Treating myself before aortic valve replacement?

[kobaha21]

Just few question about my AVA 0,5 cm and Vmax 5,3 m/s..

Ok. I read about my stenosis lot's off in this month.

I am waiting for more check ups and my TEE and before that I still working lot and my job is very hard and dinamic. Walk about 3,4 miles, driving car on job and more stuff. It is stressful but I am managing ok for now.

I read about AVA max 0,5 cm. That's a little hole of 0,5 cm through my blood goes in aorta. Bernoulli principle. Increase flow of fluid through little hole. Norman si 3 or 4 cm.
First question. Can that kill me in next months (maybe 6)before my surgery.

I am not tired. It is interesting and my blood pressure is ok. 120/80.
Heartbeats 55,60...

I am afraid of that little hole in valves goes more smaller? Is it possible?
From 0,5cm to 0,3 or like that???

What I should do? Continue to work or go to sick leave till the surgery?
Not smart enough. Winter is coming. It is cold outside and my work is half outside half in car.

Tnx.

 

[dick0236]

What I should do? Continue to work or go to sick leave till the surgery?
Not smart enough. Winter is coming. It is cold outside and my work is half outside half in car.

I'd ask your Cardiologist and/or Surgeon.

 

[kobaha21]

I'd ask your Cardiologist and/or Surgeon.

Still not get to my cardiologist. I am waiting for TEE and MTSC. When I get to my cardiologist I will ask him, till then I ask people on this forum. From their experience. Simple like that.

 

[pellicle]

Hi

Just few question about my AVA 0,5 cm and Vmax 5,3 m/s..

Ok. I read about my stenosis lot's off in this month.

that's good, I always encourage that ... did you come across this?

https://pmc.ncbi.nlm.nih.gov/articles/PMC4889185/

The conclusions are mind-bogglingly facepalm ... but then it is an older study. However the important parts are the risks ... so I'm going to echo to you what my surgeon said to me:

• keep doing light exersize
• pay attention to how you feel and don't over do it

I am waiting for more check ups and my TEE and before that I still working lot and my job is very hard and dynamic.

ok ... so you may need to explain to them the situation (unless you fear being dismissed) and perhaps they can take you away from any heavier parts of the dynamic (and does the job involve heavy lifting or just bursts of activity, dynamic simply means changing, so I'm at a total loss as to what you may exactly mean. For instance "star jumps" are "dynamic" but squats may seem static (but places strain on the heart as the muscles load up the heart). Just like you hear the pump in this hydraulic press load up when the resistance increases.



remember your muscles go from being soft and allowing blood flow when at rest to contracting and becoming tight during a lift. The result is that huge resistance changes occur and the heart loads up.

A squat
https://www.healthline.com/health/exercise-fitness/squats-benefits#muscles-worked

Walk about 3,4 miles, driving car on job and more stuff. It is stressful but I am managing ok for now.

the walking is fine, so too the driving ... what part is stressful (and if its emotional stress then you do need to consider learning better psychology for dealing with that or changing jobs in the longer term as that stuff kills you slowly).

I read about AVA max 0,5 cm. That's a little hole of 0,5 cm through my blood goes in aorta.

its the little hole which the clagged and fused valve which is supposed to open has become due to stenosis ... (just in case: late 19th century: modern Latin, from Greek stenōsis ‘narrowing’, from stenoun ‘make narrow’, from stenos ‘narrow’).

First question. Can that kill me in next months (maybe 6)before my surgery.

unlikely but injure you it will because of loading if you do not take it easier.

That injury will perhaps not be felt but will lead to ongoing complications which will emerge in the coming years such as arrythmias.

I am not tired. It is interesting and my blood pressure is ok. 120/80.
Heartbeats 55,60...

that's good, but the body is adaptable and that BP is when at rest, not what the heart must struggle against when under load

I am afraid of that little hole in valves goes more smaller? Is it possible?
From 0,5cm to 0,3 or like that???

its not just possible, its totally certain unless you die from something else first. So that's why you need the surgery to cut out that blocked up and non functioning valve and put in a new one. Which brings me to...

Remember that there is no definitive 'cure' for valve disease.

Despite the marked improvements in prosthetic valve design and surgical procedures over the past decades, valve replacement does not provide a definitive cure to the patient. Instead, native valve disease is traded for “prosthetic valve disease,” and the outcome of patients undergoing valve replacement is affected by prosthetic valve hemodynamics, durability, and thrombogenicity. Nonetheless, many of the prosthesis-related complications can be prevented or their impact minimized through optimal prosthesis selection in the individual patient and careful medical management and follow-up after implantation. ​

(citation)

As mentioned at present we exchange a diseased valve with a variety of options which then gives you "prosthetic valve disease" or something worse. Prosthetic valve disease is divided into two groups with different management approaches

1. bioprosthetic valve disease - managed surgically by replacement of that valve (so yes, heart surgery again) if you don't die before that (common in patients over 70yo because the valves last over 10 years in the elderly but the elderly don't last over 10 years). This also nearly always means being on warfarin in the last stages of that prosthetic valve
2. mechanical valve disease - managed by warfarin therapy

alternatives to those two are "homografts" and or some complex combination of homografts and autografts ... lets not do the Ross now.

