When is it time?

[jwendlandt]

I had a second opinion this week from a cardiologist in Kansas City. The doctor in Kansas City told me to wait until summer and have another echo done. He told me my heart is still normal sized and I have no symptoms. My EKG was also normal. I am glad I do not have to have the surgery right away, but I am also worried to wait too long. I have a moderate to severe leak of the aortic valve. When do doctors decide to perform the surgery? Is there a set of criteria to go by? I do not want to wait too long.

 

[ChouDoufu]

how long is too long? seems the cardiologists want to wait until the last minute,
by which time damage can already have been done. surgeons want a nice, healthy
heart to work on, which makes the operation and recovery so much easier.

you say you have moderate to severe leakage. can you provide some numbers that
the more advanced on this forum can help you understand? should be able to find
effective valve area, peak pressure gradient, ejection fraction on your echo report.

 

[ALCapshaw2]

Old School Cardiologists like to postpone surgery as long as possible. New Thinking is that it is better to FIX the problem Before there is Permanent Damage to the Heart Muscles and Walls. Once a Cardiologist has diagnosed your problem, there is little he can do to FIX the problem other than medicate to 'slow the progression'.

Often Surgeons have a better 'feel' for timing. This would be a good time to be interviewing Surgeons so that you will be able to select who you want to 'Fix' your heart before you become critical. If you would like a second opinion, make it with a Surgeon.

And YES, there are guidelines for deciding when to have surgery which include Test Measurements, Symptoms, and any other factors the Surgeon considers important to your situation.

'AL Capshaw'

 

[jwendlandt]

When is it time

When is it time

I have been told my ejection fraction is at 59%. My ekg is normal and the size of my heart is normal. I have no symptoms.

 

[ALCapshaw2]

I have been told my ejection fraction is at 59%. My ekg is normal and the size of my heart is normal. I have no symptoms.

I can see why your cardiologist wants to take a "wait and see" approach.

Assuming that your regurgitation may be progressive, this would be a good time to go "surgeon shopping" while you are still in relatively good health. You do NOT want to have to select a surgeon from a gurney in an ER somewhere! Find a guy you like and trust. As the Boy Sout Motto says: "Be Prepared".

'AL Capshaw'

 

[Cooker]

I can see why your cardiologist wants to take a "wait and see" approach.

Assuming that your regurgitation may be progressive, this would be a good time to go "surgeon shopping" while you are still in relatively good health. You do NOT want to have to select a surgeon from a gurney in an ER somewhere! Find a guy you like and trust. As the Boy Sout Motto says: "Be Prepared".

'AL Capshaw'

I agree with this 100% .... best to be ready ... I had surgery before I had any symptoms and was in good shape .... glad I did!