Aortic Valve Replacement question

[justlynn]

I am a 43 year old female with a bicuspid arotic valve.  Two years ago I had an echo that showed minor damage, I just had one again and it has stepped up to moderate.  My Cardiologist says it is a 1 point something and I have 1 to 7 years before replacement.  Problem is, everything I've read says once you start having palpatations, etc. something should be done, this is happening daily!  Other problem is, at the end of August my insurance will run out and I'm sure no one will insure me with this problem!  What do I do?  Get a 2nd opinion?  How do I go about doing that?  I feel like a walking time bomb!

[CCF-M.D.-RCJ]

Justlynn,

Thanks for your post.

I'm not totally sure what type of damage you've had to the bicuspid valve, but I think what you mean to say is that the valve is becoming stenosed (and thus the measurement of "1 point something").  If the valve is becoming stenosed, then you will likely eventually need surgery.  The types of symptoms that usually lead to surgery include shortness of breath, chest pain, or passing out.  Palpitations do not usually lead to surgery, but this symptom warrants further discussion with your doctor.

Seeking a second opinion is rarely a mistake.  Certainly, letting your insurance lapse would not be a good idea, as the surgery is very expensive.

Hope that helps.

[pookysoo]

Hello - I have a similar question that I hope you can answer for me:  I am a 41 year old hypertensive female, also with a bicuspid aortic valve.  I had a coaractation of the aorta repaired with a dacron graft nearly 25 years ago.  Arrythmias have become an ever-increasing problem for me, dramatically increasing over the past few months.  I sometimes become dizzy and somewhat nauseated when the rhythms are heavy.  They often feel like they've knocked the air out of me and I have become progressively fatigued.  It has become quite a problem for me.  I had a holter last month and the cardiologist found hundreds of PVC's and some V-tach, but this was on a mild day for the rhythms.  The echo last month showed: "Moderate calcific aortic stenosis with 50-55 gradient; Marked concentric left ventricular hypertrophy with hyperdynamic systolic function; Mild mitral regurgitation," as per the cardiologist.  His recommendation to me was that the rhythms are completely benign and "nothing" and he put me on a beta blocker and told me to come back in a year.  I, like the above-woman, am concerned that perhaps I need a second opinion.  I also don't wish to make a big deal if it truly is "nothing."  I take Diovan for the hypertension and aspirin for possible TIA's and Synthroid for hypothyroid (which was recently checked and is just slightly sluggishly out of range but the next higher dose was too high).  Thank you for this wonderful forum; I hope you will be able to give me a reply.    Most sincerely,  ~Susan

[CCF-M.D.-RCJ]

Susan,

If the irregular heart rhythms are giving you as much discomfort as you state, then by definition, they are not benign.  This is not to say that the arrhythmias may cause lasting damage.  It's just that they appear to be adversely affecting your quality of life, and thus deserve consideration of treatment.

If your doctor is not listening to you, and has offered no potential therapy, then seek a second opinion.

hope that helps.

[Sondra Elmore]

Hello...my comment is two down and unanswered

[Crow]

It sure sounded like reasonable answers applicable to this forum.
Don't know what you were looking for.

[Sondra Elmore]

No, no.  It was great.  It just got skipped totally until I posted that it was missed.  I was overlooked initially.

[gh2m]

I am a 44 year old male having bicuspid aortic value by birth. My recent Echocardiogram indicated my condition (left ventricle measurements) worsened from that of six month ago. The following dimensions may be help to answer my question:
IVSd: 1.1 cm
LVIDd: 6.3 cm
LVPWd: 1.1 cm
LVIDs: 4.3 cm
P1/2T: 362 msec
Interpretation: Dilated left ventricle with mild left ventricular hypertrophy and borderline normal systolic function. Ejection fraction of 55% to 60%; Bicuspid aortic valve with good mobility and severe aortic insufficiency, 2 jets.

The echo taken six month ago is as follows:
IVSd: 1.0 cm
LVIDd: 6.1 cm
LVPWd: 1.0 cm
LVIDs: 4.0 cm
P1/2T: 429 msec

My cardiologist has suggested more frequent monitoring (Echo test every three months) and possible replacement of aortic valve in the near future.

Although the numbers look worse than those of six month ago, I do not have any significant symptoms I can tell. No shortness of breath, no chest pain and dizziness. I am still playing volleyball once a week, riding bikes on weekends as usual without any difficulty.

I pulled out the echo report done six years ago and some numbers are actually worse:
IVSd: 0.8 cm
LVIDd: 6.7 cm
LVPWd: 0.8 cm
LVIDs: 4.6 cm
EJ: 55%

So my questions are:
1) How accurate is echo test? Is it depends on different machine, technician who reads it, particular day of time, or other factors?
2) At what numbers I need to consider replacement of aortic valve?
3) Do I need to wait for any symptoms before considering the surgery or just follow the numbers? I don't want to wait till it's too late but I also don't want to go to heart surgery unless I have to.
4) My limited internet research suggests the biological valve will only last around 10 years and the mechanical valve will last life time with definite risk of stroke. Is there any breakthrough anticipated in the near future to make biological valve last much longer than 10 years or mechanical valve free of stroke risk?

I really appreciate your answer to those questions.

[DonJose]

Regarding your health insurance, what is the reason it is running out in August??  If it is group coverage, there should be options for continuation.  And depending on what State you live in, options for State sponsored continuation/coverage may exist. --DonJose

[KENDEANN]

hello all just got back from my dr. & going over my test results i have had this since birth but never has been any problems with it, he say the valve is operating at 60%, & i need to have it checked 1 time per yr, & then depends on the progress, will depend on replacement, say 1-5 yrs. i just found this web page tonight, looks like i am not the only one, any help you all can give me would be great.

[KENDEANN]

hello all just got back from my dr. & going over my test results i have had this since birth but never has been any problems with it, he say the valve is operating at 60%, & i need to have it checked 1 time per yr, & then depends on the progress, will depend on replacement, say 1-5 yrs. i just found this web page tonight, looks like i am not the only one, any help you all can give me would be great.

[KENDEANN]

aaaaaaa