What I should do? Continue to work or go to sick leave till the surgery?

save your sick leave till after surgery ... I mentioned above all the things I think you should do.

Not smart enough.

?

Winter is coming. It is cold outside and my work is half outside half in car.

winter is winter ... it won't bother your heart valve (but if you don't wear gloves it will bother your fingers. I spent a lot of time in Finland doing outdoor activity ... both before and after getting my mechanical valve

before the mechanical valve / aneurysm repair

after it when regaining my fitness

life is a journey ... walk it and don't forget to look around and enjoy the beauty

and the fun

 

[kobaha21]

Hi


that's good, I always encourage that ... did you come across this?

https://pmc.ncbi.nlm.nih.gov/articles/PMC4889185/

The conclusions are mind-bogglingly facepalm ... but then it is an older study. However the important parts are the risks ... so I'm going to echo to you what my surgeon said to me:

• keep doing light exersize
• pay attention to how you feel and don't over do it

ok ... so you may need to explain to them the situation (unless you fear being dismissed) and perhaps they can take you away from any heavier parts of the dynamic (and does the job involve heavy lifting or just bursts of activity, dynamic simply means changing, so I'm at a total loss as to what you may exactly mean. For instance "star jumps" are "dynamic" but squats may seem static (but places strain on the heart as the muscles load up the heart). Just like you hear the pump in this hydraulic press load up when the resistance increases.



remember your muscles go from being soft and allowing blood flow when at rest to contracting and becoming tight during a lift. The result is that huge resistance changes occur and the heart loads up.

A squat
https://www.healthline.com/health/exercise-fitness/squats-benefits#muscles-worked


the walking is fine, so too the driving ... what part is stressful (and if its emotional stress then you do need to consider learning better psychology for dealing with that or changing jobs in the longer term as that stuff kills you slowly).


its the little hole which the clagged and fused valve which is supposed to open has become due to stenosis ... (just in case: late 19th century: modern Latin, from Greek stenōsis ‘narrowing’, from stenoun ‘make narrow’, from stenos ‘narrow’).



unlikely but injure you it will because of loading if you do not take it easier.

That injury will perhaps not be felt but will lead to ongoing complications which will emerge in the coming years such as arrythmias.


that's good, but the body is adaptable and that BP is when at rest, not what the heart must struggle against when under load



its not just possible, its totally certain unless you die from something else first. So that's why you need the surgery to cut out that blocked up and non functioning valve and put in a new one. Which brings me to...

Remember that there is no definitive 'cure' for valve disease.

Despite the marked improvements in prosthetic valve design and surgical procedures over the past decades, valve replacement does not provide a definitive cure to the patient. Instead, native valve disease is traded for “prosthetic valve disease,” and the outcome of patients undergoing valve replacement is affected by prosthetic valve hemodynamics, durability, and thrombogenicity. Nonetheless, many of the prosthesis-related complications can be prevented or their impact minimized through optimal prosthesis selection in the individual patient and careful medical management and follow-up after implantation. ​

(citation)

As mentioned at present we exchange a diseased valve with a variety of options which then gives you "prosthetic valve disease" or something worse. Prosthetic valve disease is divided into two groups with different management approaches

1. bioprosthetic valve disease - managed surgically by replacement of that valve (so yes, heart surgery again) if you don't die before that (common in patients over 70yo because the valves last over 10 years in the elderly but the elderly don't last over 10 years). This also nearly always means being on warfarin in the last stages of that prosthetic valve
2. mechanical valve disease - managed by warfarin therapy

alternatives to those two are "homografts" and or some complex combination of homografts and autografts ... lets not do the Ross now.


save your sick leave till after surgery ... I mentioned above all the things I think you should do.


?


winter is winter ... it won't bother your heart valve (but if you don't wear gloves it will bother your fingers. I spent a lot of time in Finland doing outdoor activity ... both before and after getting my mechanical valve

before the mechanical valve / aneurysm repair

View attachment 890676

after it when regaining my fitness
View attachment 890677

life is a journey ... walk it and don't forget to look around and enjoy the beauty
View attachment 890679

and the fun

View attachment 890678

Tnx on answers. I read that article and found many more. I know I don't have much time. Maybe year or two. I hope I will get my surgery next year in spring. Maybe before, hope so.

I my county we have good law about sick leave. For my diagnose I can be 2,3 months off work even before surgery, but they cut my salary 50%! But I can be off work long time. I will see that. Winter is not my type of year. Don't like cold and snow..
Tnx. You are really great person. Helping with advises.
Respect!

I must sleepover and think about it. Many hard days are coming.
Tnx.

