Connect
Severe Aortic Valve Stenosis
Hi,
I am just concerned with my wife situation: She is 72 years old, on accord to the cardiologist, the Echocardiogram results are: “Possible bicuspid aortic valve/ Severe aortic valve stenosis-Currently seemingly asymptomatic, though likely nearing time for intervention",
The Doctor ordered a blood test, CT of the aorta and echocardiogram in about 6 months and because she is asymptomatic, she will follow up in 12 months.
So, my question to you is: why to wait to the symptoms to schedule a surgery, wouldn’t be more risky surgery?
Any suggestion or idea will be greatly appreciated, thanks
Like
Helpful
HugInterested in more discussions like this? Go to the Heart & Blood Health Support Group.
Connect
@davej
Hi, thanks for info and good will advice, have a wonderful day.
@ce324 I've just read your first post. I thought holy cow, you could be talking about me! I've just turned 74. I have been having annual echo's for 7 years. Each result showed a progression in the stenosis/calcification, that is rated as severe. I also have a bicuspid aortic valve with fusion between Right and Left leaflets. Back in June, my new cardiologist said I'd likely need the valve replaced within the year. So, on Sept. 12th I had a coronary angiogram and a CTA TAVI. That was a 9 hr. hospital day. And, well, haven't heard anything since. Like your wife, I am fairly asymptomatic, except for the often breathlessness. I guess they are consulting the results of those tests to figure out which procedure they can do on me. But, like all comments here, I too wonder, why put it off until ...? I would certainly prefer the TAVi , versus open heart surgery, but maybe it's not possible. I don't know. I feel for you both. It is unnerving. You are not alone, and it's nice to know I'm not either. Victoria BC Canada.
@justwannasay
The Dr. last email extended the review or surgery from 6 months to 1 year because she stated that the Aorta is mildly enlarged; the true is that the Echocardiogram diagnosis is: 'Severe aortic Stenosis' and the Echocardiograms records since 2022 shows Moderate to severe aortic stenosis. That her aortic stenosis is asymptomatic. True, but why we could be waiting for the symptoms to prove the diagnosis?
I am still waiting her response, thanks and have a good day..
@ce324 Stenosis and 'enlargement' are two different qualities, or states. The stenosis means how much of the cross-section of the affected vessel is taken up by plaque. If you had a gucky garden hose, cut it in half cleanly, and then looked into the open cut end, you'd see stenosis, or the degree of stenosis, in plaque or sludge taking up some of the inner volume.
Enlargement is the swelling of the entire vessel. Whereas it might normally be 5mm in outer diameter, now it's 6mm...so 'mild enlargement'. This is to say nothing about the stenosed interior of the vessel.
@davej
Were you extremely tired, lightheaded & dizzy before you had surgery?
@cerbjk yes was tired my body felt like it was worn out. No dizziness but I did have shortness of breath when I went up steps or an incline in the street and the big one was when I carried groceries. It's been 2 years since my valve was replaced and I'm still fighting body feels like it's worn out and the shortness of breath. Plenty of tests have been run since and only explanation is ejection fraction while heart is under stress is 45 percent, typically should be 50 to 56 percent.
@davej Thanks for the response. Sorry you are still so worn out & short of breath. I wasn’t expecting you to say that after you had surgery to fix yours. That’s not good! I have a long history of heart issues. My Tricuspid valve has been leaking since 2023 & now is severe. Been in hospital here & had endless testing. Did go to Mayo & will be going back as soon as they can get me in. Have had open heart surgery & trying to avoid another. I’m basically not able to do anything as I am so fatigued, no energy, lightheaded, dizzy short of breath & chest pains. Mayo is not convinced my symptoms are all valve related.
Hi, here is the Dr. Response:
"We are not proving the diagnosis. You have a diagnosis of severe aortic stenosis essentially since at least 2022.
Treatment of severe aortic stenosis, however, is not immediate surgery. The reason is that once we put in a man-made (prosthetic) valve, that too has a 'lifespan.' If we put it in too early before you 'need it' we will need to do repeat surgery earlier too to fix the prosthetic valve. And so, this is why we wait until you have symptoms.
I do expect you to develop symptoms or other signs that your body needs to have the valve replaced. That is why we are repeating the echocardiogram in 6 months rather than waiting a year. So call around December to schedule your echocardiogram in January. If you feel you are having symptoms before then, let me now."
Is it make sense?
ce342,
good response from your doctor. However, since 2011 researchers have been suggesting that it may be better to have aortic valve surgery with severe stenosis while asymptomatic.
Watch https://www.youtube.com/watch
I wouldn't call the doctor on this and there may be other factors in your wife's medical history that encourage waiting. You might ask if waiting might preclude her chances of having trans catheter replacement.
I wouldn't be saying that I need a second opinion, but I'd get a second opinion from a doctor who has done a lot of TAVR.
Bless your choice. Hello to your wife. She may have a different preference.
I especially like that they ask if it makes sense, inviting you to respond with questions.
There are some considerations including that when you repair one valve the others seem to leak a little more.
Anesthesia can be unkind to our brains as we become a little older. If it were my heart, I'd be having the surgery as soon as I could.