Do I Really Need Surgery

[Arc_Weld]

I am a 38 yr male that was recently diagnosed with Severe AI. About 12 months ago, I accidentally discovered that my blood pressure was extremely high.. about 210/100.

My family doc put me on Norvasc to lower my pressure. About two months later, I was suffering from chest pain and was admitted into the local hospital. I failed the stress test. I was cathed and no blockages were found. Later, a heart echo determined that I had a leaking bicuspid aortic valve. Moderate 2+. EF 62%

Fast forward to May 2005, I have another heart echo, and my bicuspid aortic valve is now leaking severely 4+ and my left ventricle is enlarged [6.2 cm]. My aortic root is also enlarged [3.9 cm]. EF 60% . Chest X ray also shows my heart is enlarged

The cardiologist asks me how I feel. .. I felt great.. Strong as an Ox.

Now, its September 2005..Labor day weekend.
I work around the yard and go atving.. however.. I notice that I get short of breath really easy. Even washing the cars, I notice that I keep getting winded. That night, I wake up gasping for air. I have to walk around for I while and eventually feel better.

I go to the cardiologist the next morning. He orders a cath. The prognosis is the aortic valve is severely leaking. He recommends AVR and refers me to surgeon. The surgeon also recommends that I have the valve replaced.

If I wait, my heart will be come more enlarged along with my aortic root. I don’t want to injure my heart beyond recovery but don’t want to have the surgery too early.

The dr. says it time now… What do y’all think?

[geebee]

The fact that your heart is already enlarged and you have many symptoms indicate to me that surgery is past due. Most of us advocate surgery before any heart damage takes place and you are past that point already. You will find things getting worse faster and you need to nip this in the bud now.

Go with the doctors' recommendations and get your valve fixed now.

Best of luck and keep us posted.

[Cris N]

After reading a lot of posts here about so many cardiologists adopting a wait & see attitude, I guess I'd suspect that you need to have the surgery ... and soon. My cardiologist was the same way. I don't have my numbers but I know he was nervous when I first saw him on a Tuesday (day after my first echo) - he said something like, I'm sure the surgeon will find a way to get you on his schedule Monday, if not sooner. I did indeed have the surgery on Monday.

My symptoms sound a bit like yours - I had no idea there was anything wrong with me until I woke up in middle of night with extreme SOB. Finally went to ER late the next day. Still didn't know I had a problem. ER doc ran some tests & told me I probably had moderate emphysema. I ignored it. I went another 2 months & went to see an urgent care doc in my new town. He asked how long I had had the heart murmur. I said, what murmur? Insurance finally kicked in & I saw a PCP. 2 weeks later I had surgery. The surgeon said that the SOB was probably caused by failure of one of the chordae holding on to the valve.

Other people will most likely be along who understand the numbers. My take on it is when the surgeon says cut, and the cardiologist says cut, it's probably time to cut.

You've found a great site to help you with questions, fears, and anxiety. Ask away. I hope you come to terms with this soon and get the medical attention that you need.

Cris

[Mary]

I've got a fast answer for an easy question. See a surgeon and have the surgery. :)

[PJmomrunner]

The "severe" AI classification...the heart enlargement...the symptoms...any one of those things alone is reason enough to operate. It is not too soon. Waiting will only jeopardize your ability to recover.

[LLJ]

YES. YES. YES.
Any other questions?
Laura

[KristiinSD]

I had sort of a similar course with mitral valve, although my cardiologist was not in any rush for me to have surgery. I feel like I don't want to further compromise my heart's ability to heal by waiting any longer. I would actually liked to have this surgery yesterday. I, too, have serious shortness of breath...

It's weird though, isn't it? I imagine this is what people feel like who have cancer. I don't feel ill really so how could I need surgery? I have this recurring fantasy that I start working out somehow this will all go away...then I remember that my left ventricle is enlarged...

Good luck and glad you found us. There is lots of information here.

Kristi
mr
surgery 9/29/05

[EVELYN]

Get thee to a surgeon, and quickly!!!! IMHO!!! Enlarged heart, Severe AI, SOB!!!! "STRONG AS AN OX" but dumb as a stick......isn't that the old adage?

This is nothing to fool with.....you're young and have your whole life ahead of you, with surgery....without it, well, you know the answer.

