V
vinny
Hello!
Am new to this forum. Shall be delighted to recieve any information, further knowledge so that I can make the right decision on the course to follow.
Male 57 yrs, Height 170 cms, Weight 73 Kgs, - RHD – CMV:1969, BMV : 2002
Present Condition August 2009 NSR - HR – 68 BPM, BP – 114/80, Lungs – Clear, No Symptoms.
I have Aortic Valve Stenosis and mild Mitral Valve Stenosis and am Asymptomatic.I am presently lving in Delhi,India
I would appreciate opinion/Advice and answer to the following Questions:
1. Do I require immediate AVR or Double Valve Replacement ?
OR should I wait for Symptoms?
2. If AVR has to be done now, what options would there be later when Mitral Valve requires intervention?
3. What is a better choice of Valve in either case.
4. Are there any recomendations for Surgeons in New Delhi,India!
Thanks and Best to all.
Some medical Test Results:-
Medication since December 2008 : Cardarone - 100 mg – OD, Aquazide – 12.5mg – OD, Betaloc – 25 mg – BD, Acitrom - 2 – 2 – 3 mg . PT (INR 1.5 to 2.00)
TEE December -- 2008 Echocardiography August – 2009
MILD TR. RSVP – 30 mm Hg Severe AS
Grade II Atheroma at junction of arch AVA – 0.9 cm2 by Planimetery
and descending Aorta. 0.7 cm2 by continuity equation
Moderate to Severe AS Mean PG – 44/ 75 mm Hg
AVA – 0.8 cm2 by 2D planimetrey MILD AR
Mean PG – 31 mm Hg MILD TR . RSVP – 30 mm Hg
Mild to Moderate AR LVIDd – 5 cm
Aortic Cusps are noncoapting. LVIDs – 3 cm
Aortic Valve is tricuspid,thickend & Calcific. LVEF – 55 – 60 %
RV – Normal LA – 4.5 cm
LV – Normal Concentric LVH.
LVIDd - Normal Aortic Root diam – 3.0 cm
LVIDs - Normal Aortic Root Area – 7.1 cm2
LVEF – 55% Peak Velocity – 432 cm/sec
LA – Dilated ACS – 1.4 cm
Aortic annulus – 2.1 cm MVA – 1.7 cm2 by planimetrey
Aortic Root – 3.06 cm - 1.6 cm2 by PHT
Ascending Aorta – 3.3 cm. MILD Calcific MS
Peak Velocity - 393 cm/sec Mean PG – 8 /20 mm Hg
MVA - 2 cm2 by 2D Planimetery No MR
Mildly Calcific ,No MR CT CORONARY ANGIOGRAPHY August 2009
Mean PG – 8 mm Hg LV - appears Normal
Segments – Normal
LA – enlarged
Calcific AS & MSTotal Calcium score is zero
. Aortic Annulus – 22x21 mm
Aortic Sinus – 34x33 mm
Sino-Tribular junction- 29x30mm
Internal mammary arteries
Distal Segment – Normal
Pericardium – Normal
Pulmonary arteries – Normal
LMCA – Unremarkable, Dominant (5.2mm)
LAD – No Significant Disease (4.3mm)
LCX – Dominant & good Size (3.8mm)
RCA – Thin (3.4mm) Non-Dominant
Discrete Segment, significant disease of Mid part with moderate size distal vessel is seen. Fatty plaque is seen at mid part of non-dominant RCA Causing narrowing, just proximal to good size AM3.
3 Episodes of AF 2002 , 2007 , 2008
BMV - August 2002
POST BMV (August 2002) MVA - 1.9 cm2 by PHT, MVA – 2.1 cm2 by 2-D
No MR
Mean PG - 6 mm Hg
MAX PG – 8 mm Hg
Peak Velocity 114 cm/sec.
AORTIC VALVE (POST BMV 2002)
AVA by 2D – 1.1 cm2
AVA by Doppler – 1.00 cm2
Peak PG – 59 mm Hg
Aortic Root Diameter- 3.1 cm
Peak Aortic Velocity – 3.9 cm/sec
EF - 62%
LA – 4.6 cm
LVIDd – 4.7 cm
RV – 1.6 cm
Am new to this forum. Shall be delighted to recieve any information, further knowledge so that I can make the right decision on the course to follow.
