another cardio and ask about risk factors of non-heart related surgery.

Good Luck

 

[Bryan B]

Randy,

It sounds like you may have a couple of leaks around the sewing ring of the valve. This is not that uncommon and they often resolve on their own. But personally I wouldn't be comfortable going forward with a surgery which requires general anesthesia until I consulted with the surgeon who installed the valve. IMO moderate aortic insufficiency (approaching severe) is something you need to have looked at by the guy who put the valve in. Hopefully it's no big deal and you can move forward with your back surgery and your life. But I'm always on the side of better safe than sorry.

 

[RandyL]

My surgery is tomorrow. I feel comfortable about the surgery. I was just wondering what some of you thought about my TEE results.

 

[Mary]

My surgery is tomorrow. I feel comfortable about the surgery. I was just wondering what some of you thought about my TEE results.

I think I would want to see the surgeon before I proceeded with the back surgery, but that's me, not you.

I don't know much about regurgitation after having a valve implanted, but if it's approaching severe, I would be prepared to hear a discussion about the possibility of another surgery.

Good luck tomorrow, Randy, and next week with the surgeon. Any idea of how long you will be recuperating from the back surgery? Please keep us posted.
My thoughts and prayers are with you.
Mary

 

[Marguerite53]

Randy. That's a lot of trauma to put your old body through this year! You'd better come out of this plum perfect! You certainly have more guts than I would. You must be in a lot of pain.

I had several things to take care of this year, none as dramatic. I needed a breast biopsy where they have to put you under and use a locating wire. And a colonoscopy. My aortic valve was at severe at .53 and I ended up talking with my PCP for help in deciding what I could/should get done. Both smaller events occured before my AVR and were easily tolerated.

The only glitch was my anestesiologist for the breast biopsy. He totally freaked me out when he called the night before (as they often do) and said he really wasn't comfortable since I was at "critical" with the valve. I guess they kind of keep you going throughout it all and he was nervous about that responsibility. Nice. I was practically blindfolded and shoved into that surgery!! Not happy! But it all came out fine. Really. No problem. Of course, that is NOTHING like back surgery.

My point is that since you feel good about going into it, I'm sure you will be fine. As far as your values go, now I'm curious to see my TEE results! I only had the one on my way into surgery and have no recollection of it (or report). I think many of the entire population have mild to trace regurgitation and varying degrees of imperfection....and this can change from day to day. Your LV function is normal. That's important! I don't know how to feel about the moderate AI. I would think that sounds pretty troublesome. I would have made a call in to the surgeon for clarification of that if it were me. I don't know how leaks behave post surgery. It certainly does sound like a leak.

Well kiddo! Best of luck tomorrow. I hope someone can post for you and let us know how you are. Will be thinking of you!!

Marguerite

 

[RandyL]

Thank you M&M

The back surgery is not a big one. I will be under anthestic but for a very short time. The surgery itself lasts about 30 minutes., The incesion is about 2 inches long and is done as outpatient. I will go home the same day. I don't play golf but he said I could go golfing in 3 weeks so I think the recovery will be very short. I prolly post here after the surgery tomorrow.CYA then

P.S. My cardio conferenced with my surgeon and they both said okay to the back surgery

 

[Karlynn]

P.S. My cardio conferenced with my surgeon and they both said okay to the back surgery

Sounds like you're all set to go then. I think I'd want it taken care of as well. Since you don't know yet what the cardio or surgeon are going to say about your TEE and if you'll have to have anything done, it's probably best to get your back fixed so you aren't having to deal with two Pain in the @$$ issues at once.

 

[RandyL]

Sounds like you're all set to go then. I think I'd want it taken care of as well. Since you don't know yet what the cardio or surgeon are going to say about your TEE and if you'll have to have anything done, it's probably best to get your back fixed so you aren't having to deal with two Pain in the @$$ issues at once.

You got that right Karlynn!

 

[geebee]

Randy,

Thoughts, hugs and prayers go with you tomorrow. Looking forward to hearing how the surgery went. I hope it solves your back problems.

