Re: enlarged left ventricle

Posted By CCF CARDIO MD - MTR on July 10, 1998 at 16:03:59:

In Reply to: enlarged left ventricle posted by Janelle on July 03, 1998 at 19:21:36:






I have a bicuspid aortic valve with regurgitation.  At my last appointment my cardiologist said that my left ventricle was beginning to dilate.  He recommended surgery (probably the Ross procedure) in the near future.      Can you tell me what the normal internal dimensions are for the left ventricle?  I believe  mine is 6.6  (5.9 one year ago)?  
I am taking Altace to lower my blood pressure and help  decrease fatigue.  Will this med. reverse the  effects of my heart compensating for the  regurgitation ( dilated left ventricle), and if so, for how long?  



   _
Dear Janelle, thank you for your question.  I answered a similar question to yours
on 7/2/98 in this forum from Priscilla entitled "AVR: Porcine or Mechanical" so
first, I recommend that you read that response and check out some of the references
I listed to get more information.  Your heart is slightly dilated at the present
time. The normal left ventricular end diastolic dimension is 5.5-5.7 cm and
your value is above that.  Your cardiologist correctly decided that now is the
time for aortic valve replacement.  I detailed the pros and cons of each type
of valve that can be used to replace a diseased aortic valve in my response
to Priscilla.  A month ago, I answered a similar question on the Ross procedure
and someone wrote back with the address for a website on the Ross procedure.
If you check out the frequently asked questions section of the heart forum
under aortic valve diseae, you may find that information there.  Or, try using
an internet search engine to find the address.  The medication you are taking,
Altace, is called an ACE inhibitor.  This medication is designed to dilate your
peripheral arteries to make it easier for your heart to pump blood out to the
rest of the body. With leaking aortic valve, like you have, the blood tends to
back up into the heart with each heartbeat - that has caused the ventricle to
enlarge.  If there is less pressure for the heart to pump against, then presumably,
more blood should go in the right direction.  The Altace may slow the progression
of the ventricular dilation but it won't reverse what's already been done.  Therefore,
medical treatment for aortic regurgitation is only a stopgap measure; valve
replacement is the definitive treatment.  We have excellent cardiac surgeons here
at Cleveland Clinic and they would be happy to evaluate you for valve surgery
if you would like to be seen here.  You can call 216-444-4470 for an appointment.
I hope you find this information useful.
Information provided in the heart forum is for general purposes only.  Specific
diagnoses and treatments can only be provided by your physician.