Good luck with your decision.

Evelyn

[Ross]

http://img.photobucket.com/albums/v442/Ross/grimreaper.jpg This guy be knocking at your door very soon without it!

[ALCapshaw2]

TOMORROW would NOT be Too Early.

Where are you in Alabama?
What hospital?
What surgeon?

'AL Capshaw' (near HSV)

[tobagotwo]

It's very much time, my friend.

Your doctor seems to prescribe catheterizations too easily. It is very common for bicuspid valvers to have very clean arteries. Many people only have one catheter angiogram, and that's to determine if there are blockages just prior to surgery, and corroborate the evidence of the echoes.

Your aortic root will also need work, or it will continue to enlarge. Please make certain that they check your aorta for aneurism-related enlargement as well. You wouldn't want to have to go back in for that later, and it happens more often than is necessary.

Find a surgeon with lots of experience, who is doing hundreds of valve operations each year. And a hospital that tends to a lot of valve patients.

Best wishes,

[Yaps]

I agree , have the surgery..I also was too late and have many complications... where in Alabama are you?
I am at the gulf, near Gulf Shores. I went to Thomas Hospital for my surgery, didnt want to go all the way to Mobile..lol
Sooner the better so you may continue your life.Love yaps

[Nancy]

Get your operation done asap. You feel you are not symptomatic, but I think you are in denial mode. You have lots of symptoms. Think about it.

Sometimes people develop symptoms slowly and don't notice that they are becoming very debillitated.

I suggest you reread your own post rationally and you will see how things have gone downhill for you.

Do not wait until some sort of "event" happens to you. Take good care of yourself and get things fixed under the hood.

A surgeon will help you make the right decision. So make your appointment.

[Arc_Weld]

Thanks for all notes! :D

I currently live in Montgomery Alabama area.

I have a very active life style.
I am always working in the yard or on a project.
I don’t smoke or use tobacco.
I have no issues with my kidneys, liver, lung, diabetes, or bleeding.
I am 6’2” and weigh 220lbs… a little heavy.. not much.

I am considering surgery in two locations:
1. Sacred Heart in Pensacola Florida
2. UAB – University of Birmingham

Both seem very very good.

I am on the surgery schedule in Florida for Oct 6th, 2005
However.. I have a UAB appointment in the next few days…

I am considering a St. Jude’s Mechanical valve at this time.

What do y'all think??

PS.. this is a great site!!!!

PPS:
My wife and I love RVing.
We have a 36' Mobile Suites 5th Wheel

[afraidofsurgery]

I agree w/ the popular voice. It is time, my friend.

I was asymptomatic for a long long time and was exercising, lifting weights, working, etc., I was FINE. I started to develop shortness of breath and thought I was making it up. Had angina and thought I was imagining it. Was tired all the time and thought it was 'cause I'm a single mom. Luckily I had a scheduled visit w/ my cardio and he told me it was time. I got a second opinion and she said it was time w/o even listening to my heart!! OK I succumbed to the truth and had my surgery Sept 7. I could tell right away when i woke up from the surgery in spite of the pain and tubes etc., that I felt better.

Also have to tell you I looked up lots of articles on the timing of surgery for regurgitant (me) and stenotic (you) aortic valves. There is some debate but a number of studies have shown that long-term survival increases dramatically w/ earlier (first sign of symptoms) surgery. That got me as I planned to be around for a while for my daughter who's 6.

Also my cardio told me he's seen lots of patients deteriorate quickly after the appearance of symptoms which can result in the heart muscle not being able to squeeze normally ever again and you're permanantly stuck w/ heart failure. Yuk, I don't advise this.

Hope you can use the momentum from the posts here to sail in and get this taken care of. Use our courage if you can't find your own - that worked for me :)

Patty

[Randy & Robyn]

I'm sure at this point that this post is just being redundant but I have felt the same as you since I was diagnosed back in January. I knew for years that something was "not quite right." I could feel my pulse in my fingers and toes, had systemic hypertension, and could watch my heart forcefully pumping just by looking at my chest. No shortness of breath, no pain, and to this day I have an endless supply of energy. My previous doctor never caught the murmur. Then I switched doctors and, mirroring Cris' case above, he asked me how long I had had this murmur.