Male 57 yrs, Height 170 cms, Weight 73 Kgs, - RHD – CMV:1969, BMV : 2002
Present Condition August 2009 NSR - HR – 68 BPM, BP – 114/80, Lungs – Clear, No Symptoms.
I have Aortic Valve Stenosis and mild Mitral Valve Stenosis and am Asymptomatic.I am presently lving in Delhi,India
I would appreciate opinion/Advice and answer to the following Questions:
1. Do I require immediate AVR or Double Valve Replacement ?
OR should I wait for Symptoms?
2. If AVR has to be done now, what options would there be later when Mitral Valve requires intervention?
3. What is a better choice of Valve in either case.
4. Are there any recomendations for Surgeons in New Delhi,India!
Thanks and Best to all.
Some medical Test Results:-
Medication since December 2008 : Cardarone - 100 mg – OD, Aquazide – 12.5mg – OD, Betaloc – 25 mg – BD, Acitrom - 2 – 2 – 3 mg . PT (INR 1.5 to 2.00)
TEE December -- 2008 Echocardiography August – 2009
MILD TR. RSVP – 30 mm Hg Severe AS
Grade II Atheroma at junction of arch AVA – 0.9 cm2 by Planimetery
and descending Aorta. 0.7 cm2 by continuity equation
Moderate to Severe AS Mean PG – 44/ 75 mm Hg
AVA – 0.8 cm2 by 2D planimetrey MILD AR
Mean PG – 31 mm Hg MILD TR . RSVP – 30 mm Hg
Mild to Moderate AR LVIDd – 5 cm
Aortic Cusps are noncoapting. LVIDs – 3 cm
Aortic Valve is tricuspid,thickend & Calcific. LVEF – 55 – 60 %
RV – Normal LA – 4.5 cm
LV – Normal Concentric LVH.
LVIDd - Normal Aortic Root diam – 3.0 cm
LVIDs - Normal Aortic Root Area – 7.1 cm2
LVEF – 55% Peak Velocity – 432 cm/sec
LA – Dilated ACS – 1.4 cm
Aortic annulus – 2.1 cm MVA – 1.7 cm2 by planimetrey
Aortic Root – 3.06 cm - 1.6 cm2 by PHT
Ascending Aorta – 3.3 cm. MILD Calcific MS
Peak Velocity - 393 cm/sec Mean PG – 8 /20 mm Hg
MVA - 2 cm2 by 2D Planimetery No MR
Mildly Calcific ,No MR CT CORONARY ANGIOGRAPHY August 2009
Mean PG – 8 mm Hg LV - appears Normal
Segments – Normal
LA – enlarged
Calcific AS & MSTotal Calcium score is zero
. Aortic Annulus – 22x21 mm
Aortic Sinus – 34x33 mm
Sino-Tribular junction- 29x30mm
Internal mammary arteries
Distal Segment – Normal
Pericardium – Normal
Pulmonary arteries – Normal
LMCA – Unremarkable, Dominant (5.2mm)
LAD – No Significant Disease (4.3mm)
LCX – Dominant & good Size (3.8mm)
RCA – Thin (3.4mm) Non-Dominant
Discrete Segment, significant disease of Mid part with moderate size distal vessel is seen. Fatty plaque is seen at mid part of non-dominant RCA Causing narrowing, just proximal to good size AM3.
3 Episodes of AF 2002 , 2007 , 2008
BMV - August 2002
POST BMV (August 2002) MVA - 1.9 cm2 by PHT, MVA – 2.1 cm2 by 2-D
No MR
Mean PG - 6 mm Hg
MAX PG – 8 mm Hg
Peak Velocity 114 cm/sec.
AORTIC VALVE (POST BMV 2002)
AVA by 2D – 1.1 cm2
AVA by Doppler – 1.00 cm2
Peak PG – 59 mm Hg
Aortic Root Diameter- 3.1 cm
Peak Aortic Velocity – 3.9 cm/sec
EF - 62%
LA – 4.6 cm
LVIDd – 4.7 cm
RV – 1.6 cm
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