 

[3mm]

Many hard days are coming

You Can Do This! Using this forum to learn about ways to manage your condition shows that you have the correct mindset to handle this problem.

Focus on one day at a time. What tasks must you do that day? What is the most effective way to perform those tasks? If you feel overwhelmed, take a moment to relax; then return to work.

What I should do? Continue to work or go to sick leave till the surgery?

Consider what you would do if you were not working. Working may be better for your mental health than endless worry about your heart. This depends on your job, how you get along with your coworkers, and so on. Discuss this with a friend or family member who has common sense and good judgement.

Please continue to talk with us on the forum. We want to help!

 

[pellicle]

I must sleepover and think about it. Many hard days are coming.
Tnx.

totally welcome. I'm sure hard days are coming, not just for you but for everyone; for this is the nature of life.

“Learning is not child's play; we cannot learn without pain.”​

― Aristotle

I'm turned over into chapter 60 of my life recently and I know that things don't get easier from here. All we can do is move forward in the direction which seems like the right one to us; taking the advice from others and seeing how it applies.

For instance, I may advise someone of your age to get a mechanical valve, but that would assume things which I know nothing about that are wrong. Thinks like:

• being organised
• being responsible
• being confident at taking a small gamble
• being someone who can learn new things
• not being OCD
• not being a micro-manager
• not being decisive
• not having access to a machine to test

are attributes which fold into the understanding of "is self management for you?" Its a non trivial question.

Picking a mechanical valve has benefits and disadvantages, as too does picking a bioprosthesis; but either way at your age I would pick SAVR not TAVR if I was you (or me).


Best Wishes

 

[Chuck C]

First question. Can that kill me in next months (maybe 6)before my surgery.

The short answer is yes. At 0.5cm2, you should get surgery asap, whether or not you have symptoms. If you were severe and, say 0.9cm2, then it becomes more reasonable to wait for symptoms, but at 0.5cm2, you're basically the level beyond severe, which is critical.

When I crossed the line from moderate to severe, my AVA was 0.89cm2. I had no symptoms. In consult with my surgeon, the question was whether to wait for symptoms or get surgery soon. He strongly recommended getting surgery soon. He said that my first symptom might be sudden death, so best to get it done. Keep in mind, that was AVA of 0.89cm2, almost twice as large as your AVA.

Having said that, it is not as though you need to rush to emergency and get surgery tomorrow, but I would suggest getting it done within a few weeks. With an AVA of 0.5cm2, there is nothing to be gained by kicking the can down the road. Get your valve replaced and get on with your recovery.

It is very odd that you would not have symptoms with such a small AVA. My guess is that you probably do have symptoms but are masking them somehow. If you were an endurance athlete, running or biking, I would bet that you would be noticing a dramatic decrease in performance. This might not be picked up with just walking.

 

[Lisa from LJ]

I worked the Thursday before my Tuesday surgery. Then my husband, 7 and 5 yo kids, and I went to San Antonio, TX for the 4 day weekend before my Tuesday surgery. We went to SeaWorld and Fiesta Texas, rode roller coasters and water slides, and had a great time. My thinking was that if I didn't make it off the table, I wanted my kids to remember the fun. I felt fine and had no problem with any of this. Pay attention to your body and you will know what you're capable of doing.

 

[SatoriFound]

It is very odd that you would not have symptoms with such a small AVA. My guess is that you probably do have symptoms but are masking them somehow. If you were an endurance athlete, running or biking, I would bet that you would be noticing a dramatic decrease in performance. This might not be picked up with just walking.

Also, if it happened slowly over time, then you may not have noticed the changes in your stamina and endurance. My husband had a hard time giving definitive answers to the symptoms question. He could never answer the do you have difficulty breathing question because he smoked for many years....

 

[kobaha21]

The short answer is yes. At 0.5cm2, you should get surgery asap, whether or not you have symptoms. If you were severe and, say 0.9cm2, then it becomes more reasonable to wait for symptoms, but at 0.5cm2, you're basically the level beyond severe, which is critical.

When I crossed the line from moderate to severe, my AVA was 0.89cm2. I had no symptoms. In consult with my surgeon, the question was whether to wait for symptoms or get surgery soon. He strongly recommended getting surgery soon. He said that my first symptom might be sudden death, so best to get it done. Keep in mind, that was AVA of 0.89cm2, almost twice as large as your AVA.

Having said that, it is not as though you need to rush to emergency and get surgery tomorrow, but I would suggest getting it done within a few weeks. With an AVA of 0.5cm2, there is nothing to be gained by kicking the can down the road. Get your valve replaced and get on with your recovery.

It is very odd that you would not have symptoms with such a small AVA. My guess is that you probably do have symptoms but are masking them somehow. If you were an endurance athlete, running or biking, I would bet that you would be noticing a dramatic decrease in performance. This might not be picked up with just walking.

Tnx for answer.