Godspeed.

 

[tobagotwo]

I agree you sound good to go for the back surgery, from a non-health-professional point of view. I wish smooth sailing for the repair.

As far as the TEE, here are my thoughts. Please remember this is just my opinion...

1. Normal left ventricular systolic function
Okay, we know that's good

2. Evidence for mild mitral valve prolapse involving the anterior leaflet.
Common and likely harmless

3. Mild mitral regurgitation.
Not too bad. Keep an eye on it over time. This might be caused by LV enlargement, and/or by the prolapse, aggravated by the Aortic Regurgitation.

4. Trace tricuspid reguritation.
Trace = nothing. Trace comes and goes, may be gone next echo or the one after. May come and go for anyone anytime. Trace is not a worry point or trend at all.

5. At least moderate aortic insufficiency (approaching severe) with a
wide regurgitant jet noted and also a smaller regurgitant jet which seems
to originate from the attachment site of the valve.

A few questions that could affect what these may mean. Are you BAV? Is there enlargement of your left ventricle vs. the last echoes? What did the TEE say about the valve's positioning? Was the side leak there at all before?

The smaller jet (leak) first. This can be from the valve losing its attachment at the sewing points, due to tissue problems. It may be a temporary glitch, as Brian points out. It might also have been caused by torque from the valve being partly obstructed. Or it might be more permanent, like a couple of valvers I know from this site.

Trace reguritation (insufficiency) is almost always seen in a carbon (mechanical) valve. Mild regurgitation is less common and less desirable, but occurs sometimes with little real negative effect. Moderate or severe regurgitation in a carbon valve is always wrong. It may be caused by a number of things, such as:

• A blood clot under the valve.
• Scar tissue blocking the valve from closing or redirecting the blood flow.
• Improper positioning of the valve (possibly due to ripped stitches or scar tissue). That can put it at an improper angle where it doesn't receive even pressure to close, or may cause it to bump against the aortic or heart wall, interfering with its operation.
• Even a defective valve (highly unlikely).
• ...or something else entirely (general disclaimer).

It's something you'll have to keep up with, particularly watching your LV size. They'll probably want to keep it as is for as long as possible. Don't let this get ignored. Get a reason for the leak. If this is all that was on the TEE report, it was edited.

Best wishes,

 

[aussigal]

Just popped my head in here to let you know you are in my thoughts and prayers today...

I will be looking forward to hearing how well your procedure has gone...I am also really glad your Cardio & surgeon had a chat about you...

I am guessing that when you get home tonight you wont be in any pain for a day or so while the local anaesthetic is still working., and the pain (if any) from your mini-op will come on a day or two later...Thats what happened to me after my 3 level Facet-Rhizotomy...nothing a few extra pain pills couldnt wipe-out though...

Ok...I shall be waiting for your report...

 

[RandyL]

Thank you so much! I am on my way to get cut again, this will make the 4th time since January this year. I will proly never recover from "pumphead" scenario.CYA Later!

 

[RandyL]

Home already! Too early to tell about my back fix yet but I have a good feeling about it. The surgery went very well and is a piece of cake compared to OHS.Already walked to the end of the street and back.Keeping my fingers crossed that my thigh will return to near normal or normal status.
Ross is back and better and that is what counts today.

 

[Karlynn]

Was waiting to get your "all done" post. I hope it was a successful procedure for you.

 

[Mary]

Way to go Randy!

 

[geebee]

Looking forward to your post all day. So very glad all went well. Now let's get your INR back in range and staying there for awhile.
Please don't overdo it.

 

[aussigal]

YaY!...way to go Randy...gees that was very quick...and you have been off down the end of the street and back already...WOW!
I am hoping for what Gina said that your INR gets right back to 3 with no mucking around...
Take it a bit easy,. though I am sure you are anxious to keep trying out your newly mended back .

 

[tobagotwo]

Glad you're home, and only minorly scathed...

Best wishes,