I truly believe my aortic valve has been leaking badly for years. My heart is slowly enlarging. I very much want to deny that anything is wrong and that I can live with this. But deep down I know better.

In three weeks I go in for surgery and look forward to coming out with a heart that finally works right.

If you have only ai and no stenosis you might want to look into valvuloplasty as opposed to replacement. In many cases they can repair the valve.

Good luck to you,
Randy

[KathyH]

ARC,
From one RVer to another-sounds like you are on the right track now. There are some other members that have had their surgery in UAB, I don't recall anyone having surgery done at Sacred Heart in FL. Meet with the other DR ask your questions and go from there. Others will chime in that know more about those hospitals.
I have a St Jude valve, and feel it was the right choice for me. I have no problems with coumadin. I don't let it change my lifestyle.I am an active person, I ride my bike 10miles 3-4 times a week and walk inbetween. Read the section on valve choice and go with what you feel is best for you. There is no right or wrong choice.
Once you have your surgery you will realize how bad you felt. You will be amazed at how much more energy you have in 6 months.
Kathy H

[JohnnyV_46]

I wouldn't wait. I'm 8 years older than you and I really didn't have any symptoms that I was aware of. I was a smoker so I attributed the shortness of breath to that. I knew for about the last 10 years that I had high blood pressure and was taking medication for that. I had a mild heart attack Aug.16th and had cartiac Cath the next day. Found out I had 3 blocked coronary arteries along with the Bicuspid Aortic valve and an Aortic Anneuryzm. So on the 19th I had a triple by-pass, new Edwards bovine tissue valve and aortic root. I'm really starting to feel such a big difference. I wouldn't wait. It's just gonna do further damage.

[ALCapshaw2]

I had my AVR at UAB. It is an EXCELLENT Heart Hospital, ranked #13 in the nation. There are 3 primary surgeons, Dr. Pacifico who co-founded the Heart Program at UAB with Dr. John Kirklin (now deceased), Dr. James Kirklin (son of John Kirklin) who is head of the transplant team, and Dr. McGiffin (a delightful Aussie with outstanding communication skills) who assists with transplantation and does a lot of high risk surgeries.

See if you can find out who has the most experience with BAV and tissue disorders (that often accompany BAV) that may lead to aneurism development.

I've never heard of the Florida Hospital you mentioned. You can compare hospitals by procedure at www.HealthGrades.com

FYI, the success rates for first time OHS in patients under age 60 is 98%. You may want to look over the Valve Selection Forum before your appointment so that you will be familiar with the issues and tradeoffs before your interview. Once you are comfortable with a surgeon and valve choice, please schedule your surgery ASAP to prevent the development of irreversible damage to your heart muscles and walls.

If you have any more questions, feel free to ask us. That's what we are here for, to share our knowledge and experience surviving and recovering from Valve Replacement Surgery.

'AL Capshaw'

[Chuck_S]

Lots of info there. I decided on a tissue valve, however many do the mechanical.

My surgery was on July 13, 2005. I have been back to work for a little over 2 weeks.

Good luck,
CS

[OldManEmu]

From what you describe I would agree with what has already been said, surgery is in your not to distant future. I am especially concerned about your breathlessness lying down. This is often one of the first symptoms of heart failure. :eek: Without treatment I wouldn't be too confident of you making your 40th birthday. :eek: Once symptoms start if left untreated survival on average is <2 years. :eek:

[EVELYN]

Hi Arc_Weld

I have been thinking about you since I read and replied to your question. Please, Please, Please go and get this taken care of ASAP.....it is definitely NOT something to be taken lightly, especially with your symptoms. The longer you let it go, the more of a chance of long-term problems resulting from the enlargement of the heart.

My husband, Tyce, had his St. Jude's mechanical put in 3 years ago at age 59. His cardio, too, said to wait till it was time and monitored him yearly with echos. It was only when he went into afib that he said it was time.....and Tyce was done about 3 weeks later. His heart had returned back to normal size very quickly....matter of fact, when we had an echo done a week after he was out of the hospital, our cardio said it had already returned to normal.

Please don't delay.....get it done.

We are RV'ers too.....have had 2 fifth wheels, but now have a Monaco motor home.....love it!!!

Maybe we should start an RV chapter on this forum????? I know Granbonny also has one.

Please have it done!!

Evelyn

[terryj]

My husband had no symptons except his blood pressure suddenly started to go up. PCP listened to heart,heard murmur,did EKG and then sent him to cardio who did echo and then sent him to surgeon. Diagnosis was bicuspid aortic valve. His heart was enlarged. They did surgery on 9/11/01. He got the ATS mechanical valve. He was 51 at the time. He still hunts,fishes,does carpentary work around our house,uses a chainsaw to cut wood,etc. Six months after surgery his heart enlargement was reversing.

[tobagotwo]

If you're looking at mechanical valves, I would seriously consider looking at the On-X, the Sorin, and the ATS mentioned above as well. The St. Jude is a standard, but these other valves claim to be somewhat updated from what the St. Jude offers, in terms of causes of blood clots. The On-X is actually undergoing trials for possible use with aspirin, in place of coumadin (not a sure thing, so you shouldn't count on it).

St. Jude: http://www.sjm.com/devices/device.aspx?name=SJM+Regent%26%23174%3b+Valve&location=us&type=18

ATS: http://www.atsmedical.com/Content/iropvalve.php

On-X: http://www.onxvalves.com/ValveInformation.asp

Sorin: http://www.sorin-cid.com/bicarbon.asp

Any of these valves would be an excellent choice.

Best wishes,

[Granbonny]

Welcome to our great site.....I am from Selma..90 year old daddy still lives there..and I know how brutal the summer's are there. :eek: HOT and HUMID..... Many great members here have given you advice..still waiting for Danny..gadgetman..to chime in..He's from Columbus . Ga. and had his surgery at UAB....Go ahead and e-mail/pmhim.. Go to members at top of this forum..click on G's..you will find him..listed under gadgetman.....He can help with questions about UAB....Like Evelyn said%%, we, too, love our Motorhome....Just have it parked now..waiting for gas prices to go down. :D and Rita leaving, ect..Bonnie

[Gemma]

If you're looking at mechanical valves, I would seriously consider looking at the On-X, the Sorin, and the ATS mentioned above as well. The St. Jude is a standard, but these other valves claim to be somewhat updated from what the St. Jude offers, in terms of causes of blood clots. The On-X is actually undergoing trials for possible use with aspirin, in place of coumadin (not a sure thing, so you shouldn't count on it).

St. Jude: http://www.sjm.com/devices/device.aspx?name=SJM+Regent%26%23174%3b+Valve&location=us&type=18

ATS: http://www.atsmedical.com/Content/iropvalve.php

On-X: http://www.onxvalves.com/ValveInformation.asp

Sorin: http://www.sorin-cid.com/bicarbon.asp

Any of these valves would be an excellent choice.

Best wishes,

As far as I know, you can't get the Sorin valve in the USA. But either of the other two would be a great choice.
Arc Weld, I think if you re-read your opening post you'll know the answer for yourself - it's time.
Best wishes,
Gemma.

[tobagotwo]

I'm sorry - you're right Gemma. Partly. ;)

The Sorin line is handled in the United States by Carbomedics: http://www.carbomedics.com/professional_products_top.asp?from=us

Best wishes,

[RCB]

I'm sorry - you're right Gemma. Partly. ;)

The Sorin line is handled in the United States by Carbomedics: http://www.carbomedics.com/professional_products_top.asp?from=us

Best wishes,

Bob,
Are you saying that CarboMedics is making Sorin's valve line available
in the US? :confused:

[Gemma]

RCB - As I understand it, the Sorin group owns Sorin (marketed in Europe, and various other parts of the world), and Carbomedics (which those of you in the USA will be familiar with), along with some other companies. But the Carbomedics and Sorin valves aren't exactly the same - for a start, Sorin's Bicarbon valves have curved leaflets whereas the Carbomedics ones are flat.

Arc-Weld - sorry to veer off topic. We'll try and get back to your original question now :) .
Gemma.

[Ross]

RCB - As I understand it, the Sorin group owns Sorin (marketed in Europe, and various other parts of the world), and Carbomedics (which those of you in the USA will be familiar with), along with some other companies. But the Carbomedics and Sorin valves aren't exactly the same - for a start, Sorin's Bicarbon valves have curved leaflets whereas the Carbomedics ones are flat.

