aortic valve failure

[ron evans]

I am a 58 yo. male that was diagnosised with a heart murmur 35 yrs. ago. I have followed by a cardiologist for the last 5 years and have been symptom free until a couple of weeks ago. Three years ago he found a subarotic membrane below the aortic valve by echogram. He said he belived that was the cause of the murmur that previous drs. have heard. A month ago I started having shortness of breath when walking. he ordered a cath. last tues. He said the pump was weakening and the aortic pressure was 200mb inside and the gradient was only 15 above the valve. The lungs were 400mb. all arteries were very clean. He has advised me to have have repair or replacement no later than end of Jan. We are starting the planning process. I have been on Vasotec, Hytrin and atenol and keeping my bp under 150/50. He is weaning me off atenol now.
In your opinion is this as serious as he is making it sound? How safe is valve replacement surgery? He wants to use a mechinal valve. I dont like the idea of comminden(?). Excuse my mistakes but I very nervous about this turn of events.
Thank you.

[CCF CARDIO M D JMF]

Dear Ron,

It does sound like you should have your valve replaced before your heart function becomes worse and you have permanent damaaage to your heart funciton and lungs.  

If all you have is this subaaortic membrane, you may not require valve repair at all.  Can you please provide additional details so that i may assist you further.  

Your valve would need to be replaced if the valve itself were involved or smaller than it should be.

[ron evans]

i am scheduled for a TEE dec 6th and will let you know updates. I really want to let you know what a service your forum is. I've calmed down a lot just reading other responses. My Dr. says dont worry about it but it's not his heart they going to stop and hopefully start back up!

[CCF CARDIO MD JMF]

Best of luck!  YOu should do fine.

[Ron]

had my TEE today and suprised my Dr. again. I have a bicuspid aortic valve and no flapper. What he saw as the flap is the larger valve flap regressing downward at the rim. Therefore he said when the larger flap tries to close over the smaller flap it is staying open about 25%. Is this repairable in your estimation?
He said no and a mechanical valve (St. Jude) would be best. He said it will get worse in a short time. He drawed a picture but the best I can describe would be holding your arm stright out plam up then bending up at the elbow to simulate the flap and at the same time dropping the elbow down to simulate the valve dropping down in towards the chamber. does this make sense?
Would this be sometime your clinic can repair?
Thank you,

[CCF CARDIO MD JMF]

This does make sense and this may be something that the surgeons here would repair.

I would recommend a consult by Dr. Lytle here at CCF.