TEE test question

[irishmiz]

After consulting with a local heart surgeon in DC (Dr. Speir), it was suggested that I have a TEE test to find out what my mitral valve looks like post-failed repair and whether it can be re-repaired. Dr. Speir suggested that I send a copy of the test to Dr. Gillinov at Cleveland to see if Dr. Gillinov still thinks there is a 70% chance of re-repair. Speir doesn't think so.

My question is, can a TEE actually reveal the condition of the mitral valve and is it more, less or the same in terms of effectiveness as a cardio cath in diagnosing valve function? I am currently scheduled to have a cath procedure before my operation at Cleveland which is schedule for 4/21. If a TEE test yields the same results, I don't see why I would have to have cath.

Also, I've never had a TEE, but am familiar with the procedure. Will I be able to go to work after it's done?

Many thanks!

Christie

 

[Ross]

The TEE is by far the most advanced and best way to see problems with valves. By all means, give it a try. They would want the Cath to check the pressures inside the chambers. The Tee isn't something you want to invite your friends over for a party for, but it's not the worst thing on the planet either. After the sedation wears off, you could return to work, but I'd suggest skipping work for that day.

 

[MikeHeim]

I wasn't allowed to drive after my TEE, so going to work was pretty much out of the question. However, I was able to stop and eat lunch on the way home without much trouble.

It seemed like my Cardiologist was able to completely diagnose that both my anterior and posterior mitral valve leaflets were in rough shape from the TEE alone. As far as I know, the angiogram was only used to determine if I had any artery blockages.

 

[tobagotwo]

The cardiac catheterization is largely to check the cardiac arteries for blockages. A dye is released that shows up well on xray, disclosing any narrowed vessels. This is done so that any blockages can be corrected by CABG while the chest is already open. It also validates the findings in the echo.

A good TEE will give a clearer picture of the valve in action, but is unable to detail the insides of the arteries.

Strictly for purposes of determining if valve surgery is required, a standard echo is almost always sufficient. Again, it won't delineate arterial disease, though.

The vessels can be shown by an MRA (an MRI of the cardiac area). A dye is also injected in that procedure. The catheter angiogram is much more commonly used, though.

Best wishes,

 

[joanne6]

I second the opinion. The two tests are for different purposes. One, the cath, is to eval the coronary arteries, basic function of the heart.
The TEE gives a much better picture of the valves. Most docs do those plus other tests before surgery.

 

[RCB]

Although these test narrow down the problem, no surgeon will be able to tell
you for sure that a valve can be repaired till they look at it first hand. Some problems show up better than other- some repairs are more certain then others.

You have to remember that they have been "repairing" heart valves
for over 70 years( long before they could replace them ) and every year
they learn a little more and do repairs on valve that in the past would have been unrepairable. Let hope that in the future more and more valve are repaired, because it really is the best solution!

 

[cocoalab]

Andrew has had several TEE's and my understanding is they can see the valves much better with them- especially his. I would definately get it done.

The day he had his last one we actually took the train home which dropped us off a couple miles from home. We walked home in 85 degree heat, okay maybe not, but it was so funny because the pace bus wouldn't be by for several hours. We stopped at a store on the way home and got a frozen treat, then stopped at two other places. It was really fun and he had been put under for the TEE. so maybe you can go back to work.

 

[Georgia]

They did a TEE when they did my pre-surgery cath; I think this is the standard procedure.