Arc-Weld - sorry to veer off topic. We'll try and get back to your original question now :) .
Gemma.
I think your right. As I understand it, they are somewhat merged together as a corporation, but still using their unique valve systems under their specific names.

[RCB]

RCB - As I understand it, the Sorin group owns Sorin (marketed in Europe, and various other parts of the world), and Carbomedics (which those of you in the USA will be familiar with), along with some other companies. But the Carbomedics and Sorin valves aren't exactly the same - for a start, Sorin's Bicarbon valves have curved leaflets whereas the Carbomedics ones are flat.

Arc-Weld - sorry to veer off topic. We'll try and get back to your original question now :) .
Gemma.

That has also been my undrstanding. Both companies have separate valve
lines, Sorin is the parent company through a previous purchase. I got the impression from Bob's post that CarboMedics was distributing("handling")
Sorin valves in the US. Seems to me we discussed this in a thread over a year.
ago.

[Arc_Weld]

My name is Michael.
I love to tinker in my spare time.
I worked as a mechanic as I was attending college

I love to weld in my spare time.. thus Arc_Weld.
Its kind of a unique name.. I use it on Ebay too.

Anyhow.
Thanks for the great links on valves.
It obvious that I have some studying to do.
I didn’t realize that there were so many options for valves.

I have an appointment at UAB in the next few days with Dr. McGiffin.

[Gemma]

I think your right.

It does happen once in a blue moon :D .

[Gemma]

My name is Michael.
I love to tinker in my spare time.
I worked as a mechanic as I was attending college

I love to weld in my spare time.. thus Arc_Weld.
Its kind of a unique name.. I use it on Ebay too.

Anyhow.
Thanks for the great links on valves.
It obvious that I have some studying to do.
I didn’t realize that there were so many options for valves.

I have an appointment at UAB in the next few days with Dr. McGiffin.

Hey Michael, you sound kind of like my boyfriend Jim - although, I'd have to say he has the odd bit of spare time from his tinkering, rather than tinkering in his spare time :rolleyes: . Do you weld sculptures and stuff? Always thought that seemed a cool thing to do.

As for the valves - the links Bob listed are to a few of the mechanical ones available. When you throw in the various types of tissues out there too, you get probably into the hundreds :eek: . The good part is, your surgeon will probably have a couple of favourites, and give you options to choose from, rather than you needing to decide which you think is best from ALL the ones out there! Then once you know what he prefers, you can come back here and mull it over with us :) .

Gemma.

[CCRN]

Michael

I am a nurse and work every day in open heart surgery. I have also had my aortic valve and ascending aorta replaced.

Please believe me, you need surgery. The surgery might not just save your life, but preserve your quality of life as well. You will probably find it improves your life more than you can ever imagine. However, you should know that if you don't get over that Egyptian disease (De-nile) and wait too late it might just render you disabled for the rest of your life.....or cause you not to have life at all.

Don't really want to be the grim reaper here but I thought you needed to see the bare written facts. I know the nightmare you face but it has been faced many times and most are much better because of it. :)

[tobagotwo]

You're right, Gemma, RCB, and Ross. :o

I misunderstood their relationship because Sorin owns Carbomedics.

I'll be going now...

[Ross]

You're right, Gemma, RCB, and Ross. :o

I misunderstood their relationship because Sorin owns Carbomedics.

I'll be going now...
You ain't goin no where! Get back here Mister. :D

[ALCapshaw2]

Fantastic Michael!

Dr. McGiffin is a WONDERFUL person and has an outstanding reputation among patients AND Doctors. He will answer ALL of your questions so do your home work on the valve choices. Several of our members had excellent results with Dr. McGiffin and all speak highly of him.

If you don't already know, tissue valves do not require anticoagulation (unless you develop a permanent arrhythmia which is rare). The down side is that they wear out an will need to be replaced (10 to 20 years typically, depending on a lot of factors).

Mechanical Valves should last longer than you (or anyone) will live assuming there are no other developments. Unfortunately, they can cause blood clots to develop so anticoagulation (Coumadin) is required for life to prevent clots from developing. The standard St. Jude mechanical valve is the GOLD STANDARD with a long and successful track record.

