There holding me back

[ken taylor]

Hello to all ; here is my new numbers from the last ECO ascending Arota now 4.4 seven months ago 4.1 valve area now 0.88 before 0.97 peak gradient now 67 mean 36 mmhg before peak 55 mean 29 mmhg. I still do not have any severe symptoms unless you count that I no longer walk , two years before 12 miles a day now only depression from living with this hanging over my head. Ive had a hard time with the cardiologist . I want my New ON_X valve , All they say is come back in six months unless I have symptoms. I know the wall between the chambers is getting thick, They say because Ive had bypass surgery six years ago that the surgery is more dangerous for me. My reply is , that will not change in the future so lets get it done. For you that understand Ecos . What are they waiteing for??

 

[Bina]

When my aortic valve area was at .8 cm my symptoms were severe and I was on my way to surgery.
Your numbers seem to indicate that you are ready to be fixed up, there is no advantage to waiting.

 

[DeuxofUs]

I agree, you are ready. There are some cardiologists that wait until you have symptoms. I don't think this is good practice. I asked my cardio if she was "one of those" that waits and she said no way.... So, that made me feel better.

Looking at your numbers, there are plenty of docs that would say you are ready.. I would consult with another cardio if I were you and start demanding.. it's your life, your heart... no reason to wait until damage occurs.

 

[DeuxofUs]

BTW, I totally understand the depression part as I have had that since my diagnosis... I stopped exercising altogether and I am "afraid" to do anything physical. Not a way to live.. AT ALL.

 

[Bill B]

Who is "they"? Have you had a surgical consult? My cardiologist was in the "watchful waiting" camp. Waiting for symptoms, although she acknowledged there was support for doing the surgery before any marked symptoms. I got a bit nervous because my valve was shrinking fast based on repeat echos. I got a surgical consult, just seeking information on my surgical options for future reference, should I need it sooner rather than later. The surgeon, arguably one of the best there is, was surprised I had no symptoms, said that my heart was working very hard to keep things going and that I needed surgery within 6 months. I hesitate to say this to you, but he said based on the condition of my valve and the pressures within my heart that my first symptom could be my last. Anyway, I think it would be wise for you to seek another professional opinion. My original cardiologists resented that, and accused me of "directing my own care". Well, duh! I went ahead and had the surgery 3 months later and got another cardiologist. I do what my cardiologist prescribes, but I don't leave it at just that.

 

[Jeri]

I agree with the others....get another opinion. The only rationale that I can think of for waiting, is maybe they want your heart to have more time to heal since last procedure. I really don;t know but I would definitely get a second opinion. Good luck and I will keep you in prayers. Try to stay positive.,...you need all the positive energy you can muster up and stay away from negative people. Take care and God bless.

Jeri

 

[ken taylor]

Thanks to all, It was told to me that the risk is scar tissue and there is a risk of cutting a vein with a re-do surgery and they had a person die from being cut. I told them this risk would be the same now are later so lets get it done. I have another appt. in one month. I will demand surgery. I have met with the surgeon a year ago at St. Lukes in Houston.

 

[kfay]

Ken, Will this be your second surgery? If so, the risks are about the same as they are with a first surgery, and like you pointed out, it isn't going to go away with more time. I agree with the others, I would be seeking the opinion of a different surgeon, one who has experience with re-do's.

Kim

 

[ALCapshaw2]

Some (many? - mostly Old School) Cardiologists like to wait for SYMPTOMS.
FWIW, many Cardiologists (and Surgeons) use 0.8 sq cm as their 'trigger' for recommending surgery, so you are close. There are also guidelines for gradient pressures, but I don't know the exact 'cutoff'.

Personally, my definition of Symptoms is that Damage is being done to your Heart.

I suspect that Surgeons have a better perspective on WHEN to recommend surgery and would recommend getting another Surgical Consult from a Surgeon who has Lots of Experience doing "re-do's". In the right hands, second surgeries are highly successful. Your best option would be to go to a Major Heart Hospital such as the Texas Heart Institute where you had your first surgical opinion.

(In my non-professional opinion, your 'numbers' are 'close' and you do have symptoms, or at least 'life altering effects' that a good surgeon would take into consideration. As you point out, your risk factors are NOT going to improve and may actually decline with time. I see Little Benefit in waiting if you want to proceed.

'AL Capshaw'

 

[jdsmithii]

I had the opposite problem. I went in for my routine cardio appt and was told I had a thoracic aortic aneurysm at 6.0 cm and I would need surgery soon. I didn't even have any symptoms, but like Deuxofus, I was a VERY active 30 yr old that was afraid of sprinting up a few stairs for fear of rupturing the aortic root. Not a way to live for 5 months. Thankfully, I am 'over the mountain,' and I am at 4 1/2 weeks.

As Tom Petty said, "The waiting is the hardest part!"

 

[ejc61]

I know I only had mitral valve repair, but they DID NOT want to wait for symptoms to proceed. I would be looking for other opinions.