The NEW generation mechanical valves (On-X, Sorin, ATS) have been designed using the principles of fluid dynamics to reduce turbulence and lower the likelihood of clot formation. With further testing and studies, it may be possible to use lower levels of anticoagulation with these valves and as has been mentioned, the On-X valve is being studied in Europe with aspirin only.

Let us all know what Dr. McGiffin has to say about the new generation mechanical valves!

'AL Capshaw'

[RCB]

You ain't goin no where! Get back here Mister. :D

DITTO!

You are too important.

Nobody does tissue like you do :)


My original point of my question was I thought that maybe you had information that CarboMedics was distributing Sorin valves in the US now.
CarboMedics is a "tried-and-true" line, but I think Sorin is a little more advanced. Of course, GM distributed the Buick, Oldsmobile, Pontiac line
for years and is still doing the samething with the truck lines of Chevrolet
and GMC. All share only cosmetic differences in some models.

*** Sorry Cort- I know this grieves you ***

[Rush20]

I am a 38 yr male that was recently diagnosed with Severe AI. About 12 months ago, I accidentally discovered that my blood pressure was extremely high.. about 210/100.

My family doc put me on Norvasc to lower my pressure. About two months later, I was suffering from chest pain and was admitted into the local hospital. I failed the stress test. I was cathed and no blockages were found. Later, a heart echo determined that I had a leaking bicuspid aortic valve. Moderate 2+. EF 62%

Fast forward to May 2005, I have another heart echo, and my bicuspid aortic valve is now leaking severely 4+ and my left ventricle is enlarged [6.2 cm]. My aortic root is also enlarged [3.9 cm]. EF 60% . Chest X ray also shows my heart is enlarged

The cardiologist asks me how I feel. .. I felt great.. Strong as an Ox.

Now, its September 2005..Labor day weekend.
I work around the yard and go atving.. however.. I notice that I get short of breath really easy. Even washing the cars, I notice that I keep getting winded. That night, I wake up gasping for air. I have to walk around for I while and eventually feel better.

I go to the cardiologist the next morning. He orders a cath. The prognosis is the aortic valve is severely leaking. He recommends AVR and refers me to surgeon. The surgeon also recommends that I have the valve replaced.

If I wait, my heart will be come more enlarged along with my aortic root. I don’t want to injure my heart beyond recovery but don’t want to have the surgery too early.

The dr. says it time now… What do y’all think?

DO IT! I was in a similar situation at age 40. I had no symptoms whatsover. The only reason they found out I had a leaking aortic valve was because they heard the murmur when I went to the doctor to treat a nagging head cold. Within 5 weeks after diagnosis I had surgery to prevent any heart or root damage and to replace the valve. My heart had enlarged slightly, however the surgeon felt that due to the immediate action taken, no further damage would occur and the heart has actually returned to normal size. He was right.

I was born with a bicuspid valve, however it was an infection from a dental surgery 6 months earlier that caused the valve to fail. The valve had actually developed holes in it which increased the risk of a catostrophic event. Up until my echo, I had participated in weight training, biking, running and baseball with absolutely no symptoms. When I was told I need surgery, I had my cardio double check the patient record and social security number just to be sure he wasn't mixing me up with someone else.

Not to be morbid, however outwardly healthy people drop over dead because conditions like this go undiagnosed. Consider yourself blessed that you found out, like I did, beforehand.

Good luck!

[Karlynn]

Welcome Michael! I've been away on a short vacation so am just seeing your posts for the first time. So I won't say what's already been stated - you are ready! :) Sounds like you are getting your bases covered and are already getting lots of good thumbs-up for doctors and hospitals.

If you should decide to go mechanical - we have a wonderful Coumadin (warfarin - generic name) expert as one of our members who will give you the confidence of living a very active life on Coumadin. I had my mitral valve replaced almost 14 years ago with a St. Jude mechanical and at 46 years-old now, life IS good. Al Lodwick (our esteemed expert) has a web site www.warfarinfo.com that can answer any questions you have.

You are a very healthy, active man, so your surgery should go very well. Let your wife know that we have many spouses and Significant Others that are members here too, so if she has any questions we'd love to have her join to.

[SHIRL73]

I am a 38 yr male that was recently diagnosed with Severe AI. About 12 months ago, I accidentally discovered that my blood pressure was extremely high.. about 210/100.

My family doc put me on Norvasc to lower my pressure. About two months later, I was suffering from chest pain and was admitted into the local hospital. I failed the stress test. I was cathed and no blockages were found. Later, a heart echo determined that I had a leaking bicuspid aortic valve. Moderate 2+. EF 62%

Fast forward to May 2005, I have another heart echo, and my bicuspid aortic valve is now leaking severely 4+ and my left ventricle is enlarged [6.2 cm]. My aortic root is also enlarged [3.9 cm]. EF 60% . Chest X ray also shows my heart is enlarged

The cardiologist asks me how I feel. .. I felt great.. Strong as an Ox.

Now, its September 2005..Labor day weekend.
I work around the yard and go atving.. however.. I notice that I get short of breath really easy. Even washing the cars, I notice that I keep getting winded. That night, I wake up gasping for air. I have to walk around for I while and eventually feel better.

I go to the cardiologist the next morning. He orders a cath. The prognosis is the aortic valve is severely leaking. He recommends AVR and refers me to surgeon. The surgeon also recommends that I have the valve replaced.

If I wait, my heart will be come more enlarged along with my aortic root. I don’t want to injure my heart beyond recovery but don’t want to have the surgery too early.

The dr. says it time now… What do y’all think?

I had my valve replaced June 7th this year and it took until the middle of August before I felt good as I was plaqued with pneumonia. Now I feel like a new person. My energy has increased ten fold. My colour is better, (so my family tells me) I am 73 and earlier this week I thought to myself, if this energy level keeps up I am going to have to look for a job, I don't have enough to do.

So yes, have it done. You just have no idea how tired and worn out you are. The operation is a serious one but compared to a hysterectomy I would have it again anytime. The pain is less after the first few days. Just be sure you take the time needed to recover.

Good luck.

[John Cochran]

I've been away from this forum for way too long, and just today popped in and ran across this thread. I'd like to share with you the consequences of waiting "too long" since I lived through it (barely).

My AVR was three years ago in June, 2002. My surgery was delayed for several months for a variety of reasons, which aren't important. What is important are the results of waiting beyond the point where you are now.

Once your heart begins to decline, the rate of deterioration is non-linear. That is, the rate of deterioration accelerates rapidly. The body is trying to do all sorts of things to make up for the leaking valve. The left ventricle increases in size. Calcification of the valve and the aortic root accelerates. A set of conditions arise which makes sudden cardiac death a real possibility.

At the time of my over-due surgery, my aortic root had calcified to the point where the calcific deposits were severe, requiring mechanical debridement during the surgery. This structurally weakened the place where the new valve (a CryoLife Synergraft homograft) was to be sewn in. To make a long story short, the surgeons (yes, they needed more than one since my surgery ended up lasting 14 hours) could not get the bleeding to stop, in spite of the most advanced techniques and even the use of bio-glue. In total, I received 23 units of blood. I had been on a heart-lung machine way longer than anyone ever should be, and my family was told my chances of surviving were quite a bit less than 50 percent. I woke up three days after the surgery, unaware of all that had happened. My breathing was severely impeded because, even though the bleeding had eventually stopped, there were pools of blood in the space where my lungs were supposed to expand. They removed those pools of blood with a catheter through my back...and I had to be awake for those procedures.

Immediately after surgery, my ejection fraction (the percentage of blood being pumped from my left ventricle) was less than 20 percent. No one thought at the time that my heart could recover.

Fast-forward three years. I put myself through extensive cardiac therapy (outpatient program), continued an exercise program to this day, got my weight exactly where it should be, and eventually achieved a full recovery. Today I do whatever I want physically, and take no meds except a baby aspirin. This outcome had an awful lot of luck associated with it (along with good doctors and staff).

If you don't want this kind of drama in your life, get yourself scheduled for surgery ASAP.

Best wishes to you and your family during this trying time.

--John Cochran

[tony_stewart_fan]

yeA man you really need to get that done....even if they say you could wait...why would you want to, get it done and over with and do not let it have a chance to